Axios Vitals

A briefcase with a red cross on the front.

August 09, 2018

Good morning … The Oscars are adding a new category for “Best Popular Film” while pushing some of the awards for actual artistic achievement into the commercial breaks.

Is this for you? Are you the broken soul who looks upon this cash grab and thinks: Yes, it's about time all these superhero franchises got some attention! Yes, commercial success should be a factor in gauging artistic merit! Yes, I’m so tired of the Academy rewarding low-budget indie films like “The Lord of the Rings” and “Titanic”!

Well, congrats. We all now live in a nightmare of your perverse design.

1 big thing: How one failed drug ensnared so many GOP lawmakers

Chris Collins leaves a New York court yesterday. Photo: Spencer Platt/Getty Images

One Australian drug company — with only one (failed) product in one (failed) clinical trial — just keeps tripping up current and former House Republicans.

Driving the news: Federal prosecutors in New York indicted Rep. Chris Collins yesterday on charges of insider trading, stemming from the sale of shares in a company called Innate Immunotherapeutics.

It's the same company you may remember from Tom Price's confirmation as Health and Human Services secretary. He tripled his investment when divesting of the stock to become secretary, according to the Wall Street Journal.

  • Collins had been an investor in the company for 15 years, the WSJ reports, and was a member of its board.
  • Price bought almost 500,000 shares in the company, most of them in 2016, at a discounted rate only offered to a few Americans. At least four other GOP lawmakers also bought shares of Innate a few months later, according to the watchdog group CREW.
  • Of those six lawmakers, four — Collins, Price, and Reps. Billy Long and Markwayne Mullin — sat on committees with direct health care jurisdiction.

The company did not have any FDA-approved drugs on the market, and had just one product in development at the time the members of Congress bought their stock. It was in the midst of clinical trials for a rheumatoid arthritis drug.

  • That trial was deemed a failure on June 22, 2017. According to the indictment, the company let Collins know, because he was a board member. From an event on the South Lawn of the White House, he wrote back: “Wow. Makes no sense. How are these results even possible???”
  • "Within about fifteen seconds of sending his email," the indictment says, Collins started calling his son, who — along with his girlfriend and her family — quickly unloaded Innate shares.

Why it matters: An indictment on charges of insider trading, with a pharmaceutical company, while writing the laws for pharmaceutical companies, is not the look Republicans would have wanted heading into what's already a difficult midterm election.

  • The indictment, and other lawmakers' stock ownership, also raise substantive questions about whether Congress has strong enough protections in place to prevent members from profiting off information they possess or votes they cast.

2. HHS spending bill will get a vote

The Senate plans to vote on a standalone funding bill for the departments of Labor, Health and Human Services and Education shortly after it returns from its recess next week. Aides from both parties told my colleague Caitlin Owens they expect it to pass.

This is perennially one of the most controversial spending bills. The Labor-HHS spending bill hasn't passed on its own, outside of a bigger spending package, since 2007.

What we're watching: Whether senators can resist the temptation to push for political amendment votes while the package is on the floor — and whether it can be reconciled with the House.

  • "I’m sure we’ll get some sticky amendments but we won’t really know what those are and how they’ll be dealt with until they are filed," one senior GOP leadership aide told me.
  • The Senate bill will come to the floor unchanged from the version that passed the Appropriations Committee on a 30-1 bipartisan vote. It maintains the status quo on abortion, Planned Parenthood and the Affordable Care Act — three of the issues that have historically derailed it.
  • The House bill is much different. It includes partisan items like prohibition of ACA funding.

However, defense spending is a huge priority for most Republicans, which is why leadership plans to pair up the two appropriations bills.

  • "We’ll see what the Senate can produce and then make decisions from there," said Brendan Buck, a spokesman for Speaker Paul Ryan.

3. Mylan considers a sale

Mylan — the company that makes the Epi-Pen and got in so much PR trouble raising its price by 400% — is considering whether to sell off some of its portfolio, or even the whole company.

  • Overall sales are down 22% in North America, driven in part by lower Epi-Pen sales, Bloomberg reports.
  • CEO Heather Bresch also cited an "ongoing rebasing of the U.S. health-care environment."

4. Mar-a-Lago members' clout at the VA

A trio of Mar-a-Lago members with no military or government experience — Marvel chairman Ike Perlmutter, Palm Beach doctor Bruce Moskowitz and lawyer Marc Sherman — are wielding enormous influence over the VA, according to a ProPublica investigation.

Why it matters: It’s not unusual for presidents to sometimes rely on outside or even informal advice about certain issues. But ProPublica paints a picture that goes well beyond advice, reporting that the “Mar-a-Lago Crowd” influenced personnel decisions and at times directed policy initiatives.

  • “Everything needs to be run by them,” a former administration official said. “They view themselves as making the decisions.”
  • Their influence included recommending that Trump appoint former secretary David Shulkin, then later agitating for his ouster. They also delayed the VA’s contract for a new system of electronic medical records and pushed the department to undertake pet projects, some of which could have benefitted their own bottom lines, according to ProPublica.

The other side: “While we were always willing to share our thoughts, we did not make or implement any type of policy, possess any authority over agency decisions, or direct government officials to take any actions,” the three said in a statement.

Worthy of your time.

5. CVS Health’s rebate disclosure

CVS Health CEO Larry Merlo used his company’s second-quarter earnings call yesterday to shine some light on rebates, one of the most secretive components of the drug supply chain, Axios' Bob Herman reports.

By the numbers: Merlo said CVS will keep $300 million worth of drug rebates from pharmaceutical companies this year, which equates to about 3% of its earnings.

  • That is well below what Wall Street had assumed. Ann Hynes of Mizuho Securities USA, for example, estimated CVS’ drug rebates were closer to 14% of earnings.

Yes, but: “Rebate” can be an imprecise term. As we’ve previously reported, lawyers for big PBMs carefully define what constitutes a “rebate," and that definition often does not benefit PBMs' clients.

The big picture: Rebates are an important part of the drug pricing debate, and PBMs use them to their advantage. But the political focus on rebates also deflects attention away from pharmaceutical manufacturers — the companies that ultimately still dictate the high list prices of prescription drugs.

What we're watching today: HHS Secretary Alex Azar speaks to ALEC, the conservative advocacy organization (12:30 pm; livestream).

What's the greatest robbery in Best Picture history? I gotta go with 1976, when "Rocky" beat out "All the President's Men," "Taxi Driver" and, most criminally of all, "Network." But 1997 and 2007 were also grave miscarriages of justice.

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