December 29, 2025
Obesity Model & “Deal” Demo Exclusions
CMS’s BALANCE Model to facilitate coverage of anti-obesity medications (AOMs) [LLY, NVO] in Medicaid and Medicare Part D (PD) (standalone and Medicare Advantage plans) – released Dec. 23 – while still lacking key details, provides…
October 1, 2025
Rx Pricing: More Shoes to Drop or Clearing Event?
The White House’s Rx pricing agreement with PFE yesterday – with the promise of additional company deals next week – may provide industry with some incremental goodwill, but we are dubious that it takes broader…
September 10, 2025
Rx Advertising: Policy Quick Take
While we can at this point give no better than tossup odds to FDA plans to curtail direct-to-consumer (DTC) drug advertisements surviving inevitable legal challenges, we caution that the enforcement approach outlined by the agency…
August 12, 2025
Rx Most Favored Nation Company Risks
With President Trump demanding “binding commitments” from drug manufacturers to offer Most Favored Nation (MFN) pricing by Sept. 29, we outline company-specific revenue risks and our expectations for an eventual regulatory proposal in 4Q25 /…
June 27, 2025
[EXAS, GH, GILD, MYGN, HOLX] Preventive Services: SCOTUS Takes
Consistent with our expectations, the Supreme Court today upheld the validity of U.S. Preventive Services Task Force (USPSTF) appointments and – by extension – the mandate that insures cover recommended services without patient cost-sharing, lifting…
May 7, 2025
Rx Most Favored Nation (MFN) Estimates
We continue to assign ~35% odds to Congress including Medicaid Most Favored Nation (MFN) price controls into its broader reconciliation bill given: (A) the complexities of such a policy; (B) the expedited timeline lawmakers are…
November 15, 2024
RFK to HHS: Biopharma / Lifesciences Smoke or Fire?
Key Takeaways: We are initially skeptical that Trump’s selection of Robert F. Kennedy Jr. (RFK) to lead HHS can survive Senate confirmation but, if we are wrong, would note that any HHS secretary is constrained…