‘25 RX Price Increases, Mental Health Ghost Networks, More Issues For Independent Pharmacies

Hey all,

Happy Tuesday. In the price increase data I was shocked that Ozempic and Zepbound were barely above the inflation rate. I’m very interested to see what new rebate agreement look like for those drugs. Enjoy the round up!

Jacob Brody (Co-Founder & CEO, ZorroRX)

(The Wall Street Journal) Drug Price Increases for 2025

Pharmaceutical companies have raised prices on over 450 drugs in 2025, with most increases kept below 10%, though key drugs like Ozempic and Zepbound saw hikes slightly above the rate of inflation. These adjustments reflect the industry’s balancing act between addressing inflationary pressures and managing public scrutiny over drug affordability. However, these list price increases do not account for rebates and discounts negotiated with insurers and pharmacy benefit managers, which can significantly reduce the final cost. Full Article

(ProPublica) Health Plan Failures in Behavioral Health Coverage

A federal report released on January 17, in conjunction with the Treasury and Health and Human Services departments, revealed that health plans and their administrators frequently exclude essential behavioral treatments, such as therapies for substance use and autism, and provide inadequate networks of mental health providers. The findings, which include secret shopper surveys showing that many listed mental health providers were unreachable or unresponsive, highlight the prevalence of ghost networks that hinder access to necessary care. Full Article

(Fierce Healthcare) Medicare Drug Price Negotiations Impact on Pharmacies

Independent pharmacies are grappling with whether to stock drugs included in Medicare’s new price negotiation program, citing concerns over reimbursement rates that may not cover their costs. This uncertainty reflects the broader challenges small pharmacies face in balancing patient access to affordable medications with financial sustainability, as the program seeks to lower drug prices for Medicare beneficiaries. These decisions could significantly influence how and where patients access negotiated drugs. Full Article