Robert Nelsen is one of the most successful biotech VCs ever, having backed over three dozen companies that reached billion-dollar valuations. He's also a thyroid cancer survivor who credits early detection to a company in which his firm, Arch Venture Partners, never invested.
Why it matters: There is a simmering medical debate over the value of full-body scans, like the one Nelsen received, and thegrowingcohort of venture-backed startups that provide them.
Big Medicaid-managed care plans that serve the majority of the program's beneficiaries are seeing membership slip as more states redetermine program eligibility — a trend that could eat into some of the insurers' bottom lines, according to Georgetown University's Center for Children and Families.
Why it matters: If the remaining Medicaid enrollees as a group are sicker overall, plans may have to eat some of the higher cost of care unless states adjust their payment rates upward.
Why it matters: PBMs may not resonate with the average person the way big drugmakers like Pfizer do, but they play an important role in determining how much people wind up paying for medicines.