GLP-1 ARE Cost Effective, Sen. Fetterman's GLP-1 Push, Vertical Integration Run Amok

Hey all,

Today’s rundown is influenced by OptumRX repeatedly denying my Mounjaro prescription—despite having both types of diabetes (type 1.5) AND psoriatic arthritis. Apparently checking ALL the qualification boxes isn't enough these days.

Wild guess: UnitedHealth's medical loss ratio is climbing and those pesky GLP-1s are budget vampires. Enjoy the rundown!

Jacob Brody (Co-Founder & CEO, ZorroRX)

(Cost Curve) Obesity Drug Policy & Pharma Tariffs

GLP-1 obesity medications are increasingly shown to be cost-effective, but health policy conversations remain focused on controlling short-term spending rather than enabling access to transformative treatments. Brian Reid critiques ICER’s recent white paper for proposing payer-focused measures like temporary coverage denials, which ignore the long-term health and economic value of these drugs, despite ICER itself acknowledging their cost-effectiveness. He also calls out looming pharmaceutical tariffs as broadly harmful and ineffective, emphasizing that because the U.S. government is the largest purchaser of prescription drugs through Medicare and Medicaid, these tariffs will directly drive up federal spending on those programs without delivering any real benefit. Full Article.

(The New York Times) Fetterman Promotes Access to GLP-1 Drugs 

Senator John Fetterman advocates for expanded access to GLP-1 medications like Ozempic and Mounjaro, calling the Trump administration’s decision to block a Biden-era rule enabling broader Medicare and Medicaid coverage a major setback. Sharing his own health transformation after taking Mounjaro, Fetterman argues these drugs offer life-changing benefits that go far beyond weight loss, including improved heart health and potential protection against diseases like Alzheimer’s. He urges policymakers to reinstate the rule despite the budgetary effects. Full Article.

(Drug Channels) Vertical Integration in U.S. Pharmaceutical Supply Chain 

Drug Channels Institute’s 2025 update reveals that vertical integration among major U.S. insurers, PBMs, specialty pharmacies, and providers is deepening, creating sprawling healthcare conglomerates with greater control over drug pricing, utilization, and care delivery. While these arrangements are pitched as cost-saving strategies—offering efficiencies through data sharing and coordinated care—they also raise serious concerns about anticompetitive practices, lack of transparency, and inflated internal pricing. With the FTC investigating PBM reimbursement disparities and intercompany revenue flows, the need for oversight is growing alongside these megastructures. Full Article