Republicans itching to probe the pandemic response are already struggling to separate vaccine-related questions that could yield lessons learned from ones that echo theories experts say are debunked by reams of data, Axios' Caitlin Owens writes.

Why it matters: Americans' trust in public health institutions has been shattered over the last few years. Scientists warn that although there's a lot that can be learned from good-faith inquiries, there's nothing positive that can come from using public health to score political points.

Driving the news: House Republicans have launched several lines of inquiry as part of their pandemic oversight, including into the vaccine approval process.

Details: A recent letter to the FDA by Republicans on the House's Select Committee on the Coronavirus Pandemic questioned the Biden administration's approval process for COVID vaccines, alleging that "this effort may not have been to save lives but concernedly to provide cover for implementing and enforcing vaccine mandates around the country."

• The letter also raised concerns with the administration's booster shot approval process and references the departure of two top FDA vaccine officials who, according to Endpoints, said they were leaving their positions at least in part because they felt like the FDA was being sidelined.
• Scientists have raised wonky questions about booster policies and what the data best supports and say there's room for debate on the subject.

Yes, but: Some Republicans are veering well beyond questions of whether vaccine decisions were driven by politics or adequately backed by data. They're instead raising concerns about vaccine safety and whether the entire process was tainted by cover-ups.

• "No major government initiative should ever be out of reach of oversight," said Jennifer Nuzzo, director of the Pandemic Center at Brown University School of Public Health. "However, there's ways to do it that are productive and result in positive change ... and then there are ways to do it that undermine not only health and safety in respect to COVID, but sow doubt in respect to all vaccines."

Go deeper.

The Biden administration on Tuesday rejected a request to use march-in rights to break the patent of the prostate cancer drug Xtandi as a way to lower the price, Axios' Peter Sullivan writes.

Why it matters: The move is sure to lead to progressive pushback on the Hill.

• "The Biden administration has missed yet another opportunity to do something meaningful to lower prescription drug costs and protect taxpayer investments," Rep. Lloyd Doggett (D-Texas) said in a statement.

Yes, but: The administration also announced a new "review" of march-in authority, with an interagency working group to develop criteria, "including price," for using march-in rights.

• James Love, a leading advocate for using march-in rights and director of the group Knowledge Ecology International, in an email to Axios, dismissed the review as "a way to deflect criticism" of the decision on Xtandi.

What they're saying: The letter from the National Institutes of Health rejecting the request states that Xtandi is "widely available as a prescription drug."

The big picture: While President Biden touts allowing Medicare to negotiate drug prices in the IRA, some progressives want him to go further and act on his own to break patents.

A version of this story was published first on Axios Pro. Get news like this by subscribing. Use code POLICY100 which gives you $100 off.

The FDA is considering whether to recommend additional Omicron-specific COVID-19 booster shots for older adults and other vulnerable individuals, the Wall Street Journal reports.

Why it matters: The deliberations come amid reports of immunocompromised patients seeking out the shots on their own, concerned about waning protection against the virus, fewer treatment options if they do get sick and fewer public health measures to help them avoid getting sick.

• Many are worried they are getting left behind.

Catch up quick: Earlier this year, the FDA began publicly weighing plans to begin an annual COVID vaccination schedule.

• Last month, an advisory committee to the CDC discussed giving another booster to vulnerable populations, but decided against it due to lack of evidence, per WSJ.

Nonprofit and public hospitals charged commercially insured patients up to 25% more for brain scans with an MRI than for-profit facilities, a new JAMA analysis found, Axios' Arielle Dreher writes.

Why it matters: It's one of the first comparisons using data from a Trump-era hospital price transparency law to show variations in what facilities negotiate with insurers for common services.

• "This one service gives us a lens to observe hospital's strategic pricing behavior because this is a lever they can pull to make money," Ge Bai, a Johns Hopkins professor and study co-author, told Axios.

What they found: Non-profits, teaching hospitals and hospitals in more affluent areas tended to have higher markups, a lower proportion of Medicare patients and a higher likelihood of employing clinicians in MRI departments.

• For-profit hospitals in the study charged a median price of $1,509, while nonprofit and government hospitals charged a median $1,938 and $2,149, respectively. Medicare pays $400 or less for the procedure, depending on the facility type.
• Rural hospitals charged more for brain MRIs than urban hospitals in the same health system by $363.
• The findings suggest that hospitals negotiate higher prices with commercial payers when they have market power in a region or area.

🦠 Despair at the CDC as the pandemic erupted. (New York Times)

💊 Will the Ozempic era change how we think about being fat and being thin? (New Yorker)

👉 New liver transplant rules yield winners and losers as wasted organs reach record high. (Washington Post)

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