Situational awareness: President Trump is expected to issue an executive order today requiring more transparency around negotiated health care prices.
Today's word count: 1,016 words, or <4 minutes.
Sen. Chuck Grassley. Photo: Win McNamee/Getty Images
The Senate is working on a proposal that would allow state Medicaid programs to pay for new gene therapies over time, and tie those payments to patients' outcomes.
Why it matters: Tying payments to how well drugs work, on this scale, would be an enormous policy change.
Driving the news: Members of the Senate Finance Committee, led by Chairman Chuck Grassley, are exploring the idea. Grassley considers it a top priority.
How it works: Lawmakers are concerned that high prices and strained state budgets could prevent Medicaid recipients from getting access to new treatments like Zolgensma, a cure for a rare pediatric genetic disease with a $2.1 million price tag.
To address concerns that multiyear payment plans would cause manufacturers to inflate their overall price, the total cost of the payments would have to be lower than the price a state would pay all at once.
The other side: "These outcomes arrangements may be an attempt to distract from the underlying question of how much a drug should cost when it does work," Peter Bach of the Memorial Sloan Kettering Cancer Center wrote in a recent congressional testimony.
Go deeper: The real drug pricing debate is upon us
Illustration: Lazaro Gamio/Axios
If you missed "Axios on HBO" last night, you missed a doozy: A leaked trove of the internal vetting documents President Trump relied on to set up his then-new administration.
Why it matters: These documents illuminate the haphazard way in which Trump set up his administration — and expose the "red flags" vetters at the Republican National Committee identified for several nominees.
Axios published the vetting documents for people who went on to get administration jobs. And health care editor Sam Baker pulled out some of the most interesting "red flags" from Trump's health care nominees.
Congress' plans to eliminate surprise hospital bills may be unconstitutional, conservative superlawyer and former Solicitor General Paul Clement says in a new analysis.
Details: Sam breaks it down:
Yes, but: The ability to refuse to accept an insurance plan is what gives doctors leverage when negotiating their rates, Clement writes. If Congress takes away that leverage, he argues, it's effectively dictating the rates doctors have to accept.
The bottom line: Clement argues that an arbitration process between insurers and providers — the same approach providers have been supporting on Capitol Hill — would be on safer ground.
The pharmaceutical industry is gingerly placing more bets on developing drugs with cannabis — but, absent federal legalization, drugmakers are limited in their ability to conduct clinical trials or R&D, Axios's Bob Herman reports.
The big picture: Big Pharma isn't actively pushing for full legalization — indeed, some painkiller manufacturers have fought legalization in the past. But drug companies are starting to invest more time and money in cannabis research now that 33 states and D.C. allow medical marijuana.
1 big "if": The investment floodgates will break open if these products are removed as Schedule 1 drugs.
More unknowns: Nobody can say what pharmaceutical companies might charge for their cannabis-based medicines, if doctors would prescribe them, and if health insurers would pay for them.
Ouch: Epidiolex has a price tag of more than $32,000 per year — a tough cost to swallow.