HHS sees mass firings amid shutdown, with some being rescinded

Amid the federal government shutdown, HHS has seen mass firings, though some appear to have been made in error and rescinded.

On Friday, White House Office of Management and Budget Director Russell Vought announced that the reduction-in-force (RIF) initiative had begun across the federal government, which included HHS, according to a spokesperson for the department.

"HHS employees across multiple divisions have received reduction-in-force notices as a direct consequence of the Democrat-led government shutdown," the spokesperson said. "All HHS employees receiving reduction-in-force notices were designated nonessential by their respective divisions. HHS continues to close wasteful and duplicative entities, including those that are at odds with the Trump administration’s Make America Healthy Again agenda."

According to four people familiar with the staff cuts who spoke to STAT, CDC has been hit especially hard in its offices related to injury prevention, respiratory disease surveillance, and chronic disease.

In addition, STAT reports that the division within CDC's National Center for Health Statistics that directs the National Health and Nutrition Examination Survey lost all of its planners in the firings. As a result, information about health services, hospitalizations, ED visits, office visits, and individual warning signs could be missing, as will "anything related to any emerging outbreaks," according to Denys Lau, the former director of a CDC division.

However, on Saturday, some CDC terminations were rescinded.

Among those whose RIFs were rescinded were the top two leaders of the federal measles response team, those working to contain Ebola in the Democratic Republic of Congo, members of the Epidemic Intelligence Service, and the team that creates CDC's scientific journal, the Morbidity and Mortality Weekly Report.

According to an HHS official who spoke to STAT, some CDC staff mistakenly received RIF notices because of coding errors in their job classifications.

Overall, the White House is expected to cut between 1,100 and 1,200 employees from HHS, and according to a source familiar with the layoffs who spoke to Axios, a total of around 600 CDC employees have been let go after accounting for the reversals.

(Cooney, et al., STAT, 10/11; Early, Modern Healthcare, 10/10; Mandavilli/Stolberg, New York Times, 10/11; Frieden, MedPage Today, 10/10; Stolberg, New York Times, 10/11; Bettelheim, et al., Axios, 10/12; Cooney, STAT, 10/14)

RFK Jr. reasserts unproven link between Tylenol and autism

During a Cabinet meeting last week, HHS Secretary Robert F. Kennedy Jr. reasserted the unproven link between the pain reliever Tylenol and autism, suggesting people who opposed the theory were motivated by hatred for President Donald Trump.

During the meeting, Kennedy reiterated the claim while also noting there was no medical proof to substantiate it. "Anybody who takes the stuff during pregnancy unless they have to is … irresponsible," Kennedy said. "It is not proof. We're doing the studies to make the proof."

Kennedy also said during the meeting that infant boys who are circumcised have twice the rate of autism because they're given Tylenol after the procedure, seeming to refer to a study published in the Journal of the Royal Society of Medicine in 2015 that looked at ritual circumcision and the risk of autism in boys under the age of 10 in Denmark.

That study found that those who had undergone the procedure were more likely to develop autism than other boys in the study. However, researchers noted they had no data on painkillers or anesthetics used, and as a result, were unable to address whether Tylenol was linked to autism.

Shortly after the study was published, a rebuttal was published in the Journal of the Royal Society of Medicine from other scientists who said the study was "flawed" and questioned why the study didn't examine other painful conditions like urinary tract infections or consider whether general anesthesia, rather than pain, could have contributed.

Kennedy later claimed that "mainstream media" had mischaracterized his comments about circumcision and autism rates.

"As usual, the mainstream media attacks me for something I didn't say in order to distract from the truth of what I did say," Kennedy said in a post on X, citing the Danish study.

(Cha, Washington Post, 10/10; Beaumont/Ungar, Associated Press, 10/9; Choi, The Hill, 10/10)

Trump announces drug price deal with AstraZeneca

President Donald Trump on Friday announced a deal with British drugmaker AstraZeneca to lower drug prices.

As part of the deal, AstraZeneca said it will sell its drugs to Medicaid at around the same prices it offers wealthy countries in Europe. The drugmaker will also sell discounted drugs on the new government-run TrumpRx website for consumers to purchase without using insurance.

AstraZeneca also said it was investing $4.5 billion in a new manufacturing plant near Charlottesville, Virginia as part of a $50 billion commitment to U.S. manufacturing and research and development.

Under the agreement, AstraZeneca said it will receive a three-year exemption from Trump's pharmaceutical tariffs.

"Nobody ever thought they were gonna see [these prices] … and don't let Democrats take the credit," Trump said in a press conference in the Oval Office alongside AstraZeneca CEO Pascal Soriot.

Trump added that his pharmaceutical tariffs were the leverage needed to persuade large drug companies to expand and build plants in the United States.

"Now, I'm not sure that Pascal would like to say — but behind the scenes, he did say, tariffs were a big reason he came here," Trump said.

(Robbins/Sanger-Katz, New York Times, 10/10; Bettelheim/Sullivan, Axios, 10/10)

Federal court allows government to negotiate prices for large drug quantities

The U.S. Court of Appeals for the Third Circuit last week unanimously rejected a challenge by Novo Nordisk to Medicare's drug price negotiation program, ruling that the government can lump together products with the same ingredient for the purpose of choosing drugs for negotiation.

The Biden administration directed Medicare to count six of Novo Nordisk's insulin products as one item because they contain the same active ingredient, but in the lawsuit, Novo argued the government should have to negotiate for its insulin products separately.

The three-judge panel for the Third Circuit ruled that the Inflation Reduction Act, which established the drug negotiation program, doesn't allow the courts to weigh in on Medicare's selection of drugs.

While the lawsuit specifically focused on insulin products from the first year of drug price negotiations, the ruling could have a significant impact going forward since Medicare also lumped three of Novo Nordisk's diabetes and weight loss drugs — Ozempic, Rybelsus, and Wegovy — in the second round of price negotiations, as semaglutide is the active ingredient in all three.

(Wilkerson, STAT+ [subscription required], 10/7)