Companies Splurge On Health Plans Blindfolded, Ozempic Price Drops To “Still Expensive,” And Medicare’s Installment Plan Gets Ghosted By Seniors

Hey all,

Happy Tuesday! American healthcare keeps proving that “managing costs” is more performance art than practice. Employers are handing out multimillion-dollar health benefits without even bothering to compare prices, drugmakers are cutting list prices only when it makes for good PR and a stock bump, and Medicare’s shiny new payment plan is already collecting dust thanks to low enrollment. If this is reform, patients might want to brace for more of the same old chaos.

Enjoy the rundown!

Jacob Brody (Co-Founder & CEO, ZorroRX)

(BenefitsPro) Employer Health Plan’s Need A Price Check 

A new study led by Duke law professor Barak Richman finds that many U.S. employers sponsoring health plans are failing to meet even basic fiduciary duties under ERISA, with 33% not soliciting multiple coverage bids and 37% not comparing plan costs across insurers. These lapses leave employers vulnerable to class-action lawsuits and highlight growing scrutiny as federal rules expand access to health plan cost and broker compensation data. Honestly, I’ll never understand how companies can spend millions—sometimes hundreds of millions—on health benefits without even shopping around or knowing what they’re actually buying. Full Article

(Bloomberg) Novo Halves Ozempic Price for Cash-Paying Patients 

Novo Nordisk announced it will cut the out-of-pocket cost of Ozempic in half to $499 a month through its NovoCare program and a new partnership with GoodRx, making the diabetes drug more accessible to uninsured patients. The move comes amid political pressure on pharmaceutical companies to lower US drug prices and growing competition from cheaper compounded alternatives, while also boosting Novo’s stock and driving a major rally in GoodRx shares. Pharm To Table will play a major role in widely used drugs like GLP-1s, SGLT2 inhibitors, and blood thinners taken by millions, but not in smaller-volume rare disease treatments that carry high price tags.

(IQVIA Blog) M3P in 2025: Early Insights on Benefits and Uptake 

Early data shows that while Medicare’s new Prescription Payment Plan (M3P) allows patients to spread drug costs across the year, uptake has been far lower than expected, with only 15% of likely beneficiaries enrolling and just 0.53% of patients using it as of mid-2025. Low awareness, technical issues at pharmacies, and implementation challenges have limited participation, even though the program offers significant financial relief for seniors on fixed incomes and those facing high out-of-pocket costs. Only a tiny fraction of patients are using M3P? Wow, who could’ve predicted that… besides literally everyone who’s ever tried to get a new healthcare program implemented. Full Article