UHC Self-Dealing, Feds Seize Steward Execs’ Phones, & Biologics Market Exclusivity

Hey all,

Today’s rundown is focused on how corruption in the US health system. Self-dealing, fraud, and regulatory capture FTW! Enjoy the rundown.

Jacob Brody (Co-Founder & CEO, ZorroCard)

UnitedHealth’s Self-Pricing Practices (Stat News) 

UnitedHealth Group is significantly overpaying its own Optum physician practices compared to competitors in the same markets, a STAT investigation reveals, driving up healthcare costs for patients and employers. This conflict of interest allows UnitedHealth, which controls both a dominant insurer and healthcare providers, to inflate profits while independent doctors struggle to compete. Turns out, UnitedHealth’s vertical integration playbook works like a charm—as long as it’s at the expense of patients and their doctors. Full Article.

Federal Seizure of Steward Executive’s Phones (Beckers) 

Federal authorities have seized the phones of former Steward Health Care CEO Ralph de la Torre and Armin Ernst, head of Steward’s international operations, as part of an ongoing investigation into the for-profit health system. This action follows Steward’s Chapter 11 bankruptcy filing in May and a unanimous Senate vote in September to hold Dr. de la Torre in contempt for failing to comply with a subpoena. The investigation has intensified, with former U.S. House Speaker and Steward board member John Boehner testifying before a federal grand jury regarding allegations of corruption, bribery, and potential fraud within the organization. Full Article.

Biologics’ Market Exclusivity (JAMA)

A new study challenges the rationale for longer market exclusivity for biologics, finding little empirical support for the assumption that biologics require more time, resources, or weaker patent protections compared to small-molecule drugs. The analysis shows biologics have similar development timelines, higher success rates, stronger patent protections, and significantly higher revenues and treatment costs, yet they enjoy extended exclusivity and negotiation exemptions under U.S. law. These findings suggest current policies may disproportionately reward biologics over small-molecule drugs without justification. Full Article.