Health Care Cost

New bipartisan legislation would ban parent companies from owning insurers or PBMs and providers or management services organizations simultaneously.

As pharmaceutical R&D policies evolve, the authors argue it is crucial to embed American patient values in reimbursement deliberations and frameworks.

The Orphan Drug Act has boosted treatments, but Kristi Martin, MPA, MA, urges modernizing incentives and pricing to sustain future innovation.

A large commercial insurer is increasingly covering acupuncture, which is a safe and effective alternative to opioids, for multiple pain conditions.

The Consolidated Appropriations Act of 2026 gives CMS more leverage to intercept when pharmacy benefit managers are driving up prices in Medicare Part D, explains Jesse Dresser, Esq.

Poland’s senior prescription subsidies cut drug costs and catastrophic pharmacy spending for adults aged 75 or older.

A Commonwealth Fund analysis finds employer health premiums and deductibles exceed 10% of income in 19 states, worsening affordability gaps.

PBM reforms, Medicare Advantage trends, TrumpRx launch, and Express Scripts settlement highlight key shifts in drug pricing, coverage, and patient access.

Ameet Patel, MD, discusses scaling CAR T-cell therapy and bispecific therapies to improve access and potentially cure multiple myeloma.

The Consolidated Appropriations Act of 2026 acts as a first step in addressing prescription drug pricing challenges related to the role of pharmacy benefit managers (PBMs).

From prior authorization delays to PBM reforms and Medicaid gaps, experts track policy shifts that shape health equity and health care access nationwide.

Oral semaglutide (Wegovy; Novo Nordisk) expands GLP-1 weight-loss options, but pharmacy budgets and health care cost pressures persist.

First announced in September 2025, the online platform is set to offer access to prescription medications at steep discounts, with potential savings in the millions.

Oral Wegovy shifts GLP-1 obesity costs: insurance may match injectables, while cash-pay and pharmacy platforms unlock lower prices and aid programs.

The FTC first sued Express Scripts, CVS Caremark, and Optum in 2024, claiming anticompetitive and unfair rebating practices surrounding insulin.

Finance Committee leaders propose expanding Medicare negotiation, curbing middlemen, and reinvesting in biomedical innovation as part of a 2026 health care affordability strategy.

The Consolidated Appropriations Act of 2026 features new language that could change the way that pharmacy benefit managers (PBMs) operate in the US.

Increasing Medicare Advantage payments for full Medicaid enrollees was not associated with meaningful changes in inpatient or nursing home use.

The Orphan Drug Act revolutionized rare disease treatment, yet rising costs and access issues challenge equitable health care solutions.

Prior authorization remains a major health care barrier, causing delays and frustrations for insured adults seeking necessary treatments.

Explore critical health equity issues as barriers to care access and health disparities that impact treatment for allergic rhinitis and childhood vaccinations.

The upcoming price negotiations are the third cycle since the Inflation Reduction Act was passed in 2022.

CMS’s 2027 proposed MA payment rate increase of .09% falls short of expectations, potentially increasing premiums and reducing benefits for seniors.

Adults who are underweight, overweight, or obese face higher medical expenditures, varying by age, sex, and care setting.

Research reveals that socioeconomic status significantly impacts survival rates in young adults with metastatic colorectal cancer, emphasizing the need for health equity initiatives.