Latest Articles and Analysis

Prescription Drug Affordability Boards have been marketed as an easy fix for drug costs — but after six years, $28 million spent, and 394 hours of meetings, not a single PDAB has delivered savings for patients or their states. The data demands accountability.

When public employers adopt alternative funding programs to cut specialty drug costs, they don't erase the bill — they move it to ADAPs and Ryan White, the safety-net programs built for people who have no coverage at all. Workers living with HIV pay the difference in delay, disruption, and risk.

For the first time, federal rules forced insurers to publish prior authorization metrics—and the numbers confirm what patients have long experienced: denials are common, reversals are frequent, and almost no one fights back. The data opens the black box partway. It does not dismantle the barrier inside.

Prescription Drug Affordability Boards are operating in states across the country, but their primary tool — Upper Payment Limits — threatens pharmacies, Medicaid programs, and the patients they're supposed to help. The evidence is mounting that UPLs are the wrong solution to a real problem.

Rising employer premiums averaging 9.5% erode wages, forcing workers to delay care.

Break Up Big Medicine Act would force structural separation of insurers, PBMs, and pharmacies.

Medicare drug negotiation's third wave includes Biktarvy, raising HIV treatment access concerns.

Enhanced ACA subsidies expired Jan 1; Senate framework proposes two-year extension with restrictions.

European price controls demonstrate MFN policy risks: delayed access, treatment rationing, and pharmaceutical innovation collapse.

September government shutdown threatens healthcare systems during November open enrollment, risking coverage loss for 22 million Americans.

Most Favored Nation pricing threatens to import restrictive QALY-based frameworks that discriminate against expensive treatments.

Expiration of enhanced ACA subsidies threatens to increase premiums 75% and reduce marketplace enrollment by millions.

Pharmacy benefit managers extract billions while adding no value, increasing costs without improving patient access or health outcomes.

Trump administration's contradictory drug pricing policies undermine goals of affordability and innovation incentives.

Copay accumulator programs exclude patient assistance from deductibles, creating barriers to medication adherence and treatment.

FTC investigation confirms pharmacy benefit managers extracted billions in excess revenue through specialty drug markup schemes.

Insurance companies deploy AI algorithms for automated prior authorization denials, restricting patient access to prescribed treatments.

Federal policy failures on copay accumulator programs restrict patient assistance benefits.

FTC complaint against major PBMs for anticompetitive rebating and insulin pricing.

Unintended consequences of Inflation Reduction Act drug pricing provisions.