“Whereas PBMs [pharmacy benefit managers] act as intermediaries negotiating reimbursements with manufacturers and pharmacies, wholesalers operate on the acquisition side, purchasing pharmaceuticals from manufacturers and selling and distributing them to pharmacies, hospitals, and medical practices. Wholesalers compete to distribute drugs to pharmacies and medical practices — at least under the traditional business model, in which independent practices have an incentive to shop for lower-priced drugs. This market has become increasingly concentrated and transformed by vertical integration. Just three wholesalers — McKesson, Cardinal Health, and Cencora (formerly known as AmerisourceBergen) — control 98% of the wholesaler market. McKesson, the largest of … Read More
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“the number of people who reject all vaccines is quite small — so small that they are unlikely to compromise public health. The greater issue, the one we don’t discuss often enough, is the many parents who don’t identify as being opposed to vaccines but don’t always consent to them. Even before the Covid-19 pandemic, one-quarter to one-third of American parents were delaying vaccines or picking and choosing them cafeteria-style, deciding certain vaccines weren’t relevant to their family because they believed the risk for the disease was low. Some parents design their own vaccine schedules, often customizing for each child based on their perceptions … Read More
“early-onset cancer has emerged as a federal health priority. The Cancer Grand Challenges program, funded by the National Cancer Institute and Cancer Research UK, has allocated $25 million to uncover biological causes for rising rates. Early-onset cancer has also been highlighted as an area of scientific focus in the US National Cancer Plan. Research interest has concurrently surged, with the proportion of PubMed citations related to early-onset cancer more than tripling during the past 3 decades. Rising rates have also prompted recent shifts in policy, such as the US Preventive Services Task Force lowering the recommended initial age for colorectal cancer and breast … Read More
A research group reviewed each country’s residents’ probability of dying from a non-communicable disease (including, but not limited to cancers; cardiovascular diseases; diabetes; endocrine, blood, and immune disorders; non-infectious respiratory, digestive, and genitourinary diseases; neurological conditions; mental and substance use disorders; congenital anomalies; and sense organ, skin, musculoskeletal, and oral or dental conditions) at 2001, 2010, and 2019. When looking at the probability of dying from a non-communicable disease between birth and age 80 in 2019, here are the top five performers by gender, along with America, Canada and England: For females For males “the poor performance of the USA … Read More
“A report on childhood health from the federal Make America Healthy Again (MAHA) commission released in May 2025 mentions the concept of harm associated with UPF dozens of times, signaling the possible inclusion of this category in the forthcoming Dietary Guidelines for Americans, 2025–2030. The available evidence, however, suggests that a focus in national nutrition policy on reducing UPF consumption won’t make Americans any healthier. The term “ultraprocessed food” [UPF] was adopted as part of a food-classification system that was introduced in a 2009 commentary by Carlos Monteiro and subsequently named “Nova.” Initially including three groups of food, Nova was … Read More
“the drumbeat of primary care physician exits continues, atop the relative silence of trainee interest in the field, as more than 30% of US adults now lack a usual source of care. In January 2025, 3 advanced primary care management (APCM) codes were introduced to inject additional dollars into primary care (G0556-G0558). Reflecting 3 levels of medical and social complexity, these APCM codes pay a per-patient, per-month fee for advanced primary care services (eg, urgent access, care management, population health management) without requiring time-based documentation. For a low-income beneficiary with 2 or more chronic conditions, the monthly fee is $80 in … Read More
“Robust evidence shows that diabetes is preventable through lifestyle modifications aiming at weight loss. A meta-analysis including 19 randomized clinical trials confirmed the long-term beneficial effect of lifestyle interventions, even with modest weight loss. Most of these interventions targeted weight loss through an energy-reduced, healthy low-fat diet combined with increased physical activity. However, no previous trial has assessed the effect of energy reduction in the context of a relatively high-fat diet, such as the Mediterranean diet (MedDiet). The PREDIMED (Prevención con Dieta Mediterránea) trial demonstrated that an ad libitum MedDiet supplemented with either extra-virgin olive oil or mixed nuts reduced diabetes incidence … Read More
With Trump’s backing, the pharma industry is expanding the model, but experts expect its impact to be limited Excerpt – Selling drugs directly to consumers is unlikely to make most of them more affordable, even if doing so boxes out insurers and the “middlemen” known as pharmacy benefit managers, several health policy and drug pricing experts told STAT. The cash prices that pharma companies are willing to offer for their drugs (which currently stand at several hundred dollars per month) will never be as low as the prices patients can get through insurance. And if patients buy their drugs directly … Read More
“The FDA [United States Food and Drug Administration] follows the least burdensome principle, limiting its ability to require cybersecurity testing beyond what is necessary to demonstrate safety and effectiveness. As a result, hospitals incur risks of insecure devices with limited mechanism to hold manufacturers accountable. A recent FDA advisory and subsequent congressional testimony have underscored these concerns, raising urgent questions about whether current regulatory pathways are sufficient or in need of modernization. On January 30, 2025, the FDA issued a safety advisory on the Contec CMS8000 patient monitor, identifying vulnerabilities in its security protocols. These devices collect information from pulse … Read More
As a Zepbound patient, here are the seven reforms I’d like to see I highlight two: “2. Tighter oversight of manufacturers’ pricing policies and the competitive environment [..] it’s a bit rich (pun intended) for [Lilly CEO Dave] Ricks [whose total compensation was $114 million in 2024 after the company made more than $10 billion in profit last year] to complain about telehealth/compounding pharmacies like Hims & Hers offering cheaper “backdoor generics” of GLP-1s. (Note to Congress: Rather than permitting the Food and Drug Administration to stop the work of compounding pharmacies on GLP-1s — a throttling that is now well … Read More