The bipartisan 21st Century Cures Act, headed to theSenate after passage in the House by a huge margin—392 to 26—ismeeting with mixed reactions by many.

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Related: Drug makers jump, hospitals plunge in wakeof Trump win

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Some of its best features are money to fight the opioidepidemic, funding for National Institutes of Health projects—thecancer “moonshot,” the BRAIN Initiative and the Precision MedicineInitiative—and support for mental health.

Benefits to the pharmaceutical industry

But Business Insider reported that on the flip side arefeatures that spurred former supporters of the bill SenatorsElizabeth Warren, D-Massachusetts, and Bernie Sanders, I-Vermont,to withdraw their backing, with both declaring it a giveaway to thepharmaceutical industry.

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Among other changes, drug companies will no longer have tosubmit full clinical trials for approval, but will be able tosubmit “data summaries” to get drugs approved for new indications,and they will also be able to promote “off-label” drug uses toinsurers.

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Related: Paid full price for drugs? Your insurerstill gets a rebate

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That could mean that it will be faster and easier forpharmaceutical companies to win approvals—but those newly approveddrugs won’t necessarily have undergone all the safeguards formerlyin place.

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Ditto for medical devices, which will also have fewer hoops tojump through and a faster road to approval.

Less money for NIH, FDA ongoing needs

The $6.3 billion bill’s provisions for the NIH were supposed tobe guaranteed funds, but now are subject to discretionaryfunding—so even though there’s $4.8 billion for NIH’s projects, itwill have to be appropriated by Congress in the future—by no meansa sure thing.

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The FDA got $500 million under the Act, but before you cheer,the money is for its new tasks conferred by the Act. It didn’t getmuch of anything to tackle its own longstanding needs, such as foodsafety and post-approval oversight of medical products that wentthrough the fast track.

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And there’s no money for renovation of labs outside ofheadquarters, despite deterioration over time.

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Not only were Senators Sanders and Warren disappointed in theirquest to halt the bill’s passage, many patient advocacy groups alsohave been disappointed by the reduced funding provided to manyworthy recipients.

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The bill is expected to pass the Senate.

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