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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. But some experts are skeptical, saying such a model would perpetuate high prices.

Driving the news: Members of the Senate Finance Committee, led by Chairman Chuck Grassley, are exploring the idea. Grassley considers it a top priority.

  • But no policy has been agreed to, according to a spokesman for Sen. Ron Wyden, the top Democrat on Finance.

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.

  • Novartis has said it will accept payment for Zolgensma over 5 years. The Grassley-led proposal would build a similar option into Medicaid, and make it easier to adopt the same model in the private market.
  • The proposal also would require states and drugmakers to agree on clinical benchmarks that must be reached for each payment.
  • Grassley spoke of the proposal in broad strokes last week, and sources familiar provided Axios with more details.

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: Critics have said proposals like this one don’t do enough to tackle drug prices.

  • “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.
  • Bach is also skeptical of the long-term payment model: “Financing does not reduce total spending, it just changes current obligations," he added.

Go deeper: The real drug pricing debate is upon us

Go deeper

Broncos and 49ers the latest NFL teams impacted by coronavirus crisis

From left, Denver Broncos quarterbacks Drew Lock, Brett Rypien and Jeff Driskel during an August training session at UCHealth Training Center in Englewood, Colorado. Photo: Justin Edmonds/Getty Images

The COVID-19 pandemic has thrown the NFL season into chaos, with all Denver Broncos quarterbacks sidelined, the San Francisco 49ers left without a home or practice ground and much of the Baltimore Ravens team unavailable, per AP.

Driving the news: The Broncos confirmed in a statement Saturday night that quarterbacks Drew Lock, Brett Rypien and Blake Bortles were identified as "high-risk COVID-19 close contacts" and will follow the NFL's mandatory five-day quarantine, making them ineligible for Sunday's game against New Orleans.

Updated 11 hours ago - Politics & Policy

Coronavirus dashboard

Illustration: Sarah Grillo/Axios

  1. Health: WHO: AstraZeneca vaccine must be evaluated on "more than a press release."
  2. Politics: McConnell temporarily halts in-person lunches for GOP caucus.
  3. Economy: Safety nets to disappear in DecemberAmazon hires 1,400 workers a day throughout pandemic.
  4. Education: U.S. public school enrollment drops as pandemic persists.
  5. Cities: Surge in cases forces San Francisco to impose curfew — Los Angeles County issues stay-at-home order, limits gatherings.
  6. Sports: NFL bans in-person team activities Monday, Tuesday due to COVID-19 surge — NBA announces new coronavirus protocols.
  7. World: London police arrest more than 150 during anti-lockdown protests — Thailand, Philippines sign deal with AstraZeneca for vaccine.

Tony Hsieh, longtime Zappos CEO, dies at 46

Tony Hsieh. Photo: FilmMagic/FilmMagic

Tony Hsieh, the longtime ex-chief executive of Zappos, died on Friday after being injured in a house fire, his lawyer told the Las Vegas Review-Journal. He was 46.

The big picture: Hsieh was known for his unique approach to management, and following the 2008 recession his ongoing investment and efforts to revitalize the downtown Las Vegas area.

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