61 of the drugs with price hikes were being used to treat coronavirus.Jun 29, 2020 - Health
Delayed care is beating COVID-19 cases right now.May 21, 2020 - Health
Part 5 of our What Matters 2020 series.Mar 6, 2020 - Health
Health care is eating up more and more of Americans’ paychecks every year.Dec 22, 2019 - Politics & Policy
Although net prices of brand-name drugs have increased significantly over the last decade, the savings produced by generics have actually driven average prescription prices down in Medicare's pharmacy benefit and Medicaid, according to a new analysis by the Congressional Budget Office.
Why it matters: The analysis reiterates that the generic market is largely working as intended.
The big picture: UnitedHealth's revenue has tripled from 2010 to 2021, and profit has almost quadrupled. The company continues to make more of its money from owning doctor groups and controlling pharmacy benefits instead of relying on health insurance.
Patients who take pre-exposure prophylaxis (PrEP), a medication that prevents HIV, should not be paying anything out of pocket for the drug — or for any blood work or doctor visits associated with getting PrEP.
The big picture: The federal government specifically reminded health insurers last year to make sure those types of ancillary services for PrEP were free at the point of care, but some patients are getting hit with bills anyway.
Six health insurers control roughly three-quarters of the fast-growing Medicare Advantage market, according to an Axios analysis of federal data.
Why it matters: Medicare Advantage enrollment hasn't slowed down in 2022, even though dismal projections from Humana and Cigna freaked out Wall Street earlier this month, and concentration at the top remains high.
More than 28.5 million seniors and people with disabilities were enrolled in a private Medicare Advantage plan as of Jan. 1, an 8.8% increase from the same time in 2021, according to new federal data analyzed by Axios.
Why it matters: Enrollment in the controversial MA program continues to grow, and based on prior full-year trends, enrollment in 2022 likely will surpass the federal government's prediction of 29.5 million people.
The pharmaceutical industry is ready to pressure Medicare and demand the agency reverse its restrictive coverage plan for new Alzheimer's treatments like Aduhelm.
The big picture: Doctors, researchers and health policy experts praised Medicare's proposal as a way to get more data to prove whether Aduhelm works, but with billions of dollars and many other similar Alzheimer's drugs on the line, the industry is prepared for war.
The Federal Trade Commission has the dialysis industry in its crosshairs after it finalized restrictions on DaVita's latest deal in Utah.
The big picture: The FTC under Lina Khan has been heavily focused on antitrust authority over Big Tech, but the agency also has taken more critical looks at health care deals that further hurt competition and could lead to higher prices.
Why it matters: Medicare is sending a signal to the pharmaceutical industry that Aduhelm — an IV medication with unproven clinical benefit, serious side effects and a $28,000 annual price tag — and other Alzheimer's drugs must show they work to gain Medicare's full coverage and payment.
Why it matters: Under President Biden's strategy to expand access to free COVID testing, insurers will either cover costs upfront or reimburse people after they submit claims.
Because Biogen lowered the price of Alzheimer's drug Aduhelm by 50%, the federal government should "reassess" the large pending increase on Medicare's 2022 premiums that cover physician and outpatient care, HHS Secretary Xavier Becerra said in a statement today.
Why it matters: The historically high Medicare premium hike, during a midterm election year, was due in large part to Aduhelm's high price tag.