Three PBMs Own Nearly Every State’s Pharmacy Market (Surprising No One), Employers Outsource GLP-1 Costs to a Telehealth-CVS Mashup, and Danaher Swallows Masimo in a Massive Diagnostic Power Play

Hey all,

Happy Hump Day! While we marvel at the "Big Three" PBMs consolidating state markets into a neat, three-headed monopoly, it’s heartening to see CVS Caremark pivoting to "flexible" telehealth partnerships to manage the GLP-1 gold rush. Apparently, the solution to middleman-driven price bloat is to simply add another CVS Health owned layer of digital oversight, ensuring your employer can feel good about "subsidizing" costs that were inflated by the very same entities now offering the discount. It’s a closed-loop system of corporate benevolence where the only thing being trimmed more effectively than waistlines is the discretionary income of the American healthcare consumer.

Enjoy the rundown!

Jacob Brody (Co-Founder & CEO, ZorroRX)

[JAMA Health Forum] PBM Market Concentration for Prescriptions Filled at Retail Pharmacies by State and Payer Type

A cross-sectional study of 3.6 billion retail prescriptions reveals that Pharmacy Benefit Manager (PBM) markets are highly concentrated in the majority of U.S. states, particularly within Medicare Part D and Medicaid managed care sectors. The findings show that the "Big Three" PBMs—Caremark, Express Scripts, and Optum Rx—frequently control the vast majority of market share, with 46 states meeting the Department of Justice threshold for high concentration in at least one payer category. This data serves as a shocking revelation for anyone who hasn't noticed that three giant middlemen holding a "highly concentrated" stranglehold on the nation's medicine might actually be the reason your local pharmacy is closing and your inhaler costs as much as a used sedan.

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[Axios] Employers adopt telehealth partnerships to manage GLP-1 costs

Telehealth company eMed is partnering with CVS Caremark to offer employers a flexible coverage model where they can choose how much to subsidize expensive weight-loss medications for their staff. This new arrangement provides eligible workers with 24/7 clinical support and preferred pricing, ensuring higher medication adherence and better long-term health outcomes while shielding employers from the full financial burden of rising drug costs. Because if there is one thing that screams "absolute peak reliability," it is a pharmaceutical cost-saving plan managed by a pharmacy benefit manager and the former CEO of Twitter.

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[Financial Times] Danaher’s $10bn Acquisition of Wearable Health Tech Co. Masimo

Danaher has reached a definitive agreement to acquire medical device manufacturer Masimo for approximately $10bn, marking its largest deal in over half a decade and positioning the conglomerate as a market leader in pulse oximetry. The all-cash transaction follows a turbulent period of activist investor pressure at Masimo that led to a board overhaul and the unwinding of non-core consumer audio acquisitions. This strategic consolidation significantly bolsters Danaher's diagnostics franchise and signals a continued trend of heavy M&A activity within the acute care and life sciences sectors. One can't help but wonder if Apple will suddenly find its legal "spirit" a bit more collaborative now that its IP battle over heart-rate sensors involves a $150bn industrial titan instead of a standalone device maker.

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