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- Approximately 5 million fewer Americans are enrolled in ACA marketplace plans in 2026 compared to the record high of 24.2 million in 2025, according to HHS data. - The enrollment decline followed Congress's failure to extend enhanced premium tax credits, causing premiums to double on average from 2025 to 2026. - Loss of coverage threatens preventive care access, chronic disease management, and infectious disease control, potentially leading to worse health outcomes nationwide. - Experts warn that healthier individuals disproportionately dropping coverage could destabilize insurance markets and drive premiums higher for those who remain.
- Costco and not-for-profit insurer SCAN Group announced a partnership to launch a Costco-branded Medicare Advantage plan, initially in two states. - SCAN Group CEO Dr. Sachin Jain said the companies are also developing a Medigap supplemental plan for a third state, pending regulatory approval. - The collaboration builds on Costco's existing role as a preferred pharmacy for SCAN's nearly 460,000 Medicare Advantage members across five states. - The move deepens Costco's push into healthcare as some insurers scale back Medicare Advantage ambitions amid rising medical costs and tighter reimbursement.
- Commercial healthcare costs are projected to rise 9% in 2027, the highest medical cost trend in nearly two decades, according to PwC's analysis of 27 health plans covering over 103 million members. - Nearly 70% of surveyed health plans ranked providers' use of AI documentation and coding tools as a top-three cost inflator, with about 20% calling AI the number one inflationary trend. - Blue Cross Blue Shield analysis found approximately $663 million in inpatient spending and $1.67 billion in outpatient spending may be tied to AI-powered coding practices. - Experts note that AI follows existing fee-for-service incentives, increasing documentation and coding severity before it can potentially reduce costs through administrative automation.
- The bipartisan Patients Before Monopolies Act would force healthcare conglomerates like Cigna, CVS Health, and UnitedHealth to divest their retail and specialty pharmacies within one year. - Specialty pharmacy has grown to 35% of PBM revenues by 2023, making mandated divestiture a far greater threat to industry profitability than existing federal reforms. - Current reforms under the Consolidated Appropriations Act require 100% rebate pass-through and delink PBM compensation from drug list prices, but won't be fully implemented until 2029. - Experts warn that without breaking up vertically integrated structures, PBMs will continue finding ways to offset lost revenue and maintain opaque, anticompetitive practices.
- CVS Health's Caremark unit will replace Amgen's Prolia and Eli Lilly's Forteo with lower-cost biosimilar and generic alternatives on major commercial formularies starting April 1, 2026. - The formulary changes are expected to reduce prescription costs by more than 50% compared to branded drugs, building on CVS's successful biosimilar strategy that has generated $1.5 billion in gross savings. - This move follows CVS's previous decision to exclude AbbVie's Humira from formularies in favor of biosimilars, with 96% of Caremark members successfully transitioning to cheaper alternatives. - The strategy targets osteoporosis treatments after key patents expired for Prolia in 2025 and Forteo in 2019, opening the market to biosimilar competition.
- Abeona Therapeutics has identified 30 eligible patients for ZEVASKYN gene therapy treatment at specialized centers, with 12 patients in the process of scheduling treatments for recessive dystrophic epidermolysis bullosa (RDEB). - Major commercial payers including UnitedHealthcare, Cigna, Aetna, Anthem, and most Blue Cross Blue Shield plans have published policies covering ZEVASKYN treatment. - The company plans to scale manufacturing capacity from current four to six monthly slots to ten slots by mid-2026, with further expansion planned by end of 2027. - ZEVASKYN received a permanent J-Code effective January 1, 2026, which is expected to streamline billing processes for clinics administering the therapy.
- HeartFlow received FDA 510(k) clearance for its Next Generation Plaque Analysis platform, featuring an updated algorithm that shows 21% improvement in plaque detection compared to the first-generation version. - The AI-powered platform demonstrates 95% agreement with the gold standard IVUS and leverages data from approximately 273,000 patients, representing a dataset 9x larger than current plaque quantification studies. - Cigna announced nationwide coverage for HeartFlow Plaque Analysis across all business lines beginning in October, becoming the second national insurer to adopt coverage following UnitedHealthcare. - The DECIDE Registry data showed that HeartFlow Plaque Analysis led to medical management changes in over 50% of patients beyond coronary CTA alone, resulting in an expected 15% event reduction.
- CVS Health, the largest U.S. pharmacy benefit manager, will not add Gilead's new HIV prevention drug Yeztugo to its commercial plans, citing clinical, financial, and regulatory factors despite the drug's proven 99.9% effectiveness. - The decision reflects concerns over Yeztugo's $28,000 annual list price, with CVS stating it's inappropriate for manufacturers to manipulate guidelines with clinically similar products priced far higher than existing options. - AIDS activists call the decision a "grave disappointment" and missed opportunity, as Yeztugo could be transformative in ending the HIV epidemic that infects 1.3 million people annually. - Gilead remains confident in securing 75% U.S. insurer coverage by year-end and 90% by June 2026, with government programs and several state Medicaid plans already providing coverage.
- Cigna filed a federal lawsuit against Bristol Myers Squibb, alleging the company used anti-competitive strategies to maintain a monopoly on Pomalyst, a multiple myeloma treatment that generated $2.7 billion in U.S. sales last year. - The insurer claims Bristol Myers' subsidiary Celgene filed sham patent lawsuits and paid off generic manufacturers to prevent lower-cost alternatives from entering the market. - Cigna alleges Celgene defrauded the U.S. Patent and Trademark Office by withholding information about an existing patent and claiming unexpected positive results to strengthen patent protections. - The lawsuit seeks triple damages for alleged overcharges of "many hundreds of millions, if not billions, of dollars" caused by the monopolistic practices.
- The three largest U.S. pharmacy benefit managers have excluded nearly all marketed Humira biosimilars from their 2025 standard formularies, marking a dramatic shift from 2024 when eight products were covered. - PBMs are prioritizing their own private-label biosimilars through subsidiaries like Cordavis, Quallent, and Nuvaila, offering plan sponsors high-list-price and low-list-price options while excluding manufacturer-branded competitors. - Industry experts warn this formulary strategy may discourage future biosimilar market entry and manufacturer investment, potentially reducing long-term competition despite current cost benefits for payers.
