January 16, 2025
UNH: Though Confident, Public Policy Questions Remain
UnitedHealth’s (UNH) comments during its 4Q and full year 2024 earnings call about changes its it taking to head off certain public policy concerns (PBMs, prior authorization/claim denials) seem like the company is in catch-up…
January 14, 2025
[CVS, CI, UNH]: FTC 2nd (Negative) Report on PBMs Doesn’t Change Overhang Trajectory
The FTC’s unanimously-supported release of its second interim report on pharmacy benefit managers (PBMs), focused on specialty drug dispensing at affiliated pharmacies [CVS, CI, UNH] that generated an extra $7.3B in revenue over six years,…
December 18, 2024
[PBMs, Cancer Screening, Medicare Advantage] A Few Surprises in the Healthcare Spending Package but Otherwise Mirroring Prior Compromise
Following Tuesday night’s release of a short-term continuing resolution (CR) funding the government through March 14, we outline some key differences from previously-reported iterations of the healthcare extenders package, involving PBMs [CI, CVS, UNH, ELV],…
December 13, 2024
[PBMs, Hospitals, Docs] Healthcare Extenders: State of Play
While Republicans and Democrats are trying to hash out a healthcare extenders package to add to a short-term government funding measure that needs to be taken up and passed by next Friday, we ascribe just…
December 11, 2024
[CVS, CI, UNH] PBMs: Proposed Ban on Pharmacy Ownership, New FTC Chair Nominee, Trump’s Comments, Healthcare Extenders, Oh My!
Key Takeaways: While we had expected pharmacy benefit managers [PBMs] to remain in the legislative / regulatory crosshairs during the lame duck and into the Trump administration, recent developments confirm that the anti-PBM sentiment is…
December 11, 2024
Trump’s Anti-Trust Team Taking Shape
President-elect Trump’s announcement last night that he intends to name current FTC commissioner Andrew Ferguson to chair the agency reinforces our long-held view that, in general, M&A / antitrust under Trump will be more market…
December 9, 2024
[WBA, CVS] SCOTUS Sides with Arkansas Law; For Now, Contract Pharmacies Have Upper Hand vs. Pharma
This morning, the Supreme Court (SCOTUS) afforded a win to state laws protecting the use of contract retail, mail-order and specialty pharmacies (WBA, CVS, WMT, UNH, CI, RAD) that arehired by 340B hospitals and clinics…
December 3, 2024
[WBA, CVS, WMT] 340B Case on Deck at SCOTUS Conference; Regardless of Resolution, Target Remains on 340B
We could see some short-term positive news for retail, mail-order and specialty pharmacies (WBA, CVS, WMT, UNH, CI) if the Supreme Court decides not to hear the appeal of PhRMA v. McClain, a development that…
November 19, 2024
Healthcare Extenders in FY25 Spending Bill: What Is Likely, Unlikely or Toss-Up?
With likelihood growing that Congress focuses on emergency spending and a short-term continuing resolution funding the government into Q1 next year during this lame duck period, we expect that translates to Congress punting on nearly-annual,…
October 21, 2024
Managed Care Policy Puts and Takes
Key Takeaways: We remain optimistic about the long-term policy outlook for the managed care industry, despite the puts and takes for different business lines associated with the outcome of the upcoming elections on Nov. 5….