UnitedHealth Group’s multibillion-dollar pharmacy benefit manager, Optum Rx, is suing five Kentucky counties in an attempt to force them out of national opioid litigation against the company. Pharmacy benefit managers, often called PBMs, act as middlemen that negotiate prescription drug prices between drug companies, insurance plans, and pharmacies. Some lawyers and advocates say PBMs helped…
By aligning innovative scientific insights with strategic commercial pathways, the industry has the potential to fulfill its early promise – delivering safe, effective therapies that improve patient outcomes and create new opportunities for growth in the biopharmaceutical sector. The post Beyond the Hype: The Scientific and Commercial Future of Microbiome Medicine appeared first on MedCity…
California’s Medicaid program has borrowed $3.4 billion from the state’s general fund — and will likely need even more — to cover ballooning health expenses for 15 million residents with low incomes and disabilities. The state Department of Finance disclosed the loan to lawmakers in a letter late Wednesday, noting funds were needed to make…
En medio de una amarga y divisiva contienda, el ex presidente Donald Trump y la vicepresidenta Kamala Harris solo parecen coincidir en una cosa: es tarea del gobierno reducir los altos precios de los medicamentos en el país. En 2022, Harris emitió el voto de desempate en el Senado para aprobar una ley que permite…
On a recent Monday, Sandy Guzman, a community health worker in rural Oregon, drove to visit a patient in her 60s in a small city called The Dalles. The patient lived alone, and “really struggles with social isolation,” Guzman said. After a serious fall and subsequent surgery, the woman was using a wheelchair. She confided…
The post Doctor at Home Services: Personalized Care at Your Doorstep appeared first on Medifyhome.
Today, the Centers for Medicare and Medicaid Services (CMS) released the results from the Medicare Drug Price Negotiation Program for Initial Price Applicability Year (IPAY) 2027 (press release). What was the average reduction in drug prices? Across the 15 drugs included in the 2027 negotiation, on average, drug prices fell by 62% (median: 63%); accounting…
AstraZeneca’s Datroway, an antibody drug conjugate (ADC), is now FDA approved for advanced cases of breast cancer that is HR positive and HER2 negative. Datroway targets TROP2, the same cancer protein addressed by Trodelvy, a Gilead Sciences ADC also approved for breast cancer. The post AstraZeneca, Daiichi Sankyo ADC Lands FDA Approval in Advanced Breast…
Epic Systems and several healthcare providers have sued Health Gorilla and other companies, alleging they exploited interoperability networks to improperly access and monetize nearly 300,000 patient medical records without consent. The post Epic & Providers Sue Health Gorilla Over Alleged Data Exploitation appeared first on MedCity News.
This brief analyzes out-of-pocket limits in Medicare Advantage plans in 2026, variation by plan type, the distribution of enrollees facing different out-of-pocket limits, and trends over time.