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,…
January 11, 2025
[HUM, UNH, CVS, ELV, ALHC] CY26 Medicare Advantage Rates: Likely Upswing in the Final
CMS’s Friday release of the CY26 Advance Notice (AN) for Medicare Advantage (MA) insurers [HUM, UNH, CVS, ELV, ALHC, CLOV, CNC] came in better than our net YoY benchmark expectations with a proposed net increase…
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 6, 2024
[HUM, ALHC, UNH, CVS, ELV, AGL] Expectations for CY26 Medicare Advantage Advance Notice
KEY TAKEAWAYS: We expect the proposed YoY change in the CY26 benchmarks for Medicare Advantage (MA) plans is likely to be relatively flat, with a range between -1% and +1% that excludes coding trend, but…
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…
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….