PBMs Dodge Arkansas Ban, Prior Auth Turns Care Into Customer Service Hell, and AstraZeneca Joins the “Pharm-to-Table” Trend

Hey all,

Happy Thursday! We’ve officially entered my favorite season of the healthcare calendar: five months a year after I’ve hit my out-of-pocket max. For the next five months, every doctor visit, lab, and prescription technically costs me $0. It’s like an all‑you‑can‑eat buffet—except the food is prior authorizations and the maître d’ is a PBM. Of course, “free” healthcare is only free once you’ve paid thousands of dollars to unlock the prize, but for now I plan to schedule appointments like I’m trying to bankrupt UHC.

Enjoy the rundown!

Jacob Brody (Co-Founder & CEO, ZorroRX)

(Endpoints News) Arkansas PBM Law Blocked

A federal judge has halted Arkansas’ Act 624, a first-of-its-kind law aimed at preventing pharmacy benefit managers (PBMs) from owning or operating pharmacies, ruling that it likely violates the Commerce Clause and is preempted by TRICARE. The decision marks a significant victory for CVS, Cigna, UnitedHealth, and the PBM industry amid ongoing state efforts to rein in PBM business practices, as the judge cited the law’s protectionist intent and federal preemption concerns; Arkansas plans to appeal in hopes of setting a national precedent — and CVS, for its part, is no doubt thrilled it won’t have to add a “Going Out of Business” aisle next to the seasonal candy section in Arkansas. Full Article

(Substack – HEALTH CARE un-covered) How Insurers Hijacked the Doctor-Patient Relationship 

The article argues that prior authorization (PA)—originally intended to control healthcare costs—has evolved into a burdensome system that delays care, undermines the doctor-patient relationship, and drives patients to abandon treatment. By outsourcing PA to third-party vendors, insurers create a costly bureaucracy that prioritizes corporate interests over clinical judgment, costing billions annually and leading to worse patient outcomes; meaningful reform, the authors argue, will require rethinking assumptions about clinicians, shifting the burden of proof onto insurers, and holding payors accountable for care delays (looking at you, OptumRX—7 months to approve my Mounjaro, but hey, what’s a little extra weight gain and blood sugar spike between friends, right?). Full Article

(Bloomberg) and (AstraZeneca Considering Direct-to-Patient Drug Sales in US): AstraZeneca CEO Pascal Soriot said the company is exploring selling some medicines, particularly for diabetes and asthma, directly to patients in the US as part of a strategy to reduce reliance on middlemen and grow its American market. This move follows similar initiatives from companies like Roche, Eli Lilly, and Novo Nordisk, amid broader industry efforts to cut drug costs and navigate US healthcare policy changes, while also highlighting AstraZeneca’s increasing focus on US-based innovation and manufacturing. Looks like the pharm-to-table revolution is coming soon—just don’t ask for your insulin medium rare (#dadjokes). Full Article