$67 in France and $798 in US–Why Prescription Drug Prices Are so High in US

By Lawrence Wilson - Prescription drugs cost more in the United States than anywhere else in the world. President Donald Trump and some bipartisan senators want to change that. Trump has so far issued several actions related to prescription drug prices. The latest, announced May 12, is a Most Favored Nation Prescription Drug policy, requiring pharmaceutical companies to offer their lowest price to U.S. customers. Read Full Article… 

HVBA Article Summary

1. Patchwork Reforms vs. Systemic Overhaul: Despite at least a dozen actions by President Trump and multiple Senate bills aiming to lower drug costs, U.S. prescription prices remain among the highest globally. Policymakers like Sen. Thom Tillis argue that piecemeal measures—such as capping insulin prices or targeting only certain drugs for negotiation—fail to address root causes and instead call for a comprehensive overhaul of the entire pharmaceutical supply chain.

2. International Price Disparity and Lessons from Abroad: Countries like Australia, Canada, and France leverage national health systems to assess drug value and negotiate prices, dramatically lowering costs for both governments and patients. In contrast, the U.S. lacks a centralized pricing strategy, which contributes to drugs costing up to five times more than in peer nations—e.g., Trulicity is $67 in France vs. $798 in the U.S.

3. Opaque Role of Pharmacy Benefit Managers (PBMs): While PBMs are intended to negotiate better prices and streamline pharmacy operations for insurers, lawmakers such as Sen. Chuck Grassley criticize their lack of transparency and growing profit margins. PBMs’ influence over what medications are accessible and at what cost has spurred bipartisan legislative efforts to mandate clearer pricing and fee disclosures across the supply chain.

Big hospitals are squashing competition and driving up costs: ERIC

By Allison Bell - Big hospital systems are using their size and market clout to drive up employer health plan costs, the ERISA Industry Committee says in a new analysis of hospital prices. Congress should fight hospital market consolidation and ban hospital contract demands that further reduce the level of price competition, ERIC says. Read Full Article… ^{_{(Subscription required)}}

HVBA Article Summary

1. Hospital Market Power, Not Cost-Shifting, Drives Employer Rates: According to ERIC, the primary reason employer-sponsored plans pay significantly more than Medicare and Medicaid is not due to hospitals shifting costs from public plans, but rather due to market dynamics—specifically provider consolidation, employer bargaining power, and regional pricing differences. Their analysis disputes the notion that public underpayment leads to higher private rates.

2. Policy Implications: Rising Scrutiny of Health System Consolidation: ERIC’s position may intensify ongoing debates in Congress about healthcare market consolidation, including proposals to restrict hospital mergers and acquisitions. The RAND-backed data cited by ERIC suggests in-market hospital mergers raise prices by 2.6% per admission, reinforcing concerns that consolidation undermines price competition.

3. Diverging Narratives Between Hospitals and Employers: While hospital groups argue they need pricing flexibility to stay solvent post-COVID and prepare for future crises, employers and insurers accuse large health systems and private equity firms of using consolidation to shut down competitors and raise prices. The Justice Department’s recent inquiry into healthcare competition laws signals that federal regulators are watching this space closely.

FDA crackdown on off-brand Ozempic products set to take effect, threatening supply and access for many

By Deidre McPhillips - The supply of GLP-1 drugs for weight loss and diabetes treatment is expected to tighten this week with a federal deadline to halt the sale and production of off-brand products that many patients in the United States have come to rely on. Starting in 2022, increased demand led to shortages of semaglutide injections sold by Novo Nordisk under the brand names Ozempic and Wegovy, as well as tirzepatide injections Zepbound and Mounjaro from competitor Eli Lilly. Read Full Article…

HVBA Article Summary

1. FDA Ends Compounding Flexibility for GLP-1s: The FDA officially ended the temporary allowance for compounded versions of semaglutide and tirzepatide after declaring that supply shortages had resolved. As of March (tirzepatide) and now May (semaglutide), compounding pharmacies are no longer permitted to produce or sell these lower-cost alternatives, impacting potentially millions of patients who relied on them for affordability and access.

2. Access and Affordability Concerns Grow: Many patients, like Michelle Pierce, turned to compounded medications after being denied insurance coverage for brand-name GLP-1s. With the crackdown on compounding, patients now face limited options, higher costs, and fears of losing progress in managing obesity, diabetes, and related conditions. Experts warn that access barriers may worsen even as brand-name supply stabilizes.

3. Clinical and Legal Tensions Intensify: Endocrinologists express safety concerns over unregulated compounded versions but also worry that the FDA’s action may flood the healthcare system with new prescription requests, straining supply of starter doses. Meanwhile, compounding advocates and associations argue that GLP-1 shortages persist in practice and have challenged the FDA’s authority in court—unsuccessfully so far.

UnitedHealth faces shareholder scrutiny over new CEO's $60M pay package

By Alan Goforth - UnitedHealth Group continues to deal with the repercussions from the murder of UnitedHealthcare CEO Brian Thompson in December. The insurance giant is asking shareholders to approve a $60 million stock option award for new CEO Stephen Hemsley. Hemsley. who was appointed after former group CEO Andrew Witty resigned in mid-May, previously led the company from 2016 to 2017. His contract stipulates that he will receive an annual salary of $1 million and a $60 million stock option after three years as CEO. Read Full Article… ^{_{(Subscription required)}}

HVBA Article Summary

1. Controversy Over Hemsley’s Compensation Package: UnitedHealth’s board is urging shareholders to approve a compensation plan for incoming CEO Stephen Hemsley, emphasizing its alignment with shareholder interests and Hemsley's personal investment in the company—including a $25 million share purchase. However, proxy advisor Institutional Shareholder Services opposes the package, warning of potential stock option “windfalls,” while Glass Lewis supports it. The non-binding shareholder vote is due before the June 2 annual meeting.

2. Leadership Shake-Up Amid Financial Turmoil: The vote comes during a leadership transition following CEO Andrew Witty’s resignation. Witty and CFO John Rex are facing a shareholder lawsuit for allegedly misleading investors, contributing to market distrust. UnitedHealth shares plunged 22.4% in April after it slashed its 2025 profit outlook, resulting in a $119 billion drop in market value—the company’s steepest one-day decline in over 25 years.

3. Financial Forecast Uncertainty and Cost Pressures: UnitedHealth has suspended its 2025 outlook due to accelerating care activity and unexpectedly high medical costs among new Medicare Advantage enrollees. The insurer is working to stabilize its performance and anticipates returning to growth in 2026, but ongoing cost pressures and broadening benefit utilization continue to challenge near-term profitability.

Pet benefits keep a multi-generational workforce happy

By Paola Peralta - Employees are looking for benefit offerings that touch every aspect of their lives outside of work, and that includes their pets. Forty-eight percent of Gen Z employees see their pets as their children, according to a survey from Talker Research and veterinary services provider Vetster and 13% of millennials see them as siblings. Among older generations, 37% of Gen X and 39% of baby boomers see their pets as support systems. However, 98% of all ages agree that pets make their lives better, and they want their organization's help in caring for them. Read Full Article… ^{_{(Subscription required)}} 

HVBA Article Summary

1. Pet-related benefits resonate across generations and boost engagement: As pets become central to employees' lives, especially for Gen Z and millennials, benefits supporting pet care are emerging as powerful engagement tools. Many are willing to make extreme financial sacrifices for their pets, signaling a strong emotional tie that employers can tap into through tailored offerings.

2. Flexible and scalable benefit models are key for employers: Platforms like Vetster allow companies to offer pet care benefits at different investment levels—from premium subscriptions to discounted live-chat services—enabling employers to support diverse needs without overextending budgets. This flexibility helps ensure accessibility and inclusivity across income levels and life stages.

3. Personalized benefits reflect modern workforce values: The shift from one-size-fits-all to personalized benefit structures reflects employees’ evolving expectations. With household priorities ranging from child care to pet wellness, forward-thinking employers like Samsung and Amazon are prioritizing benefits that address the full spectrum of employee life, driving retention and satisfaction.

Employers are frustrated by rising healthcare costs, and they’re demanding changes

By Ron Southwick - Large employers are welcoming the Trump administration’s push for hospital price transparency. President Trump issued an executive order in February calling for hospitals and insurance companies to make it easier for consumers to see and compare prices. Hospitals say they’re meeting the requirements of federal regulations, but employers contend that it’s difficult for businesses and consumers to easily see and compare prices. Read Full Article…

HVBA Article Summary

1. Employers Demand Real Price Transparency and Accountability: Elizabeth Mitchell of the Purchaser Business Group on Health emphasized that current hospital and health plan pricing lacks sufficient transparency. Large employers, frustrated with arbitrary and excessive healthcare costs, are urging lawmakers to mandate actual prices rather than vague estimates. Price disparities of up to 10x for identical services within the same market strain both company budgets and employee finances.

2. Push for Site-Neutral Payments to Curb Cost Inflation: Employers are advocating for site-neutral Medicare payments, which would reimburse the same rate for identical outpatient services regardless of setting (hospital, clinic, or ambulatory center). This initiative aims to reduce systemic costs and consumer bills. While hospitals argue they face unique burdens, momentum is building in Congress to advance this cost-equalizing reform.

3. Primary Care Access Is Worsening Even for the Privately Insured: Despite having high-quality private insurance, employees are encountering long delays in securing primary care appointments, regardless of geography. Mitchell warns that this growing access issue undermines preventive care and employee well-being, pushing employers to prioritize policy and system changes that improve primary care availability.

80% of graduates don’t know where to start with health insurance

By Press Release - With record numbers of high school and college students graduating this year, many lack a comprehensive understanding of their health insurance options, according to new research published today by eHealth, Inc., a private online health insurance marketplace. Read Full Announcement…

HVBA Article Summary

1. Widespread Confusion About Health Insurance Basics: A striking 80% of young adults (ages 18–25) say they wouldn’t know where to start if they had to find health coverage on their own, and over half (57%) reported a poor understanding of their options upon graduation. This highlights a major gap in health insurance literacy during a critical transition period.

2. Limited Awareness of Key Coverage Rules and Financial Help: More than half (54%) of young adults surveyed were unaware they could stay on a parent’s health plan until age 26, and only 5% knew they could qualify for ACA subsidies even with incomes up to $60,000—indicating a lack of knowledge that could lead to missed opportunities for affordable coverage.

3. Health Benefits Are a Job Search Priority—but Knowledge Lags: While 79% of young adults say health benefits are a high priority when evaluating job offers, few understand non-employer options like ACA plans and subsidies. This gap underscores the importance of educating young adults about all available coverage pathways, especially as they enter the workforce.