Trump Administration Demands PBM Disclosure (Trust but Definitely Verify), Apexus Faces the 340B Hot Seat, and Pharma Realizes $1,000 Weight Loss Meds Aren't Forever

Hey all,

Happy Tuesday! In a world where the healthcare middleman has historically operated with the transparency of a lead-lined bunker, the federal government is finally asking why billions in "savings" seem to vanish into thin air before reaching actual patients. Between Senator Cassidy poking at 340B vendors and the Department of Labor demanding PBMs finally show their work, the era of "trust us, we’re the good guys" is facing a rather rude awakening. It seems even the weight-loss drug market isn't immune to a reality check, as manufacturers discover that infinite profit margins eventually collapse under the pressure of competition and the radical idea that people might actually want to afford their medicine.

Enjoy the rundown!

Jacob Brody (Co-Founder & CEO, ZorroRX)

[Axios] PBMs hit by Trump transparency rule

The Department of Labor has introduced a new rule requiring pharmacy benefit managers to provide semiannual disclosures of their earnings from drugmakers and pharmacies to the employers they serve. Under these requirements, PBMs must reveal payments, rebates, and incentives while allowing health plans to conduct annual audits of their financial activities. This push for "unprecedented transparency" signals a significant shift in regulating drug supply intermediaries, though the industry trade group's insistence that they've already "reformed themselves" suggests we should probably just take their word for it and stop asking so many pesky questions.

Full Article

[POLITICO] Senator Bill Cassidy Probes 340B Program Vendor Apexus

Senator Bill Cassidy is intensifying oversight of the 340B drug-pricing program by demanding that federal vendor Apexus disclose detailed information regarding its revenue streams and commercial business practices. The inquiry seeks to determine if the vendor's high profit margins and lack of transparency are preventing drug discounts from translating into lower costs or better access for the vulnerable patients the program was designed to serve. Apparently, the government is shocked—simply shocked—to find that a program designed to support social safety net providers has turned into a high-margin growth engine for middlemen, while the actual "safety net" remains as mysterious and hard to find as a reasonably priced prescription.

Full Article

[Reuters] Obesity drug market forecasts revised downward amid price erosion

Analysts are slashing their once-lofty obesity drug market forecasts as aggressive price cuts from Novo Nordisk and Eli Lilly signal an end to the era of thousand-dollar monthly price tags. With revenue projections for 2030 dropping by nearly 30%, the industry is pivotally shifting its focus from high-margin exclusivity to high-volume consumer accessibility. It turns out that Wall Street’s dreams of infinite profit might actually have a weight limit, as pharmaceutical giants are forced to discover that charging patients the price of a used sedan every year isn't a sustainable strategy when competition and basic economic gravity finally show up to the party. Full Article