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Choose your fighter: The Democratic debates are a chance for candidates to flash their policy chops

This week’s Democratic primary debates (two 10-candidate panels, each at 9 p.m. on MSNBC this Wednesday and Thursday) are likely to spotlight health care issues ranging from “Medicare for All” to drug pricing to addiction treatment, after months of those issues playing a central role at campaign rallies and town halls.

Already, Joe Biden has pledged to “cure cancer” as president. Sen. Kamala Harris tells crowds that “big pharmaceutical companies have unleashed an opioid crisis.” Sen. Bernie Sanders is the chief advocate of universal health coverage and a leading drug industry critic, and Sen. Elizabeth Warren is the author of a bill to allow the government to manufacture generic drugs. Experts say it’s no coincidence that the leading candidates have the biggest ideas on health care.

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“Candidates who don’t talk about tackling the rising costs of health care will fail to meet voters where they are,” Jesse Ferguson, a consultant who has worked for Hillary Clinton and House Democrats’ campaign arm, told Lev. “The debate audience will be the first time many people are hearing a series of Democratic approaches to tackle the problem of rising health care costs compared to Trump’s approach that makes the problem worse.”

A final piece of potential intrigue: vaccines. Some Democratic Party campaign arms have begun to take heat in the press for accepting campaign contributions from Claire and Albert Dwoskin, longtime party donors and longtime vaccine skeptics. Marianne Williamson, the motivational author and longshot candidate who will appear in Thursday’s debate, has called mandatory vaccination policies “Orwellian.” When she dialed her comments back, Williamson clarified that she’s skeptical not of vaccines themselves, but of — who else? — “Big Pharma.”

It’s a big week for drug pricing on Capitol Hill — and we’ve got the latest intel

Two major pieces of legislation are expected to move forward in Congress this week.

First up: The Senate Judiciary Committee is planning to hold a markup on a package of patent bills this Thursday. The drug industry successfully watered down the most consequential bill in that package, a measure from Sen. John Cornyn (R-Texas) that took aim at so-called patent thickets. (You can read plenty more about the twists and turns that process has taken, here.)

Now, it’s looking increasingly like the committee’s chairman, Sen. Lindsey Graham, may leave his own mark on the bill. (Though even Monday afternoon, rumors were flying that he may have gotten gun shy and stood down.)

Nonetheless, drug makers are on high alert over a new potential amendment from Graham that would take on so-called patent evergreening by making it harder for drug makers to use patents on new drug formulations or delivery mechanisms to block lower cost drugs from coming to market. The bill “would effectively require separate patent applications for compounds, delivery methods, [and] dosing,” a summary of that draft amendment obtained by STAT states. If enacted, this would mean a generic or biosimilar maker could copy a branded drug whose main patent has expired without having to also challenge all the secondary patents protecting the drug.

It’s also still unclear what will happen to a separate Cornyn proposal to limit the number of patent lawsuits a biologic maker can bring under federal law. Lobbyists expected Cornyn to offer that instead of his patent thicketing measure, but that language may still be in flux after objections from the generic drug industry, according to lobbyists on both sides of that fight.

Keep the popcorn handy, folks — I’d guess there’ll be plenty more drama before the markup on Thursday.

Not to be outdone, the Senate HELP Committee will mark up the “Lower Health Costs Act,” which, as of Monday, contains the long-awaited CREATES Act plus a priority of Senate Majority Leader Mitch McConnell’s: banning tobacco sales to people under age 21.

That package also contains the BLOCKING Act, a bill that would start the 180-day clock on exclusivity for first generics when they’re accused of blocking other generics from coming to market. Jeff Francer, the general counsel for the Association for Accessible Medicines — the generic drug industry’s D.C. lobby — told reporters Monday the bill would “gut 180-day exclusivity period” generic companies rely on for revenue and result in less competition overall.

That markup is Wednesday.

Insulin makers are back in the hot seat

Two bits of insulin news are catching my eye. The first is the launch of a new campaign called Affordable Insulin Now, which is being launched by Health Care Voter, the Democratically-aligned pro-Obamacare group co-chaired by ALS activist Ady Barkan, Queer Eye superstar Karamo Brown, and actress-turned-activist Alyssa Milano. The group is already out with a powerful ad, and has protested outside the headquarters of Eli Lilly. I’m paying attention because insulin affordability is one of those failures in our health care system that’s hard for drug makers to explain away, and grassroots activists have largely succeeded in turning this into a national issue. Now with the PR savvy of Health Care Voter and these celebs taking on the issue, it’ll be even harder for insulin makers to avoid the spotlight.

Second is a new bill from Sen. Tina Smith (D-Minn.) that would require insulin makers pay into new state-administered insulin emergency funds. The funds would pay for short-term supplies of insulin for uninsured or underinsured patents at risk of rationing insulin, according to a summary. It’s a novel idea that I imagine could get some Republican support. That being said, the bill also has a number of provisions that most Republicans won’t like, including a measure that would cut biologic drug exclusivity and another that would penalize insulin makers for both past and future price hikes. Worth watching to see if this emergency fund idea catches on, nonetheless!

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