The entire pharmaceutical industry faced a moment of reckoning in 2017, right after President Trump was elected the first time and said drug companies were “getting away with murder” over their high prices.
The race was on to build a newer, better PR machine that piled blame elsewhere while giving the appearance of modest profits. One of the components of that machine has been the increasing frequency of drug company “price transparency” reports — carefully curated documents that make it appear the prices of medicines are barely increasing, or even going down.
But the reports disclose no pricing information about specific drugs,
manipulating the reality over how much Americans spend on prescription drugs. They also distract from the industry’s universal opposition to full, mandated price transparency on prescription drugs, which the Trump administration is currently considering.
Read more from me, which includes a breakdown of Johnson & Johnson’s latest price transparency report and what the industry heavy-hitters are saying about Trump’s proposal for full drug price transparency.
influence
MAGA meets Medicare Advantage dark money
Chuck Callesto is a MAGA social media influencer, sunglasses planted firmly on his forehead in his online avatars. He has fired off thousands of Trump-praising posts on X, where he has almost 1 million followers.
But last month, Callesto waded into health policy by extolling Medicare Advantage — and blasting Republicans who considered including Medicare Advantage reforms in Trump’s tax bill. That caught the attention of my colleagues
Casey Ross and John Wilkerson.
It turns out some of the language that Callesto used in at least one of his posts is nearly identical to language used by Medicare Advantage Majority, a dark money group that backs the privatized version of Medicare and promotes talking points similar to those made by large health insurers. Other MAGA accounts flooded social media sites with similar posts about Medicare Advantage, coinciding with big ad buys from Medicare Advantage Majority. The reforms never made it into the tax bill.
Lawmakers are not happy about the posts that attacked Republicans, and are now looking into them.
Welcome to another weird corner of the internet, one that involves staunch loyalty to a $550 billion program that has never saved taxpayers money. Read more from Casey and John.
earnings
Health insurers cull their way to profit
Rarely do we see a quarter with such huge variation in how health insurers performed. Four of the country’s biggest publicly traded insurers lowered their profit outlooks for the year, while two others raised them, my colleague
Tara Bannow writes. Just one, Cigna, stayed the course.
The story lately has been more members getting more care across virtually all types of insurance. Tara observed that how insurers are faring this year depends on what they did to prepare for the onslaught.
Humana and CVS Health, the two winners that emerged, have aggressively culled unprofitable Medicare Advantage members, and Cigna did the same with Affordable Care Act members. “It’s sort of like where you came from in ’24 matters,” Fitch Ratings’ Brad Ellis told Tara.
Another huge factor: their more profitable pharmacy benefit managers and provider subsidiaries. Cigna, for example, got a big boost from its Express Scripts PBM, and CVS from its Caremark PBM. UnitedHealth Group’s Optum subsidiary is still more profitable than its insurance business, but not as much as it had been in previous years.
Read more from Tara.
