Health care costs

The big picture

The coronavirus pandemic hasn't stopped drug price increases
The coronavirus pandemic hasn't stopped drug price increases

61 of the drugs with price hikes were being used to treat coronavirus.

Jun 29, 2020 - Health
The coronavirus is slowing health care spending

Delayed care is beating COVID-19 cases right now.

May 21, 2020 - Health
Watch: As Medicare for All debate rages on, costs keep going up

Part 5 of our What Matters 2020 series.

Mar 6, 2020 - Health
The health care debate we ought to be having

Health care is eating up more and more of Americans’ paychecks every year.

Dec 22, 2019 - Politics & Policy
Deep Dive: The drug pricing maze

It can be enormously frustrating for patients — and profitable for everyone else.

Nov 17, 2018 - Health

All Health care costs stories

Jan 20, 2022 - Health

The drugs pushing prescription prices down for Medicare patients

Illustration: Annelise Capossela/Axios

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.

Jan 20, 2022 - Health

The pandemic-proof health care giant

Data: SEC filings; Chart: Jacque Schrag/Axios

The second year of the pandemic did not dampen UnitedHealth Group's finances, and the company actually surpassed its initial 2021 revenue and profit projections.

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.

Jan 20, 2022 - Health

When you're charged a copay you shouldn't owe

Peter Sacco fought with his health plan to clear a copay he should have never been charged. Photo: Peter Sacco

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.

Jan 19, 2022 - Health

The big Medicare Advantage players keep getting bigger

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Note: Insurance startups include Alignment Healthcare, Bright Health, Clover Health and Devoted Health; Data: Centers for Medicare & Medicaid Services; Chart: Jared Whalen/Axios

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.

Jan 18, 2022 - Health

Medicare Advantage enrollment soars almost 9%

Illustration: Aïda Amer/Axios

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.

Jan 14, 2022 - Health

Big Pharma's last-ditch lobbying blitz for Aduhelm

Illustration: Aïda Amer/Axios

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.

Jan 13, 2022 - Health

FTC cracks down on DaVita's market power

DaVita has caught the FTC's attention. Photo: Igor Golovniov/SOPA Images/LightRocket via Getty Images

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.

Jan 11, 2022 - Health

Medicare proposes covering controversial Alzheimer's drug, with restrictions

Aduhelm's list price for the average patient is more than $28,000 per year. Photo: Biogen

Medicare has proposed covering the controversial Alzheimer's drug Aduhelm, but only for patients who enroll in a randomized clinical study.

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.

Jan 10, 2022 - Health

Insurers to cover costs for at-home COVID tests starting Saturday

COVID-19 rapid at-home test kits rest on a table at a free distribution event for those who received vaccination shots or booster shots on Jan. 7 in Los Angeles. Photo: Mario Tama via Getty Images

Health insurers will be required to cover costs for over-the-counter, at-home COVID tests starting this Saturday, the Health and Human Services Department announced Monday.

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.

Jan 10, 2022 - Health

Biden administration wants Medicare to reconsider premium hike

HHS Secretary Xavier Becerra. Photo: Greg Nash-Pool/Getty Images

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.

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