Posts Tagged ‘PBMs’

Health Insurance Chaos and GLP-1 Coverage Trends

January 30, 2026 — Good luck if you want to make sense of headlines about health insurance and coverage trends for GLP-1 medicines. Peruse the headlines and you can find just about any narrative you want. “Rising health premiums push more small business to drop coverage,” according to Inc. “Employers are opting out of covering GLP-1s,” claims Hines, a […]

Profiteering and the Criminal Trade in Bogus Obesity Medicines

December 15, 2025 — Business is apparently booming in the criminal trade for bogus obesity medicines. The Times (London) reports that criminals are selling dangerous weight-loss jabs on social media and in gyms. They write that: “Pharmaceutical bosses have issued a stark warning about medicines such as Mounjaro sold online without safety controls as gangs branch out from hard […]

Striking Growth of GLP-1s in Women with PCOS

December 14, 2025 — Truveta this week published data that reveals striking growth in the use of GLP-1s by women with PCOS (polycystic ovary syndrome). Prescriptions for semaglutide or tirzepatide have risen by more than 700% in women with PCOS, according to their analysis. So don’t think that this is slipping right by the bean counters at drug benefit […]

Are PBMs Becoming Irrelevant?

November 24, 2025 — Americans are only barely aware of the role that pharmacy benefit managers play in health insurance. But what they do know is not good. To the extent that most people know anything about these shadowy players in health insurance, they know PBMs control which drugs they can get, how much hassle it is to get […]

A Striking Contrast in Heart Disease Outcomes at ESC 2025

September 1, 2025 — Researchers presented and published two major studies of heart disease outcomes at the ESC Congress of the European Society of Cardiology over the weekend with strikingly different findings. In the REBOOT study, scientists found that beta blockers have no effect on outcomes when given to patients after a heart attack. None. People might be better […]

Is a Door Opening for Obesity Medicines in Medicare?

August 2, 2025 — When the new administration announced in April that it would not be implementing expanded access to obesity medicines in Medicare, they suggested this would not be the final word. Yesterday, we got a hint of what might come. Paige Winfield Cunningham reported in the Washington Post that CMS has drafted a plan to allow Medicare […]

As Legitimate GLP-1 Compounding Ends, Rabbit Holes Open Up

May 2, 2025 — The last legitimate path for GLP-1 compounding closes on May 22 and consumer protection advocates are worried about rabbit holes opening up to exploit the desperation of some patients. Yesterday, the National Consumer League (NCL) released survey results to suggest a great deal of confusion and misinformation about off-brand versions of GLP-1 medicines. Perhaps more […]

Access to Care for Obesity: Steps Forward and Back

March 24, 2025 — There’s no denying it. More people are getting access to care for obesity than ever before. In part this is because health professionals have a range of tools for providing that care. GLP-1 agonists like semaglutide and tirzepatide are a big part of that.But those drugs carry a price tag that is blowing up pharmacy […]

Skimming Profits, Sowing Disparities, and Dimming Prospects

February 12, 2025 — The revolution in obesity care brought on by semaglutide and tirzepatide is beginning to look a little shaky, says Tina Reed on Axios. The U.S. healthcare system is skimming profits from them, thus sowing disparities, and quite possibly dimming the prospects for broad gains in health. Peter Antall is Chief Medical Officer at the digital […]

Let’s Check the Scorecard on Our 2024 Predictions

December 30, 2024 — This year is rapidly winding down and already, our gaze is shifting toward expectations for the coming year. So before that shift is complete and we start making predictions for 2025, let’s check the scorecard for the expectations we had for 2024. A year ago, we put forward predictions of five hot topics for the […]