Category: drug costs

The Real Costs of the New Alzheimer’s Drug, Most of Which Will Fall to Taxpayers

The annual cost of lecanemab treatment quadruples if the expense of brain scans to monitor for bleeds and other associated care is factored in. The full financial toll likely puts it beyond reach for low-income seniors at risk of Alzheimer’s, experts say.

New Weight Loss Drugs Carry High Price Tags and Lots of Questions for Seniors

Although nearly 40% of Americans 60 and older are obese, Medicare doesn’t cover weight loss medications. Meanwhile, studies haven’t thoroughly examined new drugs’ impact on older adults.

KFF Health News’ ‘What the Health?’: The Long Road to Reining in Short-Term Plans 

It took more than two years, but the Biden administration has finally kept a promise made by then-candidate Joe Biden to roll back the Trump administration’s expansion of short-term, limited-duration health plans. The plans have been controversial because, while they offer lower premiums than more comprehensive health plans, they offer far fewer benefits and are […]

Wait, What’s a PBM?

Pharmacy benefit managers, or PBMs, are companies that negotiate the prices of prescription drugs. Hear about their role in raising drug prices and the ongoing efforts to regulate this complex industry.

What You Need to Know About the Drug Price Fight in Those TV Ads

At least nine bills introduced in Congress take aim at pharmacy benefit managers, the powerful middlemen that channel prescription drugs to patients.

Patients Squeezed in Fight Over Who Gets to Bill for Pricey Infusion Drugs

To drive down costs, insurers are bypassing hospital system pharmacies and delivering high-priced infusion drugs, including some used in chemotherapy, via third-party pharmacies. Smarting from losing out on billing for those drugs, hospitals and clinics are trying to convince states to limit this practice, known as “white bagging.”

Slow Your Disenroll

More than a million Americans have lost Medicaid coverage since pandemic protections ended. The Biden administration is asking states to slow disenrollment, but that does not mean states must listen. Meanwhile, a Supreme Court decision gives Medicaid beneficiaries the right to sue over their care, and a new deal preserves coverage of preventive services nationwide as a Texas court case continues. Rachel Cohrs of Stat, Alice Miranda Ollstein of Politico, and Sandhya Raman of CQ Roll Call join KFF Health News’ Mary Agnes Carey to discuss these issues and more. Also this week, KFF Health News’ Julie Rovner interviews Dan Mendelson, CEO of Morgan Health, a new unit of JPMorgan Chase, about employers’ role in insurance coverage.

Debt Deal Leaves Health Programs (Mostly) Intact

The bipartisan deal to extend the U.S. government’s borrowing authority includes future cuts to federal health agencies, but they are smaller than many expected and do not touch Medicare and Medicaid. Meanwhile, Merck & Co. becomes the first drugmaker to sue Medicare officials over the federal health insurance program’s new authority to negotiate drug prices. Joanne Kenen of the Johns Hopkins Bloomberg School of Public Health and Politico, Lauren Weber of The Washington Post, and Jessie Hellmann of CQ Roll Call join KFF Health News’ chief Washington correspondent, Julie Rovner, to discuss these issues and more. Also this week, Rovner interviews KFF Health News senior correspondent Sarah Jane Tribble, who reported the latest KFF Health News-NPR “Bill of the Month” feature, about the perils of visiting the U.S. with European health insurance.

Many People Living in the ‘Diabetes Belt’ Are Plagued With Medical Debt

The “Diabetes Belt,” as defined by the Centers for Disease Control and Prevention, comprises 644 mostly Southern counties where diabetes rates are high. Of those counties, KFF Health News and NPR found, more than half also have high levels of medical debt.

When an Anti-Vaccine Activist Runs for President

Robert F. Kennedy Jr.’s official entry into the presidential race poses a thorny challenge for journalists: how to cover a candidate who’s opposed to vaccines without amplifying misinformation. And South Carolina becomes the latest state in the South to ban abortion after roughly six weeks of pregnancy. Alice Miranda Ollstein of Politico, Rachel Cohrs of Stat, and Sarah Karlin-Smith of the Pink Sheet join KFF Health News chief Washington correspondent Julie Rovner to discuss these issues and more. Also this week, Rovner interviews KFF Health News senior correspondent Aneri Pattani about her project to track the billions of dollars coming from opioid makers to settle lawsuits.