State PBM Reform On Trial, Highmark's Low Profits, Preventing Alzheimer's

Hey all, 

Happy Monday! Watching pharmacy benefit managers (PBMs) frantically race to court every time a state dares to implement meaningful reform has become a predictable farce. I nearly choked on my coffee laughing as I read CVS's latest legal filing, where they argue—with breathtaking audacity—that Arkansas' reform law would somehow destroy patient choice while making medications unaffordable for working families and forcing beloved neighborhood pharmacies to close their doors. The moral contortions these corporate giants perform might be laughable if the consequences weren't so devastating.

Enjoy the rundown!

Jacob Brody (Co-Founder & CEO, ZorroRX)

(Endpoints News) PBM Regulation Case Awaits Supreme Court

The U.S. Supreme Court is still deciding whether to hear Oklahoma’s challenge to a ruling that invalidated parts of its 2019 law regulating pharmacy benefit managers (PBMs), after the solicitor general—originally appointed under the Trump administration—recommended the Court not take the case. The decision carries major implications for how much power states have to regulate PBMs without conflicting with ERISA, which governs most employer health plans and covers half the U.S. population. Funny enough, for an administration that touted states’ rights and PBM reform, even President Trump’s solicitor general said, “Yeah… pass.” Full Article

(Modern Healthcare) Highmark Health Plans & Allegheny Health Earnings

Highmark Health’s Q1 2025 net income plunged to $13 million from $194 million a year earlier, as its insurance arm faced steep losses due to increased utilization in Medicare Advantage and Medicaid. Despite a $9 million operating loss in the insurance division, Allegheny Health Network posted $8 million in operating income—its first non-COVID-aided profit in five years—thanks to higher patient volumes across all care areas. Turns out when people actually use their health insurance, insurers lose money. Full Article

(Ground Truths) Predicting and Preventing Alzheimer’s Disease

Dr. Eric Topol writes about how new tools including blood-based biomarkers like p-tau217, DNA methylation clocks, and AI-analyzed retinal scans are enabling early, accurate identification of individuals at high risk for Alzheimer’s disease—years before symptoms appear. These breakthroughs, combined with lifestyle interventions, immune-boosting vaccines, and potential preventive drugs like GLP-1 agonists, present a historic opportunity to shift from treating Alzheimer’s to preventing it altogether. The challenge now is not just scientific advancement, but ensuring these innovations are equitably implemented to truly change the course of the disease. Full Article