Good morning. If you're into stories about creative health care fraud involving extremely expensive skin cream, here ya go.
Here's an eye-popping stat to start your morning off with: The 5 largest conglomerates combining health insurance and pharmacy benefits are on track this year to be bigger than the 5 preeminent tech companies, my colleague Bob Herman reports.
Yes, but: The tech companies cumulatively were 5 times more profitable than the health care companies in 2018 and are projected to be 3.5 times more profitable this year.
It's also worth remembering health insurance giants today do a lot more than just paying out claims for medical care and prescriptions.
The debate around prescription drug prices — including the Trump administration's proposal tying some Medicare drug prices to what other countries pay — raises an important question: How do other countries decide what to pay for drugs?
The bottom line: All of these methods are complicated and have their own drawbacks, but the question of how to regulate drug prices has been asked and answered many times before.
Georgia Gov. Brian Kemp plans to seek a waiver for something-short-of-full Medicaid expansion, according to the Atlanta Journal-Constitution.
In Utah, a bill that would limit Medicaid expansion to only covering those up to 100% of the poverty level passed the state House of Representatives on Friday after passing the Senate earlier that week, the Deseret News reports.
OptumRx, the pharmacy benefit manager arm of UnitedHealth Group, sent a letter to drug companies in December outlining its demands in the event that the company lowers list prices, according to a Bernstein investor memo.
Our thought bubble: Drug companies and PBMs are openly at war with one another, both from a public relations standpoint and a financial one, and it's in each party’s interest to selectively air practices that may be deemed unsavory.
Thanks for reading, and have a great week!