OFFICIALS SEARCH FOR CASH IN GLOBAL VAX PUSH — The Biden administration is turbocharging its effort to boost inoculations in low- and middle-income countries to prevent new, more-transmissible variants from emerging — an effort that would also protect Americans at home, three senior administration officials working on the effort tell POLITICO's Erin Banco There's a problem: The administration is running out of money to support the global vaccination push, and negotiations with Congress on securing new funding have stalled. Without additional cash, the Biden administration could fall behind in its 2022 Covid-19 goal of getting shots into arms. That includes its work with COVAX, the global vaccine facility, and local governments to boost inoculations in the 30 countries with vaccination rates below 10 percent, the officials said. The backdrop: The new, urgent approach to inoculating the world comes after the administration spent months in the spring and summer of 2021 focusing on direct donations to nations instead of distributing doses through COVAX — a move that initially confused global vaccination allocation and delayed getting shots into arms, according to two of the senior administration officials working on the federal government's effort. Those officials said senior health officials had initially urged the White House and National Security Council to donate 100 percent of its doses through COVAX. The cash shortage could have big implications for global vaccination, considering how much COVAX relies on the U.S. for vaccines and financial support. COLLINS IS BACK — We hardly had time to miss former National Institutes of Health Director Francis Collins, who will become President Joe Biden's science adviser, the White House said late Wednesday, while Alondra Nelson will become its acting director of the Office of Science and Technology Policy. Both will split the role left vacant by Eric Lander's resignation. "I want all of you to know that the President will value this collaboration greatly as we work toward naming and nominating a permanent science adviser and director of OSTP who will go through the Senate confirmation process," deputy chief of staff Bruce Reed told OSTP employees on a call this evening with Nelson and Collins, as Alex Thompson reported in West Wing Playbook. What happens next: The search is on for a permanent replacement for Lander, who abruptly resigned last week following POLITICO reports of bullying behavior in his office. But Biden needs someone to helm the sweeping proposals the former director shaped, like a revamp of the cancer moonshot and the potential creation of the Advanced Research Projects Agency for Health. FTC POISED TO VOTE ON INVESTIGATING PBMs — The Federal Trade Commission is deciding this afternoon whether to probe the business practices of pharmaceutical middlemen known as pharmacy benefit managers, or PBMs, report Megan and Leah. Three players — CVS Caremark, Express Scripts and OptumRx dominate nearly 80 percent of the market, prompting lawmaker and advocacy groups' calls for antitrust action. The commission's vote would trigger a study, not law enforcement action, by the agency, but the FTC can use information obtained from its research to open investigations into specific companies. What to expect: Matt Seiler, the general counsel of the National Community Pharmacists Association, will be one of more than 63 people who've signed up to speak at the FTC's meeting today. "PBMs are pushing a false narrative that their practices support community pharmacies and reduce costs for patients. They do not. This study should put that myth to rest once and for all," he says in his remarks obtained by POLITICO. Rep. Buddy Carter (R-Ga.), a pharmacist, has submitted video comments; Rep. John Rose (R-Tenn.), another PBM critic, will also be speaking. BIDEN OFFICIALS WEIGH MEDICARE CONTRACT SHIFT — The administration is debating whether to overhaul a major Trump-era program tied to Medicare as soon as next week in the face of rising pressure from prominent progressive Democrats, Rachael and Adam Cancryn scooped. The timing: While the administration initially planned to announce changes to the program today, a person with knowledge of the matter said it's now likely to take a few more days to finalize the revamp. The Trump program — known as a direct contracting model — allows private companies to participate in Medicare as part of a broader health department effort to improve care while limiting the government's costs. Yet the initiative has since come under increased scrutiny from the left, setting up a clash between the administration and liberals like Sen. Elizabeth Warren(D-Mass.) and Rep. Pramila Jayapal (D-Wash.), who warn that Biden is smoothing a path to privatizing Medicare by keeping it intact. Biden health officials are weighing a range of potential changes, from new constraints to outright termination, several people familiar with the matter told Rachael and Adam. Providers participating in the program expect a Biden administration decision as early as today.
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