Not every year is eventful on the health policy front; but even taking COVID-19 out of the equation, 2022 proved to be a fairly significant one on Capitol Hill. 

The year saw major changes in abortion access, the first drug pricing regulation measures passed in decades and several mentality shifts around things like mental health and the pandemic.

Here are the biggest health policy moves in 2022 that will have ripple effects into 2023.

Abortion access

Perhaps the biggest health policy event in 2022 was the overturning of Roe v. Wade and its impact on everything from the midterm elections to reproductive health companies’ marketing strategies.

In June, the Supreme Court overturned the landmark decision, removing the constitutional right to abortion on the federal level. Abortion has since been banned in about 13 states and restricted to some extent in several others.

In response to the decision, the Biden administration moved to boost access to reproductive health services, including Food and Drug Administration-approved medication abortion and contraception, though some abortion advocates argued it was too little, too late.

The ruling also had ripple effects on the pharma industry, particularly companies that focus on contraception and reproductive health. Telehealth company Nurx, which provides contraception and birth control prescriptions, saw a 300% increase in emergency contraception requests when the Supreme Court draft was leaked.

Companies like Evofem Biosciences, a women’s sexual and reproductive health business, also felt the impact of the ruling on how they craft their messaging around contraception. Ensuring women still have access to FDA-approved products — even amid abortion restrictions in certain states and payers not providing coverage — became top of mind for the team at Evofem, chief commercial officer Katherine Atkison told MM+M in June.

These repercussions will be felt in 2023, as medical marketers continue to grapple with a patchwork of abortion laws across the nation.

Drug pricing regulation

Another major policy move of 2022 was the historic drug pricing regulation included in the Inflation Reduction Act.

That legislation gave the federal government the ability to negotiate Medicare prices for certain expensive drugs starting in 2026. It also capped out-of-pocket prescription costs for people on Medicare at $2,000 starting in 2025.

Still, there’s much work left to be done on the drug costs front, and it continues to be an important topic both among bipartisan lawmakers and the general public.

One provision that would cap the price of insulin at $35 per month didn’t make it into the final legislative package, for example, and insulin prices have remained a hot topic throughout 2022. 

During Elon Musk’s messy Twitter takeover, a fake Eli Lilly tweet announcing it would make insulin free poked at the issue, went viral and cost the company billions in market cap. More recently, entrepreneur Mark Cuban has also vowed that his Mark Cuban Cost Plus Drug company would eventually begin offering low-cost insulin.

Department of Health and Human Services Secretary Xavier Becerra also noted this year that the government plans to eventually look into other price reduction options, even so-called ‘march-in rights’ that would allow the federal government to take over a company’s drug patent and license it out to other manufacturers to reduce prices.

Still, moving into 2023, we probably won’t see much in terms of new major legislation passing on the drug pricing regulation front. Instead, we’ll begin to see the Centers for Medicare Services start to get the ball rolling on the legislation officially passed in 2022 — defining how to implement the new Medicare negotiations, and how they will select the first 10 drugs for 2026.

COVID-19 shift

With 2022 also came a shift in the pandemic mentality and COVID-19 policies. While the emergency phase isn’t quite over, it may as well be for all intents and purposes. Chalk it up to COVID fatigue, or lack of money.

Renewed COVID-19 aid funding was dropped from the government funding bill in March, and Congress hasn’t approved any new money since. Despite the Biden administration requesting $10 billion in COVID-19 aid in November, no funding was carved into the end-of-year omnibus package.

Plus, President Biden casually declared ‘the pandemic over’ in September — a comment that may be seen as an offhand remark, but was probably more illuminating about the nation’s changing attitude toward the pandemic. Compared to the sense of urgency over the past two years, 2022 saw much of the COVID-19 restrictions, programs and rules begin to fall away.

The federal government has officially begun preparing for the end of the public health emergency, meaning it will stop purchasing vaccines, treatments and tests to distribute to the public — and the pandemic will move into its endemic phase. As it currently stands, the federal government won’t have as much of its testing, tracking and vaccination infrastructure in place heading into 2023.

A greater spotlight on mental health

2022 brought an even greater spotlight on mental health as a public health issue. Several bipartisan lawmakers introduced mental health bills this year, aiming to ease the mental health workforce shortage in schools and areas of need.

This year, the U.S. Preventive Services Task Force released recommendations advising health care providers to screen all adults under the age of 65 for anxiety, underscoring the need for increased attention on the mental health crisis. But a shortage of psychiatrists, therapists and other mental health workers hampered efforts to get more people into treatment this year.

One bipartisan bill introduced as a draft in September aimed to tackle that issue, by allowing Medicare to cover marriage and family therapists, as well as mental health counselors for the first time. It would also add 400 residency positions through Medcare to help train more psychiatrists. 

Mental health advocates called the draft legislation and other proposed mental health bills a “significant step” toward addressing the problem federally.

Mental health will likely continue to be a policy priority for lawmakers moving into 2023.

Accelerated approval debate

Following the FDA’s approval of Biogen’s controversial Alzheimer’s drug Aduhelm in July 2021, the agency’s accelerated approval pathway — which allows drugs to be fast-tracked to approval — came under more intense scrutiny. 

When Robert Califf was nominated as the new FDA commissioner in early 2022, he vowed to take a tougher stance on the pathway and to revamp it so pharma companies would be held accountable to provide post-approval studies.

2022 saw months of debate in Congress, with some Republicans pushing for a measure that would actually make it easier for the FDA to use the pathway, touting innovation. Another Democrat-led bill would restrict the pathway, and give the FDA more power to hold drugmakers accountable if they violated it.

A few measures ended up being squeezed into the end-of-year omnibus spending package that would give the FDA the ability to require companies to maintain the post-approval studies rule. It would also create an intra-agency council to make sure the pathway is being held to proper standards.

Scrutiny over the accelerated approval pathway — and whether adjustments would make it more effective in getting safe, new drugs that work to the public — will likely continue into 2023.

The FDA’s e-cigarette and nicotine battle

The FDA’s battle to get Juul and e-cigarette products off the market continued throughout the year. 

In June, the FDA denied the ability to market Juul products, noting “there are scientific issues unique to the Juul application that warrant additional review.” They ordered Juul products off the market, its latest step in cracking down on youth vaping.

Around the same time, the agency announced it was developing a proposal to cut nicotine in cigarettes by 95% — aiming to both make smokers less dependent on the drug, and reduce the extent of health issues associated with smoking.

That proposal hasn’t yet been passed, however, and the FDA is coping with a large volume of illegal vaping products in the market. According to a recent independent review, the FDA’s tobacco regulators are overwhelmed and fatigued by the e-cigarette workload, and its Center for Tobacco Products has not defined clear priorities. Those issues will likely pour over into 2023, as the agency continues its battle.