Aduhelm — the pricey Alzheimer's drug that sparked congressional scrutiny of the Food and Drug Administration's process for fast-tracking approvals as well as fears of Medicare insolvency — is coming off the market, drugmaker Biogen said Wednesday.
Why it matters: Despite Aduhelm's lackluster performance, its accelerated approval in June 2021 drove urgent conversations about how the health care system can afford a new wave of expensive treatments that for the first time slow Alzheimer's progression, albeit mildly.
Hundreds of thousands of Texans recently have lost Medicaid coverage due to faulty eligibility software from Deloitte, consumer advocacy groups alleged in a complaint to the Federal Trade Commission on Wednesday.
Why it matters: While the filing is focused on Medicaid redeterminations in Texas, where about 1.8 million people have been removed from the rolls since April, the advocates claim the issues are part of recurring problems with eligibility systems Deloitte has provided to state Medicaid programs.
Insurers who administer private Medicare plans would see their base payments cut slightly next year, by 0.16%, under a federal proposal announced Wednesday.
But the insurers still could see $16 billion more in 2025 revenues once payments are adjusted based on how sick their enrollees appear, Medicare officials said.
Why it matters: More than half of Medicare enrollees now get their coverage from Medicare Advantage plans. But experts say the plans are overpaid and that coverage costs taxpayers tens of billions of dollars more than it should.
New Medicare drug pricing negotiations, which kick into high gear Thursday, for the first time will allow the federal government to tie a medicine's price to how well it works compared with similar treatments.
Why it matters: Other countries already make these kind of value assessments, but it's a fundamental shift for the U.S. government to wade into a process that involves making challenging — and sometimes politically sensitive — calculations about how to value the benefits drugs provide.
Surging demand for blockbuster anti-obesity drugs like Ozempic and Wegovy lifted Novo Nordisk's market value past $500 billion on Wednesday, cementing the Danish drugmaker's status as Europe's biggest company by market cap.
Why it matters: The company's value is more than $100 billion above Denmark's entire GDP, and the GLP-1 drugs could help its sales grow as much as 26% this year.
Fewer than 1 in 5 adults (17%) say they know how much health care products or services will cost in advance, according to new Gallup polling with Bentley University.
Zoom in: No matter how you slice up the data — by age, education level, insurance status, etc. — the results were pretty much the same, "suggesting a society-wide lack of awareness" about personal health care costs, Gallup's Stephanie Marken wrote in a memo.
The stepped-up demand for medical care that's left health insurers nervous is bringing good vibes to the hospital industry, whose outlook was buoyed Tuesday by HCA Healthcare's better-than-expected fourth quarter earnings.
Why it matters: A post-pandemic surge in outpatient care driven by Medicare enrollees who deferred surgeries during the crisis has been good news for hospital operators who've also seen their margins improve and were able to reduce their reliance on costly contract labor where possible.
As everyone in health care is trying to figure out which patients should get pricey new weight-loss drugs, a biotech company spun out of the Mayo Clinic is betting the genetics-based approach it's pioneering may hold the answer.
Why it matters: Despite soaring demand for the class of drugs known as GLP-1s, certain patients may do better with older and cheaper treatments for obesity.
"Sesame Street" favorite Elmo's wellness check-in post on X asking "How is everybody doing?" has been met with thousands of responses this week.
The big picture: Many made clear in the comments section that they're not doing so well — with some citing being laid off, feeling tired or noting they're "depressed and broke."
