Be­fore Sen. Joe Manchin (D-WV) put the fi­nal ki­bosh on the Build Back Bet­ter Act late last year, De­moc­rats had nev­er been so close to pass­ing ma­jor drug pric­ing re­forms.

But af­ter that bill died in the Sen­ate, even as Manchin vowed to back such pric­ing re­forms, reach­ing 50 votes to pass a bill un­der rec­on­cil­i­a­tion seemed to be stretch­ing out of reach as the con­gres­sion­al sum­mer re­cess nears and as midterm elec­tions ap­proach.

Now, how­ev­er, Pres­i­dent Joe Biden is sig­nal­ing an 11th-hour push is com­ing around drug prices, with plans to not on­ly al­low Medicare to ne­go­ti­ate, but to make in­sulin af­ford­able too. The House in late March passed a bill to cap in­sulin prices at $35 per month but the Sen­ate has yet to vote on the bill.

“I think we’re go­ing to be able to get a change in Medicare and a re­duc­tion in the cost of in­sulin. In­sulin — if you know any­body who has type 2 di­a­betes or has a child who has it, they need the shots dur­ing the week. It could cost them up to 1,000 bucks a week. And it may not cost more than $35 [to make],” Biden said in com­ments made yes­ter­day near his beach house in Re­hoboth, DE.

Alex Law­son, ex­ec­u­tive di­rec­tor of the non­prof­it So­cial Se­cu­ri­ty Works who’s been work­ing on drug pric­ing re­forms on Capi­tol Hill, told End­points News:

It all has to hap­pen by the Au­gust re­cess. And there is still a re­al path to get­ting it done. And every­one keeps say­ing they want to get it done, but it is ab­solute­ly put up or shut up time in terms of low­er­ing drug prices for the De­moc­rats.

Mean­while, NBC News scooped to­day that AARP is air­ing ads this week in West Vir­ginia, giv­ing Manchin cov­er to con­tin­ue sup­port­ing these ma­jor drug pric­ing re­forms.

“We know we have the votes to pass Medicare ne­go­ti­a­tion through rec­on­cil­i­a­tion, and we are com­mit­ted to push­ing back when­ev­er PhRMA and their al­lies try to mis­lead the pub­lic and block Con­gress from low­er­ing pre­scrip­tion drug prices,” Nan­cy Lea­Mond, the chief ad­vo­ca­cy and en­gage­ment of­fi­cer for AARP, told NBC.

House Dems al­so called on the Sen­ate late last month to quick­ly move on a rec­on­cil­i­a­tion bill with these re­forms.

Those pos­i­tive com­ments fol­low heat­ed in­ter­nal bat­tles among Dems over the use of Medicare to ne­go­ti­ate drug prices, which the phar­ma­ceu­ti­cal in­dus­try and its lob­by­ists have fierce­ly sought to de­feat.

A hand­ful of Sen­ate Dems, like New Jer­sey’s Bob Menen­dez, whose state is home to many in the life sci­ences in­dus­try, have been re­luc­tant to come on board with Medicare ne­go­ti­a­tions as the in­dus­try has made clear that it could come at the cost of new drugs. And one lost Dem means any rec­on­cil­i­a­tion bill will fail.

If these bat­tles near the fin­ish line again, many will be look­ing to the Con­gres­sion­al Bud­get Of­fice for guid­ance. The CBO pre­vi­ous­ly es­ti­mat­ed the Medicare ne­go­ti­a­tions could lead to a 10% re­duc­tion in the num­ber of new drugs over 30 years, al­though it did not es­ti­mate what types of drugs might hit the cut­ting room floor.

Re­gard­less, it’s now or nev­er for Biden and De­moc­rats as some who are hand­i­cap­ping this fall’s elec­tion see the 50-50 Sen­ate shift­ing to Re­pub­li­can con­trol, which like­ly spells the end for Medicare ne­go­ti­a­tions.

Two weeks ago, Biohaven hit an all-time high in weekly Nurtec prescriptions. CEO Vlad Coric attributes at least some of that success to a new interactive Twitter campaign that encourages patients to free their feed of potential migraine triggers.

Earlier this month, Biohaven in partnership with Twitter launched the #RelieveYourFeed campaign that allows users to customize their app settings based on their migraine triggers.

Over the past few months, oncologists have been talking a lot about the ASCO conference. Not surprising considering its import and the study data presented, but what may be less expected is the second most talked about topic of health equity.

That’s according to data from The Harris Poll and the new expert network the researcher is building out. While the company has been doing deep data dives into specific health issues or conditions for pharma clients, it’s now monitoring influencer networks of therapy area specialists to find out what experts are really thinking about.

Earlier this year, Novartis touted its radioligand as a major piece to counter competition in the cancer space. However, the physical production of its products has had anything but a smooth ride.

In May, Novartis had to suspend production of Lutathera and Pluvicto, its two primary radiotherapies. According to the company, this was done out of an abundance of caution as a result of potential quality issues identified in its manufacturing. The production suspension impacts the commercial and clinical trial supply of the products.

The rise of pharma environmental, social and governance (ESG) efforts in the past two years has been meteoric as investors turn their attention to sustainable funding. However, investors aren’t the only ones watching. Patients are beginning to tune into pharmas’ ESG promises too.

Patient advocacy groups familiar with ESG regard it as an important issue and want to be included in helping pharma companies set ESG policies and targets, according to a new report from PatientView. That’s quite different from what the investment community wants across a variety of Gartner’s defined financial, competitive, strategic and perception goals.