Aetna Sues Drugmakers for Collusion, Telemedicine for Seniors, & Certificate of Need Laws.

Hey all,

Welcome to the first rundown of the year. I hope we’re ready for what is looking to a year with a lot of change in healthcare and health benefits. Enjoy the rundown!

Jacob Brody (Co-Founder & CEO, ZorroRX)

(Fierce Healthcare) Aetna Sues Drugmakers for Price-Fixing and Collusion:

Aetna has filed a lawsuit against multiple pharmaceutical companies, including Pfizer, Novartis, and Teva Pharmaceuticals, alleging a conspiracy to fix prices of 111 generic medications. The lawsuit claims these drugmakers engaged in secret communications and meetings to artificially inflate drug prices, thereby increasing their profits at the expense of consumers and insurers. Apparently only Aetna is allowed to overcharge without competition. Full Article

(The New York Times) Telemedicine Access for Seniors Under Medicare:

Medicare’s telemedicine services, expanded during the COVID-19 pandemic, are at risk of reduction, potentially affecting millions of seniors who have come to rely on virtual healthcare. While telehealth has increased accessibility, especially for those in remote areas, concerns about cost, fraud, and quality of care have led to debates over its future under Medicare. As policymakers deliberate, the balance between maintaining access and ensuring program integrity remains a central issue. Full Article

(Washington Post) Health Care Start-Ups and Certificate-of-Need Laws:

Health care entrepreneurs nationwide face significant hurdles due to certificate-of-need (CON) laws, which require proving the necessity of new services before entering the market, often enabling established businesses to block competition. Originally intended to prevent resource oversaturation and control costs, critics argue these laws now stifle innovation, maintain monopolies, and restrict access to services like mental health beds, medical transport, and surgical centers. Advocates, however, claim they ensure equitable resource allocation and prevent workforce strain in an already overburdened system. Full Article.