Abortion, Obamacare, and drug approvals: American health care faces a pivotal moment

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Good afternoon, readers.

We’re heading into the Memorial Day weekend here in the U.S. It’s bound to be a celebratory occasion with so many Americans fully vaccinated (including more than half of U.S. adults). The summer is upon us and the public is ready to let loose.

But as much as we should take some time for a well-needed (but responsibly executed) long weekend around large crowds, let’s not lose track of the bigger health care picture. Because there are some massive decisions coming down the pike that will affect everything from the future of the Affordable Care Act (also known as Obamacare), to abortion rights, to approvals for highly controversial drugs such as Biogen’s aducanumab.

Every one of these issues is fundamentally political in nature. The GOP has been fighting Obamacare since its inception via dozens of lawsuits and is still seeking to throw out the law in its entirety. Most legal experts believe the effort will fail, despite a conservative-dominated Supreme Court taking up the latest case against the law. We should see a decision on that in the next few weeks, or even days. Abortion? The court will decide whether to overturn one of the core aspects of the historic Roe v. Wade ruling sometime next year.

Those are crucial issues that are being covered heavily in other media. What I want to focus on here, though, is the upcoming decision on Biogen’s Alzheimer’s drug. You see, President Biden has a critical opening on his health care team: a permanent Food and Drug Administration (FDA) commissioner. That means that a decision over what could be the first-ever approved therapy to treat the underlying cause of Alzheimer’s will occur under the auspices of Janet Woodcock, the interim head of the agency.

Woodcock is a respected veteran of the industry and a physician, and has served in leadership roles at the FDA for decades. But she’s also raised some controversy for her decisions to support approvals for opioid products and other treatments despite third-party FDA advisers’ concerns. When it comes to Biogen’s Alzheimer’s treatment, those outside counselors slammed the drug’s clinical trial design and questioned its efficacy. But patient advocacy groups, boosted by the pharmaceutical industry, have engaged in a public pressure campaign to get the drug approved, with the help of celebrities like Samuel L. Jackson. After all, something is better than nothing, right?

Well, maybe not. That’s not how the FDA is supposed to work—its job is to consider the safety and efficacy of a new drug. Then again, this is the real world, with its competing players and interests. We’ll see how well the agency can stick to its mission there.

Read on for the day’s news, and see you again next Thursday.

Sy Mukherjee
sy.mukherjee@fortune.com
@the_sy_guy

DIGITAL HEALTH

Google rolls out a health equity tracker. Google is launching a project meant to sniff out health disparities across communities in the United States. There's clearly a pandemic-related element here given how this outbreak has exposed societal inequities, particularly in health (inequities which existed long before, I might add). COVID-based health disparities will be the first area of focus in this project for that very reason. But it doesn't end there. The Satcher Health Leadership Institute at the Morehouse School of Medicine, Google, biotech giant Gilead Sciences, the Annie E. Casey Foundation, and the CDC Foundation are all collaborating to create a demographic map of sorts to keep tabs on these inequities. This includes keeping tabs on the number of COVID cases in specific regions that may house more minorities than others and other conditions such as diabetes or other chronic illnesses, and their long-term effects on various communities. (FierceHealthcare)

INDICATIONS

China's COVID vaccine evolution. My colleague Grady McGregor has been a go-to pro on the COVID vaccine beat in the many parts of the world that happen to not be the United States. His latest? An exploration of how China, which has been demonized on a number of fronts over the course of the pandemic, has transformed its own immunization campaign. But that turnaround is also a little award from a political philosophy perspective, as Grady spells out. "China's rapidly accelerating vaccine campaign underscores the advantage of Beijing's authoritarian regime and its disregard for the belief systems—personal liberty, religious freedom—that are stoking vaccine hesitancy in the U.S.," he writes. "Even though vaccinations remain voluntary, Beijing can pull powerful levers, like requiring vaccinations at state-owned enterprises and leaning on Communist Party members to take the jab, to spur uptake." (Fortune)

THE BIG PICTURE

Half of U.S. adults are now fully vaccinated. Some good news going into the weekend - more than half of the U.S. adult population is now fully vaccinated against COVID. We'll see what happens with variants going forth, and the switch over in the supply and demand change. But as always, look to our weekly maps of how the vaccination campaign is going, including the vaccination rates in your individual state. (Fortune)