Exclusive: Drugmakers raise US prices on 350 medicines despite pressure from Trump

By Michael Erman – Drugmakers plan to raise U.S. prices on at least 350 branded medications including vaccines against COVID, RSV and shingles and blockbuster cancer treatment Ibrance, even as the Trump administration pressures them for cuts, according to data provided exclusively by healthcare research firm 3 Axis Advisors. The number of price increases for 2026 is up from the same point last year, when drugmakers unveiled plans for raises on more than 250 drugs. The median of this year's price hikes is around 4% - in line with 2025. Read Full Article...

HVBA Article Summary

1. Significant Increase in Drug Price Hikes: The number of branded medications facing price increases in the U.S. has grown compared to the previous year, with at least 350 drugs affected. This trend continues despite ongoing political pressure to reduce costs, indicating that pharmaceutical companies are maintaining or expanding their pricing strategies. The median price hike remains consistent with the prior year, suggesting a sustained approach rather than a one-time adjustment.

2. Selective Price Reductions Amid Broader Increases: While most drugs are seeing price hikes, a small number—around nine—will experience list price cuts, including a substantial reduction for the diabetes drug Jardiance. These reductions are largely tied to government negotiations, such as those for Medicare, rather than voluntary actions by manufacturers. The targeted nature of these cuts highlights the limited scope of price decreases compared to the widespread increases.

3. Complex Pricing Dynamics and Policy Responses: Drugmakers are balancing public and governmental scrutiny with business objectives by negotiating discounts with insurers and setting different prices for various market segments. Some companies justify the increases as necessary to support innovation and offset rising operational costs. However, experts note that recent government deals have only modestly impacted overall drug pricing, and U.S. patients continue to pay significantly more for prescriptions than those in other developed countries.

Most Americans will face unaffordable healthcare, study suggests

By Kelly Gooch – A new analysis suggests the cumulative financial strain of healthcare is more widespread than annual snapshots indicate — and most Americans will experience unaffordable costs during their lifetimes. The study, published Dec. 22 in JAMA Internal Medicine, was conducted by researchers from Harvard Medical School in Boston, the City University of New York’s Hunter College and Public Citizen’s Health Research Group. Using longitudinal data from the Medical Expenditure Panel Survey (2018-2022), the team tracked 12,645 U.S. adults and analyzed their experiences with several indicators of healthcare financial strain. Read Full Article...

HVBA Article Summary

1. Long-Term Financial Strain Is Widespread: The study found that healthcare-related financial strain is not just a short-term or isolated issue, but rather a cumulative problem that affects a large portion of Americans over time. By tracking individuals over four years, the research highlights that many people will eventually face unaffordable healthcare costs, even if they do not experience them every year. This approach provides a broader perspective than annual surveys, revealing the persistent nature of the problem.

2. Vulnerable Groups Face Greater Risk: Certain populations, such as those with low income, no insurance, chronic illnesses, or recent hospitalizations, are more likely to encounter significant financial burdens from healthcare. These risk factors increase the likelihood of both high out-of-pocket expenses and the need to skip necessary medical care due to cost. The findings suggest that addressing disparities in healthcare access and affordability is crucial for improving overall health outcomes.

3. Health and Financial Consequences Are Interconnected: The study notes that high medical costs can lead individuals to forgo needed care, which may further deteriorate their health. Among participants who died during the study period, a majority had experienced financial strain in the years leading up to their death. This underscores the link between financial barriers and adverse health outcomes, emphasizing the importance of policies aimed at reducing the cost burden on patients.

Employers offering voluntary benefit plans face ERISA fiduciary suits

By Allison Bell – Employers may face a new wave of lawsuits over the cost and value of their voluntary benefits menus. Attorneys with Schlichter Bogard — a firm known for filing suits over the fees and fund options at employers' 401(k) retirement plans — are now helping workers sue employers and their benefits advisors in federal courts over concerns about voluntary benefits options. Read Full Article... ^{_{(Subscription required)}}

HVBA Article Summary

1. Lawsuits Allege ERISA Violations Over High Costs and Broker Payments:

   Four lawsuits filed in December 2023 in federal courts in Illinois and New York accuse employers—such as Community Health Systems (CHS), United Airlines, Laboratory Corporation of America (LCA), and Universal Services of America—of violating ERISA fiduciary duties in administering voluntary benefits programs. The suits claim that employers and advisors (including Gallagher, Mercer, Lockton, and Willis Towers Watson) allowed excessive broker fees, promoted insurance products with high premiums, and selected providers with low benefit-to-premium ratios.

2. Plaintiffs Cite High Commissions and Poor Return on Premiums: The complaints highlight substantial disparities in costs and returns. For example, one former Universal Services employee paid $89.96/year for accident insurance, $304.72/year for critical illness insurance, and $124.28/year for hospital indemnity insurance. A current employee pays significantly more: $191.36, $795.60, and $283.92, respectively. Plaintiffs allege that Mercer and Lockton collected about $23 million in commissions from Universal Services’ voluntary benefits from 2014 to 2019, with commission rates reaching 39%—far above the 2%–8% range seen in comparable companies like Kohl’s and Dollar Tree. They also claim participants received less than $0.50 in benefits for every $1.00 paid in premiums.

3. Dispute Over Fiduciary Duty and ERISA Coverage of Voluntary Benefits: Although voluntary benefits are typically exempt from ERISA under a “safe harbor” provision, plaintiffs argue that defendants’ active roles—such as including employer logos in promotional materials and assisting in benefit enrollment—make them subject to ERISA’s fiduciary standards. At Laboratory Corporation of America, for instance, an employee pays $99.84/year for accident insurance, $547.82/year for critical illness insurance, and $205.14/year for hospital indemnity insurance. According to the complaint, Willis Towers Watson received $2 million in commissions from these policies between 2019 and 2024, amounting to 28% of premium payments, which plaintiffs argue is excessive under fiduciary duty standards.

6 insurer moves in 2025 that signal a heightened PBM focus

By Elizabeth Casolo – Even amid a widespread regulatory crackdown on pharmacy benefit managers, some payers have been leaning into their own businesses in 2025. Here are six payer moves indicating growing PBM interest: 1. Independent Health’s PBM subsidiary, Pharmacy Benefit Dimensions, is one driver behind the insurer’s plans to join MVP Health Care. “Some of the opacities that the larger pharmacy benefit management companies have used are going to be stripped away, and having a truly transparent model, where all of the efficiencies and savings are passed on to the customer, is where things are going to end up,” Independent Health CEO and President Michael Cropp, MD, told Becker’s. Read Full Article...

HVBA Article Summary

1. Insurers Increasingly Invest in PBM Operations: Despite regulatory scrutiny, several major health insurers are doubling down on their pharmacy benefit manager (PBM) businesses. Moves include mergers, in-house PBM development, and new transparency-focused models. This trend suggests that payers see direct PBM control as a strategic asset for managing costs and adapting to industry changes.

2. Shift Toward Transparency and Rebate-Free Models: Companies like Cigna’s Evernorth and UnitedHealth’s Optum Rx are introducing or expanding rebate-free and transparent pricing models. These initiatives aim to pass more savings directly to consumers and address criticisms of opaque PBM practices. However, the transition to these new models may present operational challenges and require significant adjustments for both insurers and clients.

3. Health Plans Emphasize Control Over Pharmacy Benefits: Industry leaders and executives highlight the importance of owning and managing pharmacy benefits to ensure long-term viability. By integrating PBMs within their organizations, insurers hope to better control drug costs, improve transparency, and respond more effectively to regulatory pressures. This approach is seen as essential for health plans of all sizes to maintain competitiveness in a rapidly evolving market.

Brokers can’t ignore these three shifts heading into 2026

By Rick Hirsh – The past year brought significant legislative and economic shifts that are changing how employers plan for 2026, and the uncertainty is influencing what employers expect from their broker partner. Three key trends are expected to play a significant role in shaping the benefits landscape next year, and the brokers who understand them now will stay valuable to clients when decisions get harder. Read Full Article...

HVBA Article Summary

1. Labor Market Volatility and Its Impact on Benefits Administration: Employers are shifting from a labor hoarding approach to a pattern of smaller, more frequent layoffs, termed the 'forever layoff' cycle. This increased workforce volatility complicates benefits administration, particularly in maintaining billing accuracy and timely updates, which can lead to overpayments and coverage disputes. Brokers need to anticipate this volatility and implement stronger controls and automation to manage frequent employee changes effectively.

2. Evolving Employer Preferences on Health Coverage Models: Individual Coverage Health Reimbursement Arrangements (ICHRAs) remain a minority choice among employers, with only 4% offering them in 2024. However, rising healthcare costs in 2026 will prompt employers to continuously reassess their benefits strategies, potentially shifting between models based on cost and complexity considerations. Brokers must be prepared to advise clients on the tradeoffs of different coverage options and facilitate smooth plan transitions without overburdening HR and finance teams.

3. Increased Demand for Risk Management Expertise from Brokers: Employers are raising expectations for brokers to provide strong risk management guidance, with 94% expecting such support but only about half feeling they receive it. Given the cost pressures and market volatility anticipated in 2026, brokers who offer practical, market-informed risk advice will build greater credibility and trust with their clients. This trend underscores the importance of brokers enhancing their expertise and service offerings in risk management to remain competitive.HVBA Article Summary

With loan repayment looming, help employees with education support

By Lee Hafner - As economic issues like inflation and high healthcare costs continue, the fiscal burden of education — from college to advanced degrees to professional development — is especially daunting for employees. Those with federal student loans will feel extra pressure starting in January, when the government plans to reinstate collection tactics such as wage garnishment and loss of tax refunds for borrowers in default (typically deemed as nine months behind in payments). Read Full Article… ^{_{(Subscription required)}}

HVBA Article Summary

1. Combining Education Support with Financial Guidance Helps Tackle Long-Term Debt: Employer benefits that blend education support—such as tuition reimbursement or access to training programs—with financial assistance, including student loan repayment or personalized savings advice, can significantly help employees manage and overcome long-term debt. This approach benefits workers across all age groups, not just recent graduates, and addresses a growing financial burden that many did not anticipate.

2. Accessible, Low-Cost Solutions Can Provide High Impact: Even if employers are unable to provide direct financial aid, they can still offer impactful support by partnering with third-party platforms that educate employees on federal and state loan relief programs, like Public Service Loan Forgiveness. These partnerships require minimal investment from employers while providing valuable resources that can lead to substantial financial relief and improved employee satisfaction.

3. Education Benefits Drive Retention, Upskilling, and Recruitment: Offering benefits that support ongoing education and career development—such as free courses, certifications, and upskilling programs—can help employees adapt to changes like AI-driven job shifts, while also enhancing retention. Workers are more likely to stay when they see a path for internal growth, and such benefits also strengthen recruitment by signaling that the organization is committed to both financial wellness and long-term career advancement.

Weight-loss Pill Approval Set to Accelerate Food Industry Product Overhauls

By Jessica DiNapoli and Waylon Cunningham – Packaged food makers and fast-food restaurants may be forced to overhaul more of their products next year as newly approved, appetite-suppressing GLP-1 pills become available in January, analysts say. More Americans are expected to try the ‌drugs as a pill rather than as a shot because the medication will be cheaper and many patients are hesitant to inject themselves. The U.S. Food and Drug Administration approved Novo Nordisk's Wegovy GLP-1 pill on Monday, sending shares of food companies down on Tuesday. ⁠Eli Lilly's rival medication is expected to gain approval from regulators next year. Read Full Article...

HVBA Article Summary

1. Impact on Food Industry: The approval of oral GLP-1 weight-loss medications is expected to significantly influence the packaged food and restaurant sectors. Companies are already responding to shifting consumer preferences by introducing products with higher protein content and smaller portion sizes. The trend is likely to accelerate as more consumers adopt these medications, prompting further product reformulation and targeted marketing.

2. Consumer Behavior Shifts: Studies indicate that households using GLP-1 medications reduce their spending on groceries and fast food, with notable decreases in purchases of snacks, soda, and bakery items. Although these reductions tend to reverse when medication use stops, the convenience and lower cost of pills may encourage longer-term use and broader adoption. This could result in sustained changes in eating habits and demand for certain food categories.

3. Corporate Strategies and Market Response: Food manufacturers and restaurant chains are proactively adapting by labeling products as "GLP-1 friendly" and launching new menu options that cater to users of these medications. Companies like Conagra, Danone, Nestle, and Chipotle have introduced or expanded offerings that emphasize high protein and smaller portions. These strategies reflect an industry-wide recognition of the growing market segment influenced by weight-loss drugs.

Health insurance ranks as most-valued benefit among US workers: Indeed

By Kristin Kuchno – Health insurance is the most-valued employee benefit among U.S. workers, according to a Dec. 4 report from Indeed’s Hiring Lab. The findings are based on Indeed’s 2025 Workforce Insights Survey, which polled 80,936 adults between May and June across eight countries: the U.S., UK, Germany, France, Japan, Ireland, Australia and Canada. Read Full Article...

HVBA Article Summary

1. Health Insurance and Paid Leave Are the Most Valued Employee Benefits: Among U.S. respondents, 67% identified health insurance as one of their top five to ten most-valued employee benefits. This was followed closely by vacation and paid sick days, indicating a strong preference for essential health and personal time benefits. Supporting this, a separate December study found that health insurance was the top deciding factor for Americans considering a career change.

2. Benefit Preferences Differ by Gender, Highlighting Work-Life Balance for Women: Women in the U.S. were more likely than men to favor remote work by 11 percentage points, flexible hours by 7 points, parental leave by 5 points, and childcare assistance by 3 points. Globally, women also more frequently selected mental health days and bereavement leave, while men more often preferred stock compensation, company cars, and performance bonuses—highlighting differing priorities by gender in benefit preferences.

3. Workplace Flexibility Remains Popular but Has Stalled in Growth: Although flexibility is still in demand, the percentage of U.S. job listings offering remote or hybrid work rose from 7.1% in early 2020 to 14.4% in November 2023, but slightly declined to 13.7% by October 2025. To attract and retain Generation Z healthcare workers—who prioritize financial wellness, mental health, and flexibility—some employers, such as Texas Health Resources, have begun tailoring benefits, including adding an extra paid day off in 2024.