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Medication Pricing & Affordability stories

Oct 13, 2026

UnitedHealth raises 2026 profit outlook as medical cost pressures ease

UnitedHealth Group raised its 2026 profit forecast and reported better-than-expected third-quarter earnings, signaling progress in managing elevated medical costs and its broader turnaround efforts.

Oct 13, 2026·4 sources
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Oct 9, 2026

Hospitals sue Trump administration over 340B drug discount rebate pilot

The American Hospital Association has filed another lawsuit against the Trump administration over plans to convert the 340B federal drug discount program from upfront discounts to after-the-fact rebates.

Oct 9, 2026·2 sources
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Oct 7, 2026

PhRMA sues Trump administration over Medicare drug pricing program

The pharmaceutical industry's main lobbying group filed a lawsuit to block the Trump administration's GLOBE pilot program, which would benchmark US Medicare drug prices to lower international costs. The program aims to test 'most-favored nation' pricing policies.

Oct 7, 2026·3 sources
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Sep 30, 2026

Trump administration finalizes Medicare drug pricing rule with $440 million in savings

CMS finalized the GLOBE demonstration program aimed at matching Medicare drug prices to international rates, but projected savings fell dramatically from $11.9 billion to $440 million after exempting 96% of drugmakers. Only four companies will participate after others signed separate pricing agreements.

Sep 30, 2026·4 sources
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Sep 28, 2026

Medicare drug price negotiations strain oncology practices despite patient cost relief

The Inflation Reduction Act's Medicare out-of-pocket cap is reducing costs for cancer patients, but community oncology leaders warn that negotiated drug price cuts are creating financial pressures on medical practices.

Sep 28, 2026·2 sources
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Sep 17, 2026

CVS Aetna streamlines cancer prior authorizations into single unified request

CVS Health's Aetna insurance division is combining all different preapproval requirements for cancer care into one unified request starting next year, simplifying the authorization process for cancer patients.

Sep 17, 2026·3 sources
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Sep 14, 2026

New documents reveal problems with Medicare's AI prior authorization pilot

Newly released records show Medicare's controversial AI-based prior authorization pilot program experienced lengthy treatment delays, technical problems, backlogs, and early warnings about contractor readiness issues.

Sep 14, 2026·2 sources
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Sep 13, 2026

US Medicare most-favored-nation drug pricing policy could delay launches in lower-price markets

A new modeling study published in The Lancet suggests that US Medicare's most-favored-nation pricing policy, which ties Medicare payments to prices in other high-income countries, could reduce US spending on brand-name drugs but incentivize pharmaceutical companies to increase prices or delay launches in lower-price markets like Europe.

Sep 13, 2026·3 sources
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Sep 9, 2026

Trump administration announces $500 Obamacare rebate checks for 1 million enrollees

President Trump announced plans to send $500 rebate checks to approximately 1 million Americans in 30 states who the administration claims were overcharged for Affordable Care Act coverage, with the payments expected before the November midterm elections.

Sep 9, 2026·4 sources
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Sep 8, 2026

Sandoz CEO warns Trump generic drug tariffs would raise costs for American patients

The CEO of Swiss pharmaceutical company Sandoz cautioned that President Donald Trump's threatened tariffs on generic drugs would ultimately be paid by American patients, as manufacturers could pass increased costs onto consumers.

Sep 8, 2026·1 source
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Sandoz CEO warns Trump generic drug tariffs would raise costs for American patients

The CEO of Swiss pharmaceutical company Sandoz cautioned that President Donald Trump's threatened tariffs on generic drugs would ultimately be paid by American patients, as manufacturers could pass increased costs onto consumers.

Sep 8, 2026·1 source
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Sep 1, 2026

UnitedHealthcare removes prior authorization requirement for 1,700 procedure codes

UnitedHealthcare announced it is eliminating prior authorization requirements for 1,700 diagnostic and procedure codes starting in October 2026, part of its commitment to reduce utilization management controls by 30%. The move received cautious approval from healthcare experts, though some questioned the practical impact of the changes.

Sep 1, 2026·3 sources
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Kenya signs deal with Pfizer to cut cancer drug prices by more than seven times

The Kenyan government has reached an agreement with US pharmaceutical company Pfizer that will reduce the cost of cancer medications by more than sevenfold, according to President William Ruto. The deal is expected to significantly lower treatment costs for cancer patients across the country.

Sep 1, 2026·1 source
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Aug 26, 2026

White House to announce new drug pricing deals with biotech companies

The Trump administration plans to announce a new round of drug-pricing agreements with several midsized biotech companies on Monday, according to people familiar with the matter.

Aug 26, 2026·2 sources
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RevMed's pancreatic cancer pill daraxonrasib wins FDA approval at $475,000 annual cost

Revolution Medicines' breakthrough pill targeting KRAS mutations in advanced pancreatic cancer received FDA approval, priced at over $475,000 per year. The drug nearly doubles survival in patients with this hard-to-treat cancer.

Aug 26, 2026·2 sources
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Aug 25, 2026

US employers increasingly dropping weight-loss drug coverage as healthcare costs rise nearly 10%

About 14% of US employers plan to drop GLP-1 drug coverage in 2027 as healthcare costs are projected to increase by nearly 10%, according to surveys from the Business Group on Health and Aon.

Aug 25, 2026·2 sources
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Aug 20, 2026

U.S. employer healthcare costs projected to rise 9.5% in 2027, exceeding $19,000 per employee

Insurance broker Aon forecasts U.S. employer healthcare costs will jump 9.5% in 2027 to over $19,000 per employee on average, driven by increased medical utilization and high-priced drug spending, representing potentially the largest increase in two decades.

Aug 20, 2026·2 sources
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Aug 14, 2026

Two-thirds of new drugs launched above cost-effectiveness thresholds, ICER reports

A new ICER analysis found that net launch prices for new medicines spiked significantly between 2022 and 2025, with two-thirds of new drugs priced above cost-effectiveness guidelines. About a quarter of drugs launched in the most recent year had annual net prices exceeding $500,000.

Aug 14, 2026·5 sources
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Aug 3, 2026

Sandoz to pay $478.5 million to settle price-fixing allegations

Sandoz agreed to pay $478.5 million to settle long-running price-fixing allegations with multiple U.S. states in a major pharmaceutical antitrust case.

Aug 3, 2026·1 source
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Sandoz agrees to $450 million settlement with 43 US states over generic drug price-fixing allegations

Swiss generic drugmaker Sandoz has reached a settlement agreement to pay $450 million to 43 US states and territories to resolve antitrust litigation alleging anti-competitive conduct and price manipulation in the generic medicines market. The settlement includes no admission of wrongdoing and will not affect the company's financial guidance.

Aug 3, 2026·9 sources
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Jul 7, 2026

CMS Proposes Cuts to 340B Drug Pricing Program Payments in 2027 Medicare Rule

The Centers for Medicare & Medicaid Services has proposed cutting Medicare payments for drugs purchased under the 340B Drug Pricing Program in its 2027 rule, reigniting a long-standing dispute between safety-net hospitals and federal regulators over the program designed to help vulnerable populations access medications.

Jul 7, 2026·2 sources
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Jun 27, 2026

States target pharmacy benefit managers in effort to lower prescription drug prices

Multiple U.S. states are implementing measures to regulate pharmacy benefit management companies that oversee prescription drug coverage for health insurers, as part of efforts to reduce medication costs for consumers.

Jun 27, 2026·2 sources
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May 18, 2026

Supreme Court Rejects Challenge to Medicare Drug Price Negotiation

The U.S. Supreme Court has rejected a legal challenge to Medicare's drug price negotiation program, a decision that may make remaining pharmaceutical industry lawsuits more difficult to pursue.

May 18, 2026·1 source
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May 13, 2026

Optum Rx Replaces Traditional PBM Model with Flat Fee-Based Structure

Optum Rx announced it will transition away from the traditional pharmacy benefit manager model to a flat service fee structure, with group purchasing fully converting to flat fees by end of 2027.

May 13, 2026·1 source
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May 6, 2026

UnitedHealthcare Eliminates Prior Authorization Requirements for 30% of Healthcare Services

UnitedHealth's insurance unit announced it will eliminate prior approval requirements for 30% of healthcare services, reducing delays and paperwork for patients and doctors. This represents a major policy shift affecting one of the nation's largest health insurers.

May 6, 2026·1 source
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May 1, 2026

U.S. prescription drug spending projected to exceed $1 trillion in 2026, driven by weight-loss medications

Americans are expected to spend more than $1 trillion on prescription drugs in 2026, according to a new report from the American Society of Health-System Pharmacists. The surge is largely attributed to the growing popularity of GLP-1 weight-loss drugs.

May 1, 2026·3 sources
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Apr 30, 2026

Supreme Court Hears Arguments on 'Skinny Labeling' Generic Drug Case

The Supreme Court heard oral arguments on a case involving 'skinny labeling' practices that have significant implications for generic drug availability and access, with justices appearing to signal the practice may survive legal challenge.

Apr 30, 2026·2 sources
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Apr 27, 2026

Mark Cuban’s Cost Plus Drugs Targets Employer Health Costs With New Plan

Cost Plus Drugs introduces a new strategy to partner with employers, aiming to lower prescription drug costs through transparent pricing and direct distribution models.

Apr 27, 2026·2 sources
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Apr 20, 2026

CVS Caremark Settles with FTC Over Drug Rebate Practices, Agrees to Count TrumpRx Purchases Toward Deductibles

CVS Health's Caremark pharmacy benefits unit reached a settlement with the U.S. Federal Trade Commission to curb controversial rebate practices in the pharmacy benefits market. The agreement requires Caremark to count consumer purchases from Trump's TrumpRx program toward insurance deductibles, mirroring a similar settlement previously reached with Cigna.

Apr 20, 2026·4 sources
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Apr 14, 2026

Maryland Sets First State-Level Price Cap on Diabetes Drug Jardiance

Maryland's state affordability board has set its first-ever price cap for a prescription medicine, targeting the type 2 diabetes drug Jardiance. The board will oversee a process to lower the drug's cost by January 2027.

Apr 14, 2026·1 source
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Apr 7, 2026

Biosimilar drugs gain ground in US market with new approvals and market leadership

The FDA approved Ranluspec as the first interchangeable ranibizumab biosimilar, Biocon launched denosumab biosimilars Bosaya and Aukelso in the US, and Celltrion's Truxima became the first Korean biosimilar to lead its segment in US prescriptions.

Apr 7, 2026·3 sources
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Apr 4, 2026

Trump Administration Negotiates Drug Pricing Deals with Smaller Pharmaceutical Companies

The White House is negotiating new drug-pricing agreements with smaller biotechnology companies facing the threat of 100% tariffs on imported medicines, according to multiple sources with knowledge of the meetings.

Apr 4, 2026·1 source
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Mar 24, 2026

FTC Reaches Settlement with CVS Over PBM Insulin Price Manipulation

The Federal Trade Commission struck a proposed settlement with CVS over charges that its pharmacy benefit manager manipulated insulin prices and impeded patient access. The FTC estimates the settlement will save Americans up to $7 billion in out-of-pocket costs over 10 years.

Mar 24, 2026·1 source
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Feb 6, 2026

Trump Announces Phased Tariff Plan on Generic Drug Imports: 0% Until 2028, Then 100% and 200%

President Donald Trump announced that imported generic drugs will face no tariffs for two years starting August 1, 2026, after which tariffs will rise to 100% in August 2028 and 200% from 2029 onward. The policy aims to encourage domestic pharmaceutical manufacturing but raises concerns about future drug price increases for consumers.

Feb 6, 2026·9 sources
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Dec 18, 2025

Trump announces all 50 states to participate in Medicaid 'most favored nation' drug pricing program

President Trump announced that all 50 states, Washington D.C., and Puerto Rico have agreed to participate in his administration's 'most favored nation' drug pricing initiative for Medicaid programs, which aims to lower prescription drug costs by tying prices to those paid in other countries.

Dec 18, 2025·6 sources
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Top claims

  • ▪UnitedHealth Group's two-year turnaround follows a financial crisis in 2025 caused by a major cyberattack, missed earnings targets, and the killing of a top executive outside its investor meeting in New York nearly two years ago
  • ▪The full-year 2026 profit outlook increase marks the third time UnitedHealth Group has raised its annual guidance during 2026
  • ▪UnitedHealth Group's medical cost ratio was reduced by a $610 million reserve benefit resulting from lower-than-expected medical cost claims for services rendered earlier in 2026

People involved

Donald TrumpWilliam Ruto

Subtopics

Drug Policy, Pricing & Approval35Drug pricing policy13Pharma11US health policy & drug pricing10Drug Approval and Clinical Trials8Government and Regulatory Policy8Healthcare Access and Insurance8Healthcare Policy8Pharmaceutical Industry7Public healthcare7Regulatory compliance7Drug pricing6FDA regulation & drug policy6Generic drugs & biosimilars6Medicare & drug pricing policy6Drug Classes & Treatment Access5Healthcare costs5Trump administration5US healthcare regulation5Medicare4Prior authorization4Tariffs & trade wars4Pharmaceutical pricing3AI regulation & lawsuits2

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