Congress Passes Continuing Resolution: After nearly a month of partisan disagreements, House and Senate leadership forwarded a continuing resolution (CR) to President Biden’s desk on Wednesday afternoon. The CR runs through December 20, with both the House and Senate returning to Washington on November 12. That gives Congress about 20 legislative days to complete work on the FY25 Appropriations bills and/or pass another CR.  

Lame Duck Session Awaits After Recess: With the passage of the CR and the general election looming on November 5, Congress will remain in recess until after the vote. Legislators will return to a busy “lame duck” period, with a list headlined by NDAA and FARM Bill reauthorization considerations. Members are also looking to pass several health-related policies before the end of the year, namely a telehealth flexibility extension; a stopgap physician pay measure or more complete formulary reform; Hospital at Home, IPPS, and MDH program reauthorizations; and PBM transparency legislation.  

Senate HELP Holds Hearing on Ozempic Drug Costs: On Tuesday, the Senate HELP Committee held a hearing featuring Novo Nordisk CEO Lars Jørgensen over the costs of Ozempic, Wegovy and similar weight loss drugs, requesting explanations for why the U.S. faces a higher list price than other countries. Committee Chair Bernie Sandes (I-VT) asked Jørgensen why Novo Nordisk charges $969 per month for Ozempic in the U.S., compared to $155 per month in Canada or $59 in Germany. Jørgensen said Novo Nordisk does not set U.S. prices, but PBMs and insurance companies are responsible.  

City of Baltimore Sues Biogen: On Wednesday, the City of Baltimore filed a suit against drug developer Biogen, alleging the company worked with pharmacy benefit managers to suppress generic versions of MS treatment Tecfidera. The suit says Biogen developed a slight alteration of Tecfidera called Vumerity as their patent expired, and then worked with PBMs to convince doctors to switch patients to the newer drug rather than generics. Vumerity’s patents were declared invalid four years ago.  

FTC to Sue PBMS Over Insulin Rebates: Last Friday, the Federal Trade Commission announced an administrative suit against Optum Rx, Express Scripts and Caremark, alleging the companies artificially inflated insulin prices. “PBMs have created and manage a system in which drug manufacturers compete for formulary placement by raising (not lowering) drug list prices so they can feed the higher rebates that PBMs demand,” Rahul Rao, FTC Bureau of Competition Deputy Director, said in a statement.

Democrats Unveil Affordable Care Act Subsidy Plan: On Wednesday, a bicameral group of Democratic lawmakers unveiled legislation to extend federal subsidies that assist the cost of health insurance for millions of Americans. The effort tees up another Affordable Care Act fight that could stretch into next year. The legislation would make tax credits that lower the cost of plans sold through the Affordable Care Act permanent.  

Senate Opens Probe into 340B Program: On Tuesday, Senate HELP Committee Ranking Member Bill Cassidy (R-LA) wrote to the CEOs of Eli Lilly and Amgen asking for more information regarding the companies’ restrictions on drug discounts under the federal 340B program. Cassidy is requesting “numerical data and specific examples” of how restrictions led to “fewer duplicate discounts or diversion of 340B drugs to ineligible patients.”

Free At-Home Covid Tests Are Back: The Biden administration is reviving its free coronavirus test program ahead of an expected wave of cases this winter. Households can now request four free at-home tests through covidtests.gov, with shipping set to begin Monday. Federal officials say the tests will detect the latest variants that are in circulation.

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