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Friday, February 26, 2021

Centessa’s founder on the new company’s unique R&D model

 

Putting together a quarter-billion dollar pharma company from ten mergers in four months is not for the faint-hearted – but that’s what biotech investment guru Francesco de Rubertis has achieved with his latest project Centessa. In an interview with pharmaphorum’s news editor Richard Staines, de Rubertis explained how he did it and how the company is taking a unique approach to R&D.

The idea behind Centessa had been in Francesco de Rubertis’ mind for many years – but the influx of investment into pharma and biotech during the last year is what has allowed it to become a reality.

It was only in September last year that the co-founder and partner at life sciences investment firm Medicxi decided that the time was right to realise his vision, which he describes as an “asset-focused” model.

At its heart are ten biotech startups that Medicxi has already invested in and run the rule over – but the philosophy runs deeper than that, according to de Rubertis.

Each company was selected because they are based around a single asset, which in de Rubertis’ view would be good enough to be a lead drug in the pipeline of any pharma company.

Initially the company, where de Rubertis will serve as chairman, will focus on 15 drugs.

Only four of the drugs are in the clinic, but each biotech will be focused solely on the development of one or two potential medicines.

The final part of the strategy is that each subsidiary is led by biotech entrepreneurs who are focused around the development of their drugs.

Each CEO is passionate about their projects, and are not career scientists who are looking for a 30 year stay at a big pharma running lots of different projects.

It’s this combination of elements that de Rubertis thinks will make the company a success after raising $250 million in Series A investment by General Atlantic, with co-leaders Vida Ventures and Janus Henderson Investors heading a list of blue-chip VCs such as Boxer Capital, Franklin Templeton and LifeSci Venture Partners.

The CEO is Saurabh Saha, formerly global head of translational medicine at Bristol-Myers Squibb.

Chief scientific officer is Moncef Slaoui, who was asked to step down from his gig as chief scientific advisor on the US government’s Operation Warp Speed when president Biden took charge in January.

Slaoui is also a partner at Medicxi, and has previous experience at GlaxoSmithKline, which famously trialled a similar R&D approach but with limited success.

The Centessa Subsidiaries are comprised of ApcinteX, Capella BioScience, Janpix, LockBody, Morphogen-IX, Orexia Therapeutics, Palladio Biosciences, PearlRiver Bio, Pega-One and Z Factor.

Projects include treatments for haemophilia, idiopathic pulmonary fibrosis, various kinds of cancer, pulmonary arterial hypertension, narcolepsy, kidney disease and the rare disease alpha-1-antitrypsin deficiency (see box at page end).

Putting all the pieces together has been a tough ask for de Rubertis, who spoke to pharmaphorum immediately after one of the company’s first board meetings.

Ten mergers in two months


He told us: “Doing one M&A is a big endeavour. Imagine doing ten – it has been pretty intense.

“I had the idea for a few years but I decided to get going in September 2020.”

Most mergers involving several biotechs occur because they are failing and come from the need to salvage something from various burnt-out projects.

But in this case each company was thriving and had offers on the table from big pharma companies wanting to add their drugs to their pipelines.

It took all of de Rubertis’ powers of persuasion from his many years in biotech investment to get them to buy into his idea – but once they were convinced the project came together quickly.

De Rubertis explained: “These were not failing companies. In that case it is easy to do mergers.

“I had to have a few calls over weekends and nights. I had to explain to them the full power of the Centessa vision.

“I had to spend two months convincing CEOs then two months doing ten M&As alongside fundraising.”

But he said once he had the CEOs on board, all the pieces fell into place. “Execution has been easy,” he said.

Big pharma R&D woes


De Rubertis, who made his name as an investor at Index Life Sciences before joining Medicxi, said he expects a better success rate than at GlaxoSmithKline because R&D at Centessa will be more focused and led by data rather than a broader corporate strategy.

While GSK abandoned a similar approach to R&D in 2017 when Emma Walmsley took over, de Rubertis thinks that because each subsidiary will make decisions based on results and data produced by their projects, success is much more likely.

GSK’s pipeline is still thought of as lacklustre in some quarters and the company has had to bulk it up with acquisitions such as the cancer drugs firm Tesaro to keep things moving, despite a new approach from research chief Hal Barron.

De Rubertis noted the wider issue with R&D at big pharma, which he says is inherently more conservative and less innovative.

While they are good at getting drugs to patients, big pharma companies sometimes struggle at the early part of R&D because of their risk-averse nature and corporate goals, he argues.

He said: “They are fantastic implementation machines, but that same strength is not matched with the first part of the business, which is early stage R&D.

“The bar for a great molecule goes down when top-down determination informs where research goes. Research is not free to go where the data goes.

“Data is important for a company that has one single product. Every decision will be driven by data.”

No career scientists


The R&D culture at Centessa will be radically different from big pharma companies because of the entrepreneurial spirit that drives each of them, according to de Rubertis.

He said that one reason that GSK’s attempt at a similar model failed to produce results was the mindset of the people running them.

“They were populated with people who were looking at their career plan; they did not see their career linked to a single molecule.”

Meanwhile at Centessa each biotech is run by people who are “single purpose scientists” who will likely go back to academia if their drugs don’t work in the clinic.

The drugs being developed are all “gold medal” standard according to Centessa and would be strong enough to catalyse development of a biotech without his intervention.

Centessa is also quite UK-centric, with five subsidiaries in the UK, two in the US, and one each in Canada, France and Germany.

Although the most advanced products (see box at page end) are barely in the clinic, de Rubertis said there will be  clinical data from many Centessa programmes emerging over the next three years.

Going forward, the idea is to establish Centessa as a pharma player in its own right and grow by acquisition of single asset companies that would otherwise be snapped up in “bolt-on” deals by big pharma rivals.

De Rubertis added: “We are going to grow by acquisition. Company number 11, 12, or 13 will be anywhere where the management board finds a single asset company at clinical and preclinical stage.”

For the entrepreneurs running the biotechs, Centessa offers the kind of infrastructure support and advice available from a big pharma, with each CEO getting shares in return for getting on board.

This provides security in case their individual project does not work out.

The subsidiaries on board so far are also sold on the model that allows them to be operationally independent – within reason.

“You drive the car as long as Centessa does not think you are going down the wrong path,” said de Rubertis.

“We are going to have a really good pitch for the scientists.”

It’s this philosophy that de Rubertis says will lead to Centessa becoming an established name in the industry as a stand-alone entity, rather than another abandoned biotech project.

He concluded: “I want Centessa to be a really big pharma company in the future – with good R&D productivity.”

Centessa’s subsidiaries

ApcinteX

ApcinteX is developing SerpinPC, a specific inhibitor of the anticoagulant protease activated protein C (APC), for the treatment of haemophilia A and haemophilia B, with or without inhibitors.

Capella BioScience

Capella BioScience is developing CBS001, a neutralising therapeutic monoclonal antibody to the inflammatory membrane form of LIGHT (known as TNFSF14), for the treatment of idiopathic pulmonary fibrosis. Capella BioScience is also developing CBS004, a therapeutic monoclonal antibody to blood dendritic cell antigen 2 (BDCA2), for the treatment of lupus erythematosus (systemic and cutaneous) and systemic sclerosis.

Janpix

Janpix is developing a novel class of selective dual-STAT3/5 small molecule monovalent degraders for the treatment of various hematological malignancies, including leukaemias and lymphomas.

LockBody

LockBody is pioneering a platform technology to develop LockBody CD47 (LB1) and LockBody CD3 (LB2) for optimal targeting of solid tumours by the innate immune system.

Morphogen-IX

Morphogen-IX is developing MGX292, a protein-engineered variant of human bone morphogenetic protein-9 (BMP9), for the treatment of pulmonary arterial hypertension.

Orexia Therapeutics

Orexia Therapeutics is developing oral and intranasal orexin receptor agonists using structure-based drug design approaches. These agonists target the treatment of narcolepsy type 1, where they have the potential to directly address the underlying pathology of orexin neuron loss, as well as other neurological disorders characterised by excessive daytime sleepiness.

Palladio Biosciences

Palladio Biosciences is developing lixivaptan, an oral non-peptide, new chemical agent that works by selectively suppressing the activity of the hormone vasopressin at the V2 receptor, as a treatment for autosomal dominant polycystic kidney disease with the goal of slowing the progression of kidney function decline and avoiding the liver safety issues associated with tolvaptan.

PearlRiver Bio

PearlRiver Bio is developing ​potent and selective oral exon20 insertion mutation inhibitors intended to have ​minimal activity on wild-type EGFR and optimal pharmacokinetic properties, ​for the treatment of EGFR exon 20 insertion (with potential to target and treat Her2 exon 20 insertions) non-small cell lung cancer (NSCLC). PearlRiver Bio is also developing oral inhibitors targeting C797S-mutant EGFR and undisclosed next generation EGFR inhibitors for NSCLC.

PegaOne

PegaOne is developing imgatuzumab, a humanised, non-fucosylated, anti-EGFR monoclonal antibody for the treatment of cutaneous squamous cell carcinoma and other solid tumour indications.

Z Factor

Z Factor is developing ZF874, a small molecule chemical chaperone intended to rescue folding of the Z variant of alpha-1-antitrypsin, increasing serum levels of active protein and reducing accumulation in the liver, for the treatment of alpha-1-antitrypsin deficiency.

Francesco de Rubertis is a co-founder and partner at Medicxi. Prior to Medicxi, Francesco was a partner at Index Ventures for 19 years, having joined the firm in 1997 to launch its life sciences practice. Francesco currently serves on the boards of a number of portfolio companies, including Palladio Biosciences, Rivus Pharmaceuticals, Orexia and Inexia.

Antioxidants Go After Secondary Injury in Brain Bleeds

 Reactive oxygen species (ROS) scavengers were modestly neuroprotective in the acute period of intracerebral hemorrhage (ICH), according to a small randomized trial.

Perihematomal edema (PHE) expanded less with a 14-day course of N-acetylcysteine and selenium in the neurological ICU compared with placebo, reported Seungjoo Lee, MD, PhD, of Asan Medical Center in Seoul, Korea, and colleagues. Their manuscript was published online in Stroke.

That was true for both the edema volume (mean 21.90 vs 30.66 mL, P<0.01) and the ratio of volume at 2 weeks to that at baseline (1.19 vs 2.05, P<0.01).

However, brain hemorrhage volumes came out similar at 2 weeks with the ROS scavenger and placebo (mean 20.90 vs 18.70, P=0.74).

ROS scavenger recipients did reach target sedation levels faster (mean 5.98 hours vs 8.42 hours, P<0.01) and have shorter ICU stays (6.46 days vs 12.66 days, P<0.01) compared with the placebo group.

Yet 30-day functional outcomes on the modified Ranking Scale (mRS) didn't improve more (scores 3.34 vs 3.53 with placebo), nor were total hospital stays shorter (20.28 vs 23.71 days).

"These results propose that our ROS scavengers are potent antioxidants with properties that mitigate PHE and functional outcomes in the acute period of patients with ICH," Lee's group maintained.

Like other critically-ill patients, people with ICH have oxidative stress that contributes to direct cellular injury. PHE is an imaging marker of secondary injury following ICH, and its clinical significance has been a subject of debate.

"Discovering treatments that mitigate secondary injury is a major unmet need in the uphill battle of reducing the global burden of death and disability from ICH," according to Ashkan Shoamanesh, MD, and Aristeidis Katsanos, MD, PhD, both of the Population Health Research Institute at McMaster University in Hamilton, Ontario.

Lee's trial joins a short list of ICH clinical randomized trials showing a reduction in PHE volume with intervention and thus "provides exciting novel results supporting the potential benefit and safety antioxidant therapy in this fight," the pair wrote in an accompanying editorial.

"Although [the investigators'] findings are too preliminary to be implemented in clinical practice at this time, they are promising, supported by sound biological rationale, and warrant further exploration in large-scale clinical trials," the editorialists concluded.

Lee's group noted that ICH accounts for 10% and 27% of strokes and is associated with very high mortality and morbidity rates that have not budged in 30 years. No proven acute ICH therapies exist to date, as trial after trial has failed to show benefits to proposed medical and surgical interventions.

Their single-blind, randomized trial was conducted at several Korean centers. Eligible patients had spontaneous ICH and secondary ICH due to vascular anomalies, venous thrombosis, neoplasms, or hemorrhagic infarction (i.e., cases where hematoma and PHE can be measured on CT).

Lee and colleagues randomized 123 people to ROS scavengers (N-acetylcysteine 2000 mg/d and selenium 1600 µg/d IV for 14 days) or placebo starting within 24 hours of admission.

ROS scavenger and placebo groups shared similar baseline characteristics, including age (mean 54.4 vs 56.1 years) and sex (men 64.9% vs 53%). Initial hemorrhage volumes (34.78 vs 36.71 mL) and PHE volumes (18.47 vs 19.09 mL) were also comparable.

Hypertensive ICH was the most common type of ICH, accounting for over 40% of cases. Cerebrovascular disease was the second most common cause and was observed in 30%.

Study investigators reported no serious adverse events attributed to the ROS scavengers.

Their reasons for choosing N-acetylcysteine and selenium for this study, they said, included the abundance of existing safety data, their widespread availability, and low cost when compared with other ROS scavengers like edaravone and glutathione.

On top of the small sample size and single-blind design, the study couldn't determine whether the observed effects of ROS scavengers were due to one alone or the combination of the two.

Another major limitation was the heterogeneous cohort of ICH subtypes studied, as Shoamanesh and Katsanos noted that "the pathophysiology of secondary ICH subtypes, such as hemorrhagic neoplasms and infarction, includes additional mechanisms of brain injury and edema that likely overshadow the relative contribution of the hemorrhage to neuroimaging and clinical outcomes."

Furthermore, the literature suggests that ICH patients will need to be followed for at least 6 months to detect meaningful differences in the mRS, the editorialists added.

Nonetheless, the preliminary data from Lee's group suggest that "PHE can be mitigated safely through supplemental antioxidant therapy with ROS scavengers," they said.

Disclosures

30 Popular mHealth Apps Vulnerable to API Attacks

 The 30 most popular mHealth apps are highly vulnerable to API cyberattacks, which could enable unauthorized access to full patient records, such as protected health information and personally identifiable information, according to a report from Knight Ink and Approov.

Alissa Knight, a leading cybersecurity analyst and partner at Knight Ink, analyzed the leading apps over the course of six months to assess vulnerabilities. The companies behind these apps agreed to participate in the study, as long as the findings were not directly attributed to the vendor.

App use has dramatically increased amid the COVID-19 pandemic, with more than 60 percent of people downloading an mHealth app and about 318,000 mHealth apps available for download through major app stores. As such, attacks on these endpoints are also on the rise.

For the analyzed apps, the average number of downloads for each was 772,619. Knight sought to determine the risk APIs and vulnerabilities in mHealth apps pose to these mHealth companies and patient PHI.

The findings were both alarming and surprising.


The report estimates that about 23 million mHealth users have been exposed, at a minimum, through the 30 evaluated apps. Given the number of users leveraging the total 318,000 apps available for download, it’s likely the number of users with exposed data is much greater.

About 77 percent of the assessed apps contained hardcoded API keys, some of which will not expire. Another 7 percent contained usernames and passwords, with 7 percent of the API keys belonging to third-party payment processors that warn against hard-coding their secret keys in plain text.

Another 50 percent of the tested APIs did not authenticate requests with tokens, while 63 percent of the apps contained hardcoded private keys.

The researcher also found 114 hardcoded API keys and tokens, meant to be used for authenticating with the mHealth company and third-party APIs.

Further, the researcher found API keys and tokens for for Google, Branch.io, Braze, Tune, Optimizely, Cisco Umbrella, Microsoft App Center, Bugsnag, Contentful, Stripe, Amazon AWS, Radaee, Sendbird, AppsFlyer, Facebook, Vonage, SalesForce and Mparticle.


And 100 percent of all tested API endpoints were vulnerable broken object level authorization (BOLA) attacks, which leads to unauthorized access to complete patient records, downloadable lab results and x-ray images, blood work, allergies, and PII, like contact details, family member data, and even Social Security numbers.

In fact, 50 percent of the records accessed contained names, social security numbers, addresses, birthdates, allergies, medications, and other sensitive data for patients.

“Look, let’s point the pink elephant out in the room. There will always be vulnerabilities in code so long as humans are writing it,” Knight said in a statement. 

“Humans are fallible. But I didn’t expect to find every app I tested to have hard-coded keys and tokens and all of the APIs to be vulnerable to BOLA vulnerabilities allowing me to access patient reports, X-rays, pathology reports, and full PHI records in their database. The problem is clearly systemic,” she added.

The statistics only worsen throughout the report: 100 percent of the apps failed to implement certificate pinning, which allowed the researcher to perform X-in-the-middle attacks against the app.


As a result, the researcher was able to view PII and PHI for patients who weren’t assigned to the researcher’s clinician account.

What’s more, 27 percent of the apps were not secured against reverse engineering through code obfuscation.

The results for the tested APIs were equally concerning: 50 percent of the APIs allowed medical professionals to access the pathology, X-rays, and clinical results of other patients. The researcher also found a replay vulnerability, which allowed her to replay days-old FaceID unlock requests, enabling her to take over other users’ sessions.

The findings demonstrate shielding actions for APIs are urgently needed now to protect mHealth apps from API abuse. Further, security standards required to comply with US government FHIR/SMART standards are just not enough to secure mobile apps and the APIs. 

“These findings are disappointing but not at all surprising. The fact is that leading developers and their corporate and organizational customers consistently fail to recognize that APIs servicing remote clients such as mobile apps need a new and dedicated security paradigm,” Approov Founder and CEO David Stewart said in a statement.

“Because so few organizations deploy protections for APIs that ensure only genuine mobile app instances can connect to backend servers, these APIs are an open door for threat actors and present a real nightmare for vulnerable organizations and their patients,” he added.

As such, mHealth platform developers and all organizations using mobile applications must adopt key privacy and security measures to protect patient data and other sensitive resources. 

The report made several key recommendations to accomplish this, including the need to address both app and API security. These entities must also secure the development process and harden apps and ensure run-time protection is also in place.

Certificate pinning is also critical to defending against X-in-the-middle attacks. When properly implemented, it will not impact availability or performance. Developers and entities also need to gain visibility into controls to ensure the effectiveness of implemented tools, which will allow them to be easily adjusted for compliance with HIPAA and to maintain privacy and security.

Lastly, the report stressed the need for pen testing, as well as regularly performed static and dynamic code analysis.

The report adds to previous data, which highlighted the massive privacy risks of third-party apps that don’t fall under HIPAA regulations. Multiple reports show both mHealth and mental health apps routinely share data without transparent policies about the practice.

Not only that, but the COVID-19 vaccine distribution has spurred a 51 percent increase in attacks on healthcare web apps.

Combined with the vulnerabilities outlined in this report, the need for Congress to take action on regulating these apps will be imperative in the coming year.

“mHealth apps – even before the pandemic – have had real problems with security,” Chloé Messdaghi, Chief Strategist, Point3 Security, said in a statement. “Unfortunately, many of these types of apps don’t have strong security – they don’t allow MFA, they only require short passwords, and of course, the API-related issues this researcher has underscored.”

“Another area of vulnerability is how the apps are put together. Are they using OS software? If so, are they checking for vulns in OS code? That’s a common problem, and it’s worth remembering that anything that’s free usually comes with a price,” she added.

https://healthitsecurity.com/news/30-popular-mhealth-apps-vulnerable-to-api-attacks-posing-phi-risk

Second Becerra Hearing No Easy Ride

 HHS secretary nominee Xavier Becerra's second Senate confirmation hearing was much more divisive than the first, with Republicans on the Senate Finance Committee questioning him sharply on his record as California's attorney general and his views on abortion and reproductive rights.

Contraceptive Coverage Controversy

The sharpest exchange came toward the end of Wednesday's 2½-hour hearing, when Sen. Ben Sasse (R-Neb.) asked Becerra about a discussion with another senator around a case Becerra prosecuted dealing with employers in California and other states -- including a Catholic order known as Little Sisters of the Poor -- who refused to provide birth control coverage for their employees, or to allow them to obtain such coverage through the federal government. Becerra, who is currently California's attorney general, sued the Trump administration in the case, alleging that it was not properly enforcing federal contraceptive coverage laws.

The other senator, John Thune, (R-S.D.), commented that Becerra has "spent an inordinate amount of time and effort suing pro-life organizations, like Little Sisters of the Poor, or trying to ease restrictions and expand abortion." Becerra responded that "I have never sued any nuns -- I have taken on the federal government, but I have never sued any affiliation of nuns. My actions have always been directed at federal agencies because they have been trying to do things that are contrary to the law in California and it's my job to defend the rights of my state and uphold the law."

Sasse jumped on that comment, calling Becerra's claim that he had never sued the nuns "a pretty interesting way of re-framing your bullying. You actually sued the federal government who had given an exemption to the nuns. Can you explain to us what the Little Sisters of the Poor were doing wrong?"

"We never alleged that the Little Sisters of the Poor did anything wrong," Becerra replied. "Our problem was that the federal government was not abiding by the law as we saw it, so what we did was we took action against the federal government so California could administer its programs to make sure that the Affordable Care Act continued to work." Sasse called Becerra's response "a complete nonsense answer."

Other Abortion Questions

Sasse and Thune weren't the only ones who brought up the abortion issue. "Could you name one abortion restriction you might support?" asked Sen. Steve Daines (R-Mont.). Becerra wouldn't answer directly. "I have tried to make sure that I am abiding by the law, because whether it's a particular restriction of whether it's the whole idea of abortion, whether we agree or not, we have to come to some conclusion, and that's where the law gives us a place to go," he said.

Daines tried several more times to pin Becerra down, asking whether he would support a ban on "lethal discrimination" against fetuses diagnosed with Down syndrome, or a ban on sex-selective abortions, or late-term abortions. "You're asking questions which will touch on aspects that I know have different views," Becerra answered. "I will make sure I'm respecting the law on those issues."

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HHS secretary nominee Xavier Becerra declined to say whether he would approve any particular restriction on abortion. (Photo courtesy Senate Finance Committee livestream)

Sen. James Lankford (R-Okla.) asked Becerra whether he would keep the Conscience and Religious Freedom division at HHS, which was started by the Trump administration to protect the rights of healthcare providers who have conscientious or religious objections to providing certain services, and whether he'd continue to enforce existing federal conscience laws.

"I believe deeply in religious freedom, and I will make sure that as secretary of HHS ... I will not only respect the laws when it comes to these issues of religious freedom, but I will enforce them as secretary of HHS within my department," said Becerra. He did not address the question about the Conscience and Religious Freedom division.

Republicans also had other concerns. Sen. Chuck Grassley (R-Iowa) asked, "Do you know if the Biden administration would be interested in enacting a bipartisan prescription drug pricing reform bill?" Becerra replied that "there's no doubt President Biden wants to see us lower the price of prescription medicine, and he and his team -- and if I'm fortunate to be part of that team -- will be working with you in a bipartisan fashion to reach a solution."

Sen. Todd Young (R-Ind.) was concerned about the problems that have occurred with the federal government rollout of COVID-19 vaccines. "Would you allow states like Indiana ... to opt out of these federal programs until a time where there is an adequate vaccine supply available?" he asked Becerra, who replied that he would "absolutely" consider it. "The moment I am in that seat -- we'll go to your office and we'll talk about this."

Support for Single-Payer

Sen. John Barrasso, MD (R-Wyo.), asked what Becerra would do about recent reports that the administration of New York Gov. Andrew Cuomo (D) had underreported the number of deaths occurring in nursing homes in that state. "It's important that all of us do the work to make sure data reflects the facts, and that the data is used in appropriate ways so we can make decisions on how to move forward," Becerra responded.

When Barrasso asked whether Becerra would ask the Biden administration to investigate what happened there, Becerra demurred, saying, "I don't know the facts in that particular case and it would be difficult for me to comment."

Sen. Mike Crapo (R-Idaho), the committee's ranking member, asked about Becerra's support for single-payer health insurance, which Crapo said "seems hostile to our system ... What assurances can you give Americans who have private insurance that they won't lose coverage to a Medicare for All approach?"

"We will both agree that the most important thing is to give everyone in this country coverage -- good coverage," Becerra said. However, he added, "I'm here at pleasure of the president of the United States, and he's made it very clear where he is; he wants to build on the Affordable Care Act. That would be my mission ... to build on the Affordable Care Act."

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Sen. Mike Crapo (R-Idaho), the Senate Finance Committee's ranking member, called Becerra's prior support for single-payer health insurance "hostile to our system." (Photo courtesy Senate Finance Committee livestream)

Sen. Bill Cassidy, MD (R-La.), renewed his criticism from Tuesday's hearing that Becerra was not qualified for the job because he is not a physician. "As I said yesterday, I'm a physician; should I be the attorney general of the United States? Obviously the answer's no," said Cassidy. (In 2018, however, Cassidy voted to confirm Alex Azar, an attorney and drug company executive, and not an MD, as HHS secretary.)

Democrats seemed to have expected Cassidy's comment, because Sen. Debbie Stabenow (D-Mich.), who spoke before Cassidy, said, "I know some have said they're concerned you're not a doctor. Well, our former HHS secretary was a drug company executive, and you've been on the other side as an attorney general and congressman fighting high drug prices, and that's the side I'm glad to have an HHS secretary on."

Healthcare Fraud Concerns

Democrats had other issues of concern. Sen. Maria Cantwell (D-Wash.) asked Becerra whether he would help her look into the sale of fraudulent N95 masks in the state of Washington. "I personally think we need a task force between the FDA and [Customs and Border Patrol] and the Department of Justice and others to look at this issue," she said. "We have healthcare workers and we're asking them to go into these situations, and then they're finding out big, vast amounts of supply of these masks don't meet the standards. So we need to be aggressive here with the FDA on a task force to make sure we're looking at this."

"I couldn't agree with you more," said Becerra. "I think HHS would be more than willing to work" on the issue. He cautioned that HHS's statutory role is limited to "certifying what it takes to have a mask that works," but promised to work with other agencies on the issue.

Sen. Elizabeth Warren (D-Mass.), who said she supported Becerra's nomination "all the way," asked Becerra whether he would commit to having his agency collect race and ethnicity data for COVID-19 testing and vaccination; Becerra agreed to do that.

The next step is for the Finance Committee to vote on whether to send Becerra's nomination to the full Senate for a vote; it was unclear when that will happen.

https://www.medpagetoday.com/publichealthpolicy/washington-watch/91354