GLP-1 Drugs Pose Coverage Challenges Amid Proven Health Benefits
Analysis finds GLP-1 drugs like semaglutide offer real health benefits but raise insurance coverage and cost challenges amid growing demand in the U.S. market.
Top 5 U.S. Health Policy Priorities for Congress Post-Recess
Congress returns from recess with five key U.S. health policy priorities including FY26 appropriations, OTC drug fee program reauthorization, drug pricing reform, Medicare/Medicaid extenders, and ACA tax credits.
Medicare Coverage Limits for Saxenda Highlight Challenges in Weight Loss Drug Access
Explore Medicare coverage limitations for Saxenda, a GLP-1 agonist approved for weight loss, and the implications for obesity drug access and insurance plan strategies.
Medicare Part D Premiums May Rise Up to $50 Monthly in 2025
Medicare Part D enrollees may face significant premium hikes up to $50 monthly in 2025 due to increased drug spending, policy changes, and reduced federal stabilization funding. Compare plans during open enrollment.
CMS Proposes Voluntary Medicaid and Medicare GLP-1 Coverage Trial
CMS plans a voluntary five-year trial allowing state Medicaid and Medicare Part D plans to cover GLP-1 weight management drugs, including Ozempic and Wegovy, starting in 2026-27 amid pricing and coverage challenges.
CMS Price-Substitution Policy Saves $76M on Medicare Drugs Since 2013
CMS's price-substitution policy has saved $76 million for Medicare by correcting drug pricing identified by the Office of Inspector General, improving cost efficiency while maintaining access.
Legislative Changes Delay Medicare Drug Price Negotiations for Expensive Cancer Medications
Recent Republican-led legislative changes delay Medicare drug price negotiations for costly cancer treatments, maintaining high patient costs and impacting seniors and disabled Americans.
CMS Proposes Key Medicare Part B Pricing and Reporting Updates for 2026
CMS's 2026 proposed rules for Medicare Part B include major updates to average sales price calculations, Inflation Reduction Act compliance, ASP documentation, and Medicare inflation rebates affecting government pricing.
Novo Nordisk Expands Wegovy Access with New Pricing and Legal Actions
Novo Nordisk expands access to Wegovy with a new self-pay pricing program and pursues legal actions against unauthorized compounded drug sales, impacting the obesity treatment market.
Pfizer Engages with U.S. Government on Drug Pricing Policy Discussions
Pfizer and other pharmaceutical firms have discussed most-favored-nation drug pricing with the U.S. government, highlighting potential impacts on insurance and payer strategies.