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Health officials warn of emerging synthetic opioid up to 10 times stronger than fentanyl
The newest warning from health officials is circulating as the opioid epidemic continues, this time involving a drug up to 10 times more powerful and undetectable.
This week in health care policy: November 6-13
Drug pricing and innovation Biotech groups sue CMS over the GLOBE model. Three biotech groups sued CMS over the Global Benchmark for Efficient Drug Pricing (GLOBE) model, which would require manufacturers to provide rebates on certain Part B drugs in an effort to match prices in foreign countries. They argue CMS exceeded its authority to […]
Widely used diabetes drug may offer unexpected health benefit
A Stanford study found Type 2 diabetes patients on metformin had a 39% lower risk of dying in the year after a COVID-19 infection than others.
Tommy McMillen health update after UFC star hospitalized for possible drug overdose in Scottsdale nightclub
Science got a lifeline: Now comes the hard part.
One of the most maddening things that has happened in the last two years of Trump 2.0 has been the gutting of medical research. Since losing my husband to colon cancer and my sister to pancreatic cancer, as well as many friends to various cancers and other diseases, supporting science and scientists has become a mission for me. That’s one reason I co-founded Stand Up To Cancer in 2008 — to raise money and awareness for cancer research and encourage scientists to collaborate instead of compete, which was a novel idea back then. If two heads were better than one, we reckoned that ten heads were better than two. So we organized our scientists and researchers into “dream teams” where they could share ideas and approaches and move science forward faster. Our work has been fruitful — we have raised over $800 million, and our research has contributed to several new FDA-approved drugs, like Keytruda. But I know very well that we have miles to go before we sleep and so much work to do when it comes to all kinds of diseases that take the lives of far too many Americans every year — often in the prime of their lives. So when the Trump administration started cutting our scientific infrastructure, it made me crazy. Clinical trials were stopped midstream, labs were abandoned, Ph.D. programs were dismantled, and talented scientists with potentially lifesaving ideas were left unfunded and dejected. In fact, many left their fields altogether or moved to countries where their work would be more valued and supported, financially and otherwise. That’s why, amid all the post-election analysis, I’ve been especially interested in what the midterms could mean for the future of American science. With Democrats winning both chambers of Congress, there’s finally an opportunity to push back against the Trump administration’s attacks on scientific research and public health. Will anything change now that a whole slew of new sheriffs is in town? My friend Dr. Jeremy Faust recently posed this question to a group of physicians, researchers, and health policy experts for his newsletter, Inside Medicine: What could the new Congress realistically accomplish with President Trump still in the White House? Jeremy asked me, too.
Haut.AI’s Anastasia Georgievskaya on the future of skin science
Inside Beauty spoke to Georgievskaya about the future of AI in beauty.
Endpoints seeks a business of science reporter
Endpoints News is hiring a biotech journalist to cover how advanced therapies and drug technologies turn into the medical products of tomorrow. The right candidate is business-savvy and science-minded. In this job, you’ll write about clinical trials, startups and the business of science. You’ll be responsible for helping set the agenda on a busy beat […]
Prediction Market Bets on Drug Trials Pose Health Risks
Prediction market bets on drug trials reflect sentiment, not true odds, and may invite insider trading, says Dr. Motta
Health Brief: Childhood safety vaccine report remains in limbo
Plus: Drugmaker CEOs temper expectations for AI cures
WATCH: Trump administration officials announce PTSD research funding for psychedelic drug ibogaine
MD healthcare panel endorses tax extension, prescription drug policy change
A healthcare coverage watchdog group is urging Maryland lawmakers to free up funding to meet a “desperate need” for revenue to help keep people insured.
Gene therapy seeks a cure for its brittle business model
Financial backers are wary of the pioneering medical treatment as it does not have the same economies of scale as traditional drugs
New review of the first oral PCSK9 drug, a needle-free option for high cholesterol
A new review from Binghamton University School of Pharmacy and Pharmaceutical Science explores how Lipfendra (enlicitide) can be beneficial for those who have intolerances to injectable medications. The ...
UK science minister calls for more life sciences investment
UK science minister urges biopharma to invest at home after raising drug spending under US tariff deal, as watchdog probes deal’s cost.
Healthcare panel endorses tax extension, prescription drug policy change
A healthcare coverage watchdog group is urging lawmakers to free up funding that can be used to meet a "desperate need" for revenue to help keep people insured, including calls to extend a 1% tax on insurance policies that is set to expire in 2028.
Can scientists reverse your age?
Reversing aging may sound like science fiction, but scientists have already found a way to do it—at least, theoretically. Based on a 2012 Nobel-prize winning discovery, researchers are testing whether they can revert diseased cells in the eye back to young and healthy ones. They gave people a drug this year. If it works, it’ll open the door to curing and possibly preventing other age-related diseases. And that led producer Berly McCoy to wonder: Could all this research eventually extend our human lifespans? If you like this episode, check out our episodes on zombie cells, why our hair turns gray and why we die.Interested in more science on aging? Email us your question at shortwave@npr.org.Support public media with NPR+ and enjoy perks for over 25 podcasts like this one. This show’s perks include sponsor-free listening. Learn more at plus.npr.org.
Decades in the making, MCAM enters initial human testing
After several years of development, a promising drug designed to prevent relapse to opioid use and opioid overdose is taking a critical step by entering human testing. In October, scientists at The University of Texas at San Antonio Health Science Center launched the first-in-human clinical trial of methocinnamox, or MCAM, a novel long-acting opioid receptor […]
Atman Health forms Strategic Advisory Board as It builds AI-Driven Autonomous Cardiovascular Care
Atman Health today announced the formation of its Strategic Advisory Board to guide the company as it builds AI-driven autonomous cardiovascular care and prepares its system for review by the U.S. Food and Drug Administration. The board's founding members are Robert Califf, MD, a cardiologist and clinical trialist who founded the Duke Clinical Research Institute and twice served as FDA commissioner; David Fairchild, MD, senior vice president and chief medical officer of retail health at CVS Heal
Archaeologists Drug-Tested a 2,800-Year-Old Nomad—and Found the World’s Earliest Stoner
Hair from a royal Scythian tomb holds the oldest direct evidence of people getting high on weed.
Drugs like Ozempic may also act on the brain. Scientists now want to know whether they can protect memory, after two Alzheimer’s trials came up empty - Futura-Sciences
Semaglutide and tirzepatide were developed for diabetes and obesity. Researchers in Sweden and Denmark have reviewed what is known about their effects on memory and thinking, and the picture is less simple than the hype suggests.
Ocular Therapeutix Reports Third Quarter 2026 Financial Results, Provides Business Update
BEDFORD, Mass.—Ocular Therapeutix, Inc. (NASDAQ: OCUL), an integrated biopharmaceutical company in the retina space, reported financial results on Monday for the third quarter ended September 30, 2026, and provided recent business highlights including upcoming New Drug Application (NDA) submission plans to the U.S. Food and Drug Administration (FDA) for Axpaxli (also known as OTX-TKI), its investigational product candidate for the treatment of wet age-related macular degeneration (wet AMD) and diabetic retinal diseases. Total net revenue was $12.9 million for the third quarter of 2026, compared with $14.5 million for the prior-year quarter.
Human trafficking investigation tied to Durant massage business
District 27 Drug and Violent Crimes Task Force says investigation that began in Sequoyah County is ongoing
FDA requires new safety warnings for GLP-1 drugs
The FDA is now requiring labeling updates for all GLP-1 medications due to a risk of NAION, a rare eye condition that can result in sudden, permanent vision loss.
US FDA orders new eye risk warnings for Ozempic, Zepbound
The US health regulator on Monday informed patients and healthcare providers of a potential increased risk of a serious eye condition associated with the use of GLP-1 drugs for weight loss and diabetes.
HOMETOWN HEALTH: New weightloss drug could reduce knee pain in overweight patients
An experimental weight loss drug may help reduce knee pain for overweight patients.
When Drug Pricing Collides With Politics
How the midterm results stall Trump’s MFN push, and why differential pricing, compulsory licensing and transparency dominate the WHO Fair Pricing Forum.
Could supplements be the next big opportunity in the GLP-1 weight-loss drug boom?
Novonesis is exploring whether gut health supplements could benefit patients taking GLP-1 weight-loss drugs, opening up a potentially lucrative new market.
Asking More of Science: How Daiichi Sankyo Is Challenging Assumptions About the Future of Cancer Care
After playing a key role in sparking a new era in cancer treatment through its work in antibody drug conjugates (ADCs), Daiichi Sankyo is pursuing an even bigger ambition: to shape what comes next | See how Daiichi Sankyo is asking more of science to bring the next wave of innovation to patients.
What Democratic wins could mean for health policy, according to Penn expert Ezekiel Emanuel
A Democratic-controlled Congress could try to reverse cuts to health coverage, lower prescription drug costs, and pursue other health priorities. But the president's veto power remains a barrier.
Potential impacts Democratic health care proposals on employer-sponsored health care
Summary: Democratic state and federal wins in the midterm elections could lead to Medicaid expansion in some states, and focuses attention on the House Democrats’ memo on health care priorities in the new Congress. Few of these proposals are likely to become law before 2029, but they could form the foundation for Democratic health care reform efforts after the 2028 Presidential election. Portion of total newly eligible for Medicaid if non-expansion states expanded Source: Cervantes, S et al How Many Uninsured Are in the Coverage Gap and How Many Could be Eligible if All States Adopted the Medicaid Expansion? KFF, July 27, 2026 It’s been almost a week since the midterm elections, and the Democrats will have large majorities in both the House of Representatives and the Senate, although not large enough to overcome Senate filibusters or Presidential vetoes. I reviewed some of what I thought these midterm results could mean in a post last week. In retrospect, I might have understated the elections’ impact on health care due to changes in governorship and majorities in many state legislatures. A Democratic trifecta (governorship and both houses) could mean expansion of Medicaid in Wisconsin, and a Democratic governor and House in Texas and Georgia could increase pressure in both states to expand Medicaid. That’s especially important, because Texas currently represents almost half of those who would be newly eligible for insurance from Medicaid expansions. Medicaid expansions matter to employers because they have been shown to decrease the risk of closure of rural hospitals and support workers’ ability to stay employed and productive. The House Democrats’ Cost of Living Healthcare Working Group published an 84-page memo in September with recommendations for the first hundred hours, the first hundred days, and the first year. The midterm results make this document more important. Here’s a review of what some of these recommendations could mean for employer-sponsored health insurance. Elements that could lower employer health care spending Restore the expanded advance premium tax credit for ACA plans. This could bring healthier enrollees back to the marketplace plans, which would improve the risk status of these plans and decrease the rate of uninsurance. Fewer people with insurance puts higher pressures on provider rates of employer plans. More stable ACA plans could encourage employers to consider transitioning from employer-sponsored plans to ICHRA/Choice, providing a fund for employers to purchase their own insurance on an exchange. Repeal Medicaid work requirements and other administrative rules of the One Big Beautiful Bill Act which as written will lead to a large increase in the uninsured rate. Fewer people with insurance leads to more pressures from hospitals for commercial rate increases. Extend Inflation Reduction Act negotiated drug prices to commercial health plans. These are now only applicable to Medicare Parts D (outpatient drugs) and B (drugs administered by providers. The Medicare negotiated prices are lower than net prices negotiated by PBMs. Hospital price limits. Some of the Democratic House proposals would institute site neutral payment and limit outlier hospital prices to 200% of Medicare. The average commercial health plan pays about 247% Medicare rates for inpatient hospital care, and many commercial health plans currently pay over 300% of Medicare for hospital services. PBM regulations. The proposals would mandate more transparency and prevent PBMs from paying subsidiaries more than market rates. Antitrust enforcement. The plan would break up vertically integrated health care monopolies which could lower prices through competition. Ban on non-compete contractual clauses could increase competition by increasing flexibility and supply of clinicians, although it could also increase physician leverage and lead to higher wages which could raise prices. Lower the Medicare eligibility age, which could take older, more expensive, workers off employer sponsored plans. Create a Medi-Kids plan to insure all children and potentially young adults up to age 26. These plan members have low non-preventive utilization and cost less per person than older plan members, but removing children from employer plans would decrease volatility because a few children have very high medical costs. Elements that could increase employer spending (in many instances for high value services) Mandate three primary care and three mental health visits without cost sharing Eliminate cost sharing for mental health care and substance use care during pregnancy and in the year after delivery Require coverage of infertility services Cap cost sharing for insulin, epipen and respiratory inhalers Count copay coupons and assistance toward member deductibles and cost sharing Cap total health care costs (premium and out-of-pocket costs) at 8% of household income Leave a comment Elements that could improve the market Increased price transparency Tightening enforcement of short-term plans, fixed indemnity plans, and cost-sharing ministries. These skimpy health plans skim off healthier people, leaving sicker people on marketplace exchanges and employer-sponsored health plans. Here’s a past post on the perils of cheap insurance. Most of these proposals are likely not to become law in the next two years, but could form the foundation of a Democratic proposal for health care reform in 2029 and beyond. The document does not provide cost estimates for these proposals. Share Thanks for reading! If you found this useful, please share, subscribe, like, and restack. You can find previous posts at this link. Views expressed in Employer Coverage are purely my own. Thanks for reading Employer Coverage ! Subscribe for free to receive new posts and support my work. Subscribe
Why are NC women dying during and after pregnancy? A new report examines the causes
Drug overdoses, infections and homicides were the top three causes of pregnancy-related deaths in North Carolina from 2018 to 2021.
Ministers confirms two new cancer drugs will not be covered by basic health insurance
The drug Enhertu will not be included in the basic health insurance package to help patients with metastatic stomach cancer. Negotiations with the manufacturers over the drug’s price have failed to produce a sufficient agreement, Health Minister Sophie Hermans wrote in a letter to the Tweede Kamer. The drug Skyclarys will also not be included in the basic insurance package.
Roundup: Hackensack Meridian debuts brain imaging drug; Kanvas joins HELIX
Hackensack Meridian Health debuts Pixclara brain cancer imaging, while Kanvas Biosciences moves its lab operations to New Brunswick.
Early heart procedures do not improve long-term survival in stable heart disease
Patients with stable heart disease and abnormal stress tests who have invasive procedures early in their care do not live longer than those initially treated with drugs and lifestyle changes alone, an international study shows.
Boynton Beach man becomes third arrested in alleged $32M Delray Beach THC scheme
A third suspect was arrested Friday in a multimillion-dollar drug and money laundering investigation involving a Delray Beach business, "Not Your Bakery."
Your job-based insurance cut GLP-1 coverage. Here are some options
Companies are cutting health insurance coverage for weight-loss drugs Wegovy and Zepbound. Consumers are scrambling to pay for pricey GLP-1 drugs.
From drug dealers to ritzy art galleries, artist Tyree Guyton has come a long way
Detroit artist Tyree Guyton has gone from a neighborhood art project derided as an eyesore to the grandest art galleries in the world.
What Scientists Found When They Drug-Tested Ancient Hair
People may have been getting high off cannabis 2.8K years ago—300 years earlier than thought
Hims & Hers Health (HIMS) Adds FDA Approved Obesity Drugs To Its Platform
Hims & Hers Health (NYSE:HIMS) announced a new partnership with Eli Lilly to offer Zepbound and Foundayo on its platform. The agreement brings fully FDA-approved GLP-1 obesity drugs into the Hims & Hers telehealth ecosystem for eligible patients. Patients will be able to complete consultations, receive prescriptions, and access these Eli Lilly treatments through Hims & Hers digital services. The Lilly alliance for Zepbound and Foundayo is important. However, Hims & Hers Health has broader...
A promising new medicine against heart disease fails unexpectedly
Doctors expected an experimental drug that lowers a common risk factor for heart attacks would save patients' lives. The medicine made no difference.
Highly anticipated cholesterol drug fails to prevent heart attacks, strokes
The drug, Novartis’ pelacarsen, should have worked against lipoprotein(a), a genetic type of cholesterol that causes plaque to build up in arteries, researchers said. Why didn’t it?
Health Care Disparities Persist Across Liver Diseases
Liver disease disparities tied to insurance and race spanned HCC surveillance, transplant listing, and drug access in data at The Liver Meeting 2026.
Impact of psychedelic drugs could link to age
Researchers say the drugs' impact on mental health may be different depending on the user's age.
Looking for a health insurance plan? Highmark Direct stores can help
Fall is the time to choose health coverage for the coming year. Sorting through the options can be daunting. Consumers may need to compare premiums, confirm that doctors are in-network and prescription drugs are covered, and understand access to care while traveling. Highmark Direct stores help consumers navigate those decisions
Bloomberg American Health Initiative marks 10 years of public health progress
Annual summit highlights historic U.S. declines in homicides and overdose deaths as well as the initiative's ongoing work to address drug addiction, sexual assault, and the impact of digital media on young people
Q&A: Gary Kirsh, MD, on health policy for independent urology
Independent urology practices head into 2027 facing a conversion factor cut, prior authorization hurdles, and Part B drug price negotiation, according to Gary Kirsh, MD.
Cardinal Health Grows Drug Sales, Expands Home Care Business
The Dublin, Ohio-based company reported sales of $67.5 billion for the quarter ending Sept. 30, up 5% from $64 billion a year earlier.
Extracellular vesicles in health, aging and disease
Figure 1. Stress-induced EV release by normal, stressed, aging, and cancer cells and their associated molecular cargo. Each EV type carries molecular cargo depending on the stressor and cell of origin. Senescence increases SA-EV output enriched with chromosomal DNA fragments and EphA2, promoting proliferation in Ephril-A1-positive cells via ceramide-dependent biogenesis [51]. Oxidative stress elevates intracellular Ca2+ and ROS, triggering microvesicle shedding and exosomes carrying mtDNA, oxidized proteins, and stress chaperones [15]. Hypoxia enhances exosome release with HIF-1a-driven cargo such as miR-210 and VEGF to promote angiogenesis [52]. Ionizing radiation activates p54 and TSAP6, producing EVs carrying altered miRNAs and gH2AX that induce bystander DNA-damage responses [53]. Apoptosis generates large ApoEVs containing DNA, histones, organelles, and cytosolic proteins, affecting immunity and tissue remodeling [54]. Chemotherapy and ER stress remodel EV cargo, including P-gp and PD-L1, promoting drug resistance and immune evasion [55].
New wave of health and STEM candidates could reshape US science policy
A massive cancer drug deal, a new license for gut-targeted drugs, and both regulatory and company-led halts on clinical trials led the news this week.
New wave of health and STEM candidates could reshape US science policy
A massive cancer drug deal, a new license for gut-targeted drugs, and both regulatory and company-led halts on clinical trials led the news this week.
FSU chemists develop light-powered method to resurrect 'dead-end' compounds for drug discovery
Throughout the drug development process, which can take a decade or more, tens of thousands of chemical compounds are produced that never go on to become
Jodie Sweetin recalls earning a .9 GPA during first semester of college amid addiction: ‘Got real bad real quick’
Sweetin says her increasing dependence on alcohol and drugs nearly derailed her pursuit of a degree.
What James Talarico can teach Democrats about revenge politics
One of the world’s most powerful and addictive drugs cannot be consumed or ingested. On the individual level, this drug perpetuates feelings of anger and hatred and makes our most violent thoughts feel pleasurable. On the global scale, this drug causes war and exacerbates political, social, religious and ideological divides. This is the drug of […]
Recon: Sino, Boehringer ink cancer drug deal worth $7B; CVS to split pharmacy business from insurance
Welcome to Regulatory Reconnaissance, your regulatory news and intelligence briefing.
We're raising our price target on Cardinal Health after another stellar quarter of profits
The drug distributor also raised its full-year earnings guidance.
Medicus Pharma proposes $135M SkinJect spinout through SPAC business combination
Medicus Pharma CEO Dr Raza Bokhari joined Steve Darling from Proactive to discuss a proposed transaction involving the company's wholly owned subsidiary, SkinJect, which has entered into a non-binding letter of intent with an undisclosed special purpose acquisition company (SPAC) for a potential business combination. The proposed transaction contemplates a US$135 million pre-money enterprise valuation for SkinJect, alongside a concurrent equity financing intended to support the company's SKNJCT-005 clinical study in patients with Gorlin syndrome and preparations for a potential New Drug Application (NDA). Bokhari told Proactive that the proposed deal is designed to establish SkinJect as a separately listed company focused on advancing its dermatology and rare-disease development program. Under the proposed structure, the SPAC would acquire 100% of SkinJect in exchange for newly issued common shares in the combined company. Medicus Pharma intends to retain majority economic and voting ownership, allowing existing Medicus shareholders to maintain significant participation in SkinJect's potential future value. The separation would also provide SkinJect with a dedicated financing platform to fund its clinical development activities, particularly the SKNJCT-005 study targeting Gorlin syndrome, a rare genetic condition associated with the development of multiple basal cell carcinomas. The concurrent financing is expected to support the clinical program and the work required to prepare and potentially submit a New Drug Application, subject to successful development and regulatory progress. Final ownership percentages have not yet been determined. These will depend on negotiations surrounding the definitive transaction agreement and the combined company's capitalization, including retained SPAC cash, public and sponsor shares, warrants and other potentially dilutive securities. Medicus said the proposed transaction remains subject to the completion of definitive documentation and other customary conditions. The planned spinout represents a strategic step in Medicus Pharma's efforts to give SkinJect a dedicated corporate and financial structure, while allowing the parent company to retain majority participation as the dermatology program advances towards its next clinical and regulatory milestones. #proactiveinvestors #nasdaq #mdcx #tsxv #mdcx #pharma #SkinJect #Biotechnology #Healthcare #RareDisease #GorlinSyndrome #Dermatology #SPAC #ClinicalTrials #DrugDevelopment #NDA #Biopharmaceuticals
UK backs startup Potential Sciences' AI-powered drug hunt
UK startup Potential Sciences emerged from stealth today with a sizeable seed funding round and an ambition to transform drug discovery with AI.
CVS is breaking up its pharmacy businesses
The move comes with the drugstore giant facing scrutiny from lawmakers
Breakthrough: FDA Approves First Drug Offering a 'Functional Cure' For Chronic Hepatitis B
'The start of a new era.'
Inside CVS’s Decision to Break Up a Healthcare Juggernaut
The company is splitting its drugstore and insurance businesses amid mounting regulatory pressure.
CVS plans to break up $117 billion healthcare conglomerate
CVS Health Corp. plans to spin off its retail pharmacy business in one of the biggest-ever breakups in the healthcare industry. The drugstore business will be separated into a new
CVS Health to spin off its retail pharmacies into new company after regulatory pressure
The big announcement was made on Wednesday, and many of the details are still being worked out ahead of the planned 2028 split of the company. For now, the plan is for CVS Health to retain its core Caremark and Aetna businesses, with the pharmacy company to take over prescription drug sales and urgent care services.
CVS Health to split in two, separating pharmacy business from insurance
Health insurers have grappled with higher medical costs recently, while drugstores face mounting competition from Amazon and a declining foot-traffic.
CVS Health to split in two, separating pharmacy business from insurance
Health insurers have grappled with higher medical costs recently, while drugstores face mounting competition from Amazon and a declining foot-traffic.
AI in Life Sciences Market to Worth USD 69.34 Billion by 2031, at a CAGR of 26.3%
Delray Beach, FL , Nov. 04, 2026 (GLOBE NEWSWIRE) -- MarketsandMarkets™ projects the global AI in life sciences market to grow from USD 21.58 billion in 2026 to USD 69.34 billion by 2031, at a CAGR of 26.3% during the forecast period. Market growth is fueled by accelerating adoption of AI in drug discovery, clinical research, diagnostics, and precision medicine, along with increasing investments in AI-powered life sciences solutions and the growing availability of real-world and genomic data. Ge
Health Plan Unlocks More Than $10M in Savings in Six Months Using Cohere Health's AI-Powered Pre-Payment Review
Cohere Health®, the leading clinical intelligence and operations platform for health plans, today announced that a Medicare Advantage client identified more than $10 million in savings in six months by finding complex clinical and coding errors in high-cost drug and durable medical equipment claims before payment.
CVS to split into two companies, in major breakup of its $117 billion healthcare empire
CVS Health said Wednesday it is splitting into two companies, marking one of the largest shakeups in the healthcare industry. It’s a major reversal of the mergers that brought together the nation’s largest drugstore retailer along with health insurance giant Aetna and pharmacy benefit manager Caremark.
CVS to split into two companies, in major breakup of its $117 billion healthcare empire
CVS Health said Wednesday it is splitting into two companies, marking one of the largest shakeups in the healthcare industry. It’s a major reversal of the mergers that brought together the nation’s largest drugstore retailer along with health insurance giant Aetna and pharmacy benefit manager Caremark.
CVS to split off drugstore business in major breakup of healthcare giant
The move would reverse the company's $78 billion acquisition of Aetna, and dismantle the vertically integrated healthcare conglomerate it created in 2018.
CVS to split off drugstore business in major breakup of healthcare giant
The move would reverse the company's $78 billion acquisition of Aetna, and dismantle the vertically integrated healthcare conglomerate it created in 2018.
Xeris adds longtime biotech exec to its board
The move to bring Menassie Taddese on comes amid reports that the Chicago-based rare disease and endocrinology drug company is being considered for acquisition.
'Full-time job to keep up with it': Drug pricing program changes worry WV clinic
Beginning in 2027, Trump administration changes to the federal 340B drug pricing program will increase the purchasing and administrative costs for eligible clinics, including in West Virginia, which will have to pay up front for the drugs and seek rebates from drug manufacturers.
Reports: CVS Health plans breakup that would separate Hartford-based Aetna from drugstore chain
The CVS Health Aetna breakup would separate its drugstore chain from Hartford-based Aetna and Caremark, creating two public companies by early 2028.
CVS Health To Split Into Two Companies As Pressure Mounts On Vertical Integration
CVS Health will split into two companies, putting the more than 9,000 drugstores under one business and its Aetna health insurance and pharmacy benefit operations into another.
AFGHS co-signatory countries ask health care users to help fill the financing gap
Hundreds of thousands of Ugandans living with HIV on antiretrovirals could be targeted for user fees or community health insurance schemes requiring modest premium payments, according to the April 2026 version of the country’s America First Global Health Strategy implementation narrative.1 As part of the “sustainable financing for the private not for profit sector” strategy, 491 facilities will be targeted for a phased introduction of user fees and scale up of community health insurance programs.2 In the Ugandan context, PNFP facilities include faith-based hospitals and other health facilities, US missionary organizations and centers of excellence—services that are often co-located at government facilities but run with additional financial and technical resources. 402,000 people—or about 28 percent of the total Ugandan adult PLHIV population on treatment—get ART from the private not for profit sector. The selected facilities provide the majority of ART and prevention of mother to child transmission (PMTCT) services. The plan doesn’t give the total number of clients served by the 491 facilities, so it is not possible to give a precise number. But the majority of 402,000 is a figure in the hundreds of thousands—hence the estimate I’m using.3 The April draft of the Ugandan implementation plan narrative is the only one I’ve been able to review. But the government of Uganda is not alone in turning to health care users to help fill the financing gaps caused by the abrupt withdrawal of US funds. In July 2025, the Government of Liberia introduced user fees for previously free services including “registration, accommodation, patient feeding, hospitalization, and a wide range of surgical and diagnostic procedures.”4 Earlier that year, Liberia rolled out a revolving drug fund designed to stabilize drug supplies by “allowing patients to pay a small fee for standardized, quality medications,” according to a Ministry of Health press release.5 (Both of these approaches had been proposed in the National Health Policy 2022-2031; media coverage explicitly connects the launch with the US foreign aid cuts.) The health financing strategies proposed by Uganda and established in Liberia are qualitatively different from user fees officially adopted by specific health facilities to cover funding shortfalls caused by the new US approach.6 The latter is a stopgap, adhoc change. The former is a national governmental adoption of policies that pass costs on to health care users, despite evidence that such approaches can exacerbate inequities and leave deficits unfilled. Two countries does not make a pattern, but they do point to urgent questions: Have other countries, including Liberia, included user fees or community health insurance schemes in their implementation plans? If so, do any of these narratives have what Uganda’s lacks: a fall-back plan in place in case these strategies for sustainable health systems fail to deliver—as they have before? I wonder if you think about it Subscribe Predictable pitfalls Both community-based health insurance and user fees are as old as the hills. And after decades of people climbing up these hills, duking it out, climbing back down—neither strategy has shown the results the Ugandan implementation plan is counting on. This is, in fact, a hill some folks are willing to die on. (You knew I’d get there, right?) In November 2025, an African-led team of health system experts published a paper directed at low- and middle income country governments trying to figure out how to create self-sustaining health systems. The money wasn’t coming back. It had been more than nine months since the season of freezing, waivering and wood-chippering; two months since AFGHS tumbled into the world touting co-financing requirements and reductions in future US government health aid. Governments were looking for strategies for sustainable, self-financed health systems, the authors wrote. For countries considering user fees and community health insurance to fill the financing gaps, they had a simple message: Don’t. On user fees, the paper states: “Reliance on user fees is ultimately a regressive and inequitable approach. It places a disproportionate burden on the poor and undermines health system goals of equity and financial protection. […] There is overwhelming evidence that user fees mobilise very limited resources for the public health sector, making it an inefficient mechanism for revenue mobilisation.” On community health insurance: “Attempting to shift the burden of funding previously donor-funded services, such as HIV care and management, and TB treatment, onto contributory schemes would exacerbate their fragility and fail to protect the population.”7 The WHO says that community-based health insurance “cannot be expected to provide a major source of funding or coverage,” and noted that most schemes offer only moderate benefit to individuals paying into them, and exclude the poorest segment of the population.8 And yet, the US-Ugandan implementation plan says that community health insurance is “the central pillar of this [PNFP] sustainability strategy” and that this approach that will generate “pre-paid pooled funding at facility and community level [that] improves financial risk protection for households, reduces catastrophic out-of-pocket expenditure, and generates structured, transparent revenue streams that can progressively absorb recurrent costs including health worker salaries.” Unfortunately, Uganda’s own history suggests the pillar might not be able to bear this weight. Ugandans Have Been to this Rodeo Before—and Some Want Their Money Back Uganda introduced its first community health insurance scheme in 1996 with support from international donors.9 Thirty years later, somewhere between 0.2 and 0.3 percent of the population is covered by CHI; just over 1 percent has any kind of health insurance.10 User fees were universally introduced in 1993 as a condition of a World Bank loan.11 They were abandoned in 2001, and in 2004—the year I moved to Uganda to watch the free HIV program get underway—a definitive study found that the fees did not improve health systems and outcomes.12 In 2004, most clinics and hospitals had ‘free’ and ‘fee for service’ options for getting care.13 The fee for service, or “cash and carry” programs had often been established in the years prior to PEPFAR and the Global Fund to Fight AIDS, Tuberculosis and Malaria. People who could afford to paid for the drugs, often at facilities in the private-not-for-profit (PNFP) sector. When free drugs arrived, some people who’d been paying kept on doing so, perhaps because of shorter wait times, greater confidentiality, convenience or other factors. But in the year that I spent visiting the same clinics around the country week after week—including a “center of excellence” that maintained separate days for cash and carry clients and those accessing free ARVs—lots of people who had been paying tried to switch to the free option. They’d paid because they had no other choice. They’d sold pieces of family land, begged family members for loans, bought pills by the week, and sometimes by the day. Or they were just cash-strapped, like most of us, and wanted the funds for other things. 14 Twenty-two years later, this hasn’t changed. Ugandans pay out of pocket for 30-40 percent of their health care costs, leading one paper to declare that “falling ill is more than a health crisis. It is a financial emergency.”15 One recent study found that up to 48.5 percent of households dealing with tuberculosis sold something, took out a loan or dug into savings to defray the costs of TB care—which is supposed to be universally free.16 The Ugandan implementation plan does anticipate challenges. It proposes a phased approach, with 187 facilities introducing user contribution systems in Year 1, 152 in Year 2, and 153 in Year 3. Willingness to pay and feasibility studies will precede roll out; fees will be tiered by region, and a waiver system is proposed to ensure that no one has to pay who is unable to. Moreover, the plan provides for quarterly reviews of epidemiological data to “ensure that user contributions do not compromise epidemic control gains, ART continuity for the client cohort, TB case management, or PMTCT services.” Alt text: A screenshot of a table included in the implementation plan narrative that is the subject of this stack. It’s got a fetching pink bar at the top. It uses the abbreviation “CHI” which is Community Health Insurance, and FBO which is Faith Based Organizations, and it details the number of facilities that will implement user fees with waivers and community health insurance schemes over the five years of the agreement. As I said in the footnote, this is a super interesting document with a lot of other rich material. Tell me what you see—and what you would have focused on. And if you’ve seen something like this, or anything else that strikes you, in another implementation plan, tell me that too. You can use the Substack message platform or try me on Signal at @endaplague_again.25 (because @mercoonfan was, weirdly, taken). But the plan doesn’t fully explain what will happen if this approach doesn’t work out. Yes, progress will be monitored, and corrective action triggered. However, there is no specified funding replacement if premium and fee revenue prove inadequate. Instead, the authors write, “Currently, COEs serve a total client cohort of over 180,000 across 28 facilities. In the initial years, the U.S. Government (USG) will provide financial support for clients; over time, user fees generated by COEs will become the primary source of funding for sustaining their services.” Failure does not really seem to be an option. Health insurance schemes are more acceptable to the Ugandan population than user fees. Members of Parliament and civil society traveled to Ethiopia to see how that country’s scheme worked. In a follow up report, a veteran civil society group recommended allowing the “health insurance ecosystem to grow organically and [to] keep reviewing the law and regulations as this growth takes root.”17 One study found that more than three-quarters of Ugandans were willing to join a health insurance program.18 However, coverage of community-based health insurance is minimal, as is coverage of any kind of insurance—including private plans.19 A national health insurance scheme bill has been stalled for several years and presently sits with President Yoweri Museveni.20 Community-based health insurance scheme that do exist are expanding in number, but losing enrollees. Between 2022 and 2026, the number of community-based health financing schemes across the country increased by 42 percent, while the number of people enrolled decreased by nearly 11 percent.21 None of this means that community-based health insurance should not happen in Uganda—or that people do not want insurance. It doesn’t even mean that user fees and waivers won’t ever work. But there is highly relevant evidence from Uganda and the surrounding region that it is quite optimistic to describe community health insurance and user fees as central supports for sustainable financing in any sector of the health system. And now for the best-case scenario In the best-case scenario22, the Ugandan approach does exactly what it sets out to do, and so does the Liberian fee structure and revolving pharmacy fund—though I’ve not confirmed that these are in the MoU. In one best-case scenario, Uganda is an outlier, and user fees and community health insurance are not recurrent pillars of self-sustaining financing in other countries’ implementation plans. In another best-case scenario, all countries that include these strategies enjoy success beyond anyone’s evidence-informed wildest dreams: reliable funding generated by health care users fees, great health care outcomes for everyone, no exacerbation of inequities, no crippling household debt. No sold land, repurposed school tuition or high-interest loans. In the best-case scenario, not one of the hundreds of thousands of Ugandans living with HIV receiving antiretrovirals from 491 PNFP facilities misses a refill or leaves care because of user fees or community health insurance premiums. This is the best-case scenario for these people for their own health, and for their families. It is also the best-case scenario if Uganda wants to stay on the path to eliminating HIV as a public health threat. According to the country’s most recent data, 96.5 percent of people living with HIV on antiretrovirals are virologically suppressed. Epidemic control depends ensuring that 95% of people living with HIV know their status, 95 percent of those individuals are on ART, and 95% of those individuals are virologically suppressed. Uganda is still struggling with the first “95"—a frankly abysmal 85.3 percent. If HIV epidemic control and the attendant prevention of new infections, avoidable suffering and premature death matter, the country cannot afford to lose any clients who are currently in care.23 As I write this a couple hours before the polls close for the US elections in the city I live in, I say with soul-deep sincerity: I am rooting for the best-case scenario. I think it’s safe to say that we all are.24 I think it’s also safe to say that if the US and co-signatory governments have inked plans that lead to successful expansion of community health insurance and strategic use of user fees, we all would like to know, now, so that we don’t miss the opportunity to celebrate when success happens. The implementation plan narratives have to enter the public domain. They are the fullest expression of a strategy co-created by two governments. There are assumptions and details that people living in the US and co-signatory countries need to understand that are not available in the MoUs or, to date, in the Congressional Notifications. Some of these details can help other countries that are, as I write this, still working on implementation plans. Others, like a solid count of how many other countries have plans for expanding user fees or health insurance, are important for regional and global health architecture reform initiatives. No matter how this election night turns out, there will be a slew of new Congressional member orientations, briefings and talking points papers in the next few months. Release of implementation narratives should be a bullet point in every context that AFGHS is discussed. These documents can be redacted so that procurement sensitive information isn’t disclosed. There is much more historical precedent for sharing such documents than there is for relying on user fees to fill health financing gaps. Let’s look at the information together so we can hope for the best and prepare for, you know, the other thing. Alt text: A substack first: a bicep selfie! It’s my arm - peachy-white skin, black shirt (flannel, notch neck, too hot for this appallingly balmy November weather, if you’re wondering) and a sticker that says I VOTED 2026. Beige letters on red for I voted. Beige on blue for 2026. You bet I did.25 In your wildest dreams. Subscribe 1 This is a really, really rich 95 page document. There are fascinating ideas and detailed plans in it. It is all worth reading AND I have, in this post, highlighted an instance of content that could pose challenges and certainly posits success of strategies that haven’t worked before. I would love to hear what readers’ see that’s interesting and should be lifted up as something to check for in other implementation plans. I will also shortly be adding a static page to the substack site where implementation plan documents will live. I will put the url into this footnote and it will also be there on emilybass.substack.com by the end of the week. Uganda Implementation Narrative Section 4 April 22 2026 Draft 1.51MB ∙ PDF file Download Download 2 User fees are costs charged for visits, labs, medicines or other health services, usually at the time they are provided. Community health insurance, or community-based health insurance, is what the World Health Organization calls “micro insurance,” which is health insurance targeted at low-income people. 3 As usual (by which I mean always), please prove me wrong. 4 https://smartnewsliberia.com/liberias-ministry-of-health-announces-2025-hospital-service-fees-for-public-facilities/?utm 5 https://moh.gov.lr/news/2025/grand-cape-mount-leaders-residents-embrace-new-community-pharmacy-program/?utm 6 https://www.christianitytoday.com/2026/09/hiv-usaid-pepfar-africa-foreign-aid-cuts-mission-hospitals/?utm 7 https://gh.bmj.com/content/10/11/e021270 8 https://www.who.int/news-room/fact-sheets/detail/community-based-health-insurance-CBHI 9 https://pmc.ncbi.nlm.nih.gov/articles/PMC2827475/ 10 https://pmc.ncbi.nlm.nih.gov/articles/PMC10861328/#b3-jpmph-23-110 11 https://pmc.ncbi.nlm.nih.gov/articles/PMC527704/ 12 Same citation as the footnote 2 - the article is called “Learning from failed health care reform in Uganda.” To which I say: If only. If. Only. 13 There is a whole taxonomy of user fees to be aware of, if not commit to memory. Out of pocket costs are everything that someone pays for themselves. In this Stack, user fees are planned and policy-supported out of pocket costs. There are also out of pocket costs that people pay to buy drugs or receive tests or health care assessments that would be free if the drugs were on the shelves, or the machines or kits were available, or the staff were on site. A user fee is usually designed to be modest, pegged to willingness to pay, and may be waiveable at the point of care for anyone who is unable to do so. The costs for things that would otherwise be free are whatever the market will bear and people either have to pay them or go without. Out of pocket costs for services and stuff that aren’t available in public facilities are different again from bribes or unofficial fees that some health workers may impose, even though most are indefatigable, tireless and tired, and devoted to their clients. 14 For the record—which really is these footnotes—I would give a whole stack of fridge magnets for a systematic analysis of the economic and social impact of the Mass Unemployment Event in AFGHS countries among the very people who used to be able to afford and cover user fees, both for themselves and vast family networks. Locally employed USAID technical staff, house cleaners, caregivers, drivers and technicians were financial anchors for cousins, friends, friends’ children, friends’ childrens’ cousins, teachers, pastors, neighbors and so many other kinds of kin. Aid recipients lost direct funding; many other people who had not been aid recipients, but parts of the elaborate care webs that function as safety nets for so many people, lost crucial support too. And that’s even before we get to the people who worked at the hotels and restaurants and bars where people employed by the US and its implementing partners used to spend disposable income. Those businesses have lost revenue; those folks have lost jobs. It will be some time coming—and someone will have to fund this work—but I do hope it happens. And I hope, as usual, to be proven wrong. 15 https://eprcug.org/blog/how-out-of-pocket-healthcare-costs-keep-driving-ugandans-into-poverty/ 16 Another straight-to-the-point journal article title. Households experiencing catastrophic costs due to tuberculosis in Uganda: magnitude and cost drivers. https://pubmed.ncbi.nlm.nih.gov/32938411 17 https://www.cehurd.org/download/technical-policy-brief-on-community-health-insurance-scheme/?wpdmdl=13661&refresh=6ae9122f5d4ed1793659439 18 https://pmc.ncbi.nlm.nih.gov/articles/PMC10125197/ 19 https://pmc.ncbi.nlm.nih.gov/articles/PMC10861328/#b3-jpmph-23-110 20 https://ugandapost.news/uganda-to-make-health-insurance-mandatory-by-2026/ 21 https://shu.org.ug/download/235 22 With a nod, tip of the stack hat, and wag of the Mercoon tail to a deeply valued reader who told me that I have a tendency to speculate about the worst-case scenarios a little too much of the time. 23 https://news.mak.ac.ug/2026/10/uphia-2025-shows-ugandas-hiv-status-awareness-gap-despite-strong-treatment-outcomes/ As you’ll see in the next footnote, I’ve already written a subSubstack on another topic, so I will be brief with regard to the study referenced in this article. The Uganda Population-Based HIV Impact Assessment, or UPHIA, will never happen in this way again. For more than a decade, PHIAs have been supported by the US government as a way to generate accurate estimates of country progress on key HIV indicators. They are a holdover from the PEPFAR program that was laser focused on ensuring US taxpayer dollars subsidized progress in pandemic control. There may be other population-level surveys and the data may even be publicly released, as the entire set of FY2026 MER data have not. But PHIAs will never happen again. If you’re wondering whether the estimates of HIV progress at country level might get less reliable….you’re not alone. 24 Ooh baby, I hate “we” in almost all forms. But sometimes I go there, when I am looking for company, which I am. Because this Stack moves into the somewhat-uncharted territory of assessing what the implementation plan narratives may suggest about co-signatory countries’ roles and responsibilities to the people living within their borders. The MoUs, specimen and data sharing agreements were templates. Countries’ answers fit into pre-specified questions that did not include, “how are you going to fill financing gaps and stabilize your health system as this plan unfolds?” In contrast, the implementation narratives are open form—the product of co-creation between the two governments. Co-creation can mean lots of things, but nothing leads me to believe that implementation plans are ghost-written by the US government, or that contents were imposed by the US counterparts. Instead, I think the parts of the plans that read like country government initiatives are endorsed, if not initiated by, those governments. For instance, the Ugandan implementation plan narrative describes plans for revenue-generation through fees charged for equipment calibration, repair and maintenance provided through Uganda’s National Equipment Calibration Laboratory, and laboratory accreditation through the Uganda National Accreditation Service (UGANAS), targeting private sector, PNFP, research and academic clients. That’s super specific and also quite ambitious. It doesn’t read like an American idea. There’s also a provision for solar panels, and other stuff that feels country owned and driven. This is where it gets interesting. If co-creation is the case, then both the US and co-signatory governments are accountable for the contents and the outcomes. Most discourse about AFGHS to date has focused on the decisions that America has made, or demanded that other countries make. The AFGHS architects have monopolized the hot seat. As they should, in so many ways. America absolutely created the conditions under which countries needed to come up with health financing strategies to fill unanticipated, catastrophic funding gaps. And with not-too-long a lens, we can look back and see that America is also on the hook for its role in the Bretton Woods institutions that made user fees and health system fiscal austerity conditions of loans during the era of structural adjustment. But in the here and now, it is not at all clear to me that the US is requiring Uganda or any other country to implement specific approaches to sustainable financing. Instead, it is as the authors of that paper up in footnote 6 suggest: African governments have agency. As implementation plans roll out—whether or not the narratives are shared—it will be important to understand what this agency looks like and what it means for people, including the poorest of the poor. And it will be important to figure out how to talk about it safely, respectfully and critically in places other than the literal and metaphorical footnotes. 25 This week’s song is “Once upon a time” by the Moody Blues. (I know, this is gonna be a weird, largely banger-free end of 2026 playlist. HMU with requests.) AND please do watch the video and appreciate the truly amazing opening sequence—a drum kit wasteland, a coupla plastic bags, a bit of sand. Sort of like the hill where fiscal austerity policies that put costs on health care users might go to perish. But then there’s a lady with amazing hair. It’s worth it.
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Why 2026 Is a Health Care Election
_Ypsilanti, Michigan_THE MIDTERM ELECTION IS ABOUT a lot of things: gas prices and groceries, the spread of corruption, and the future of democracy. And yet, as much as any single issue, it’s about health care. You can tell by listening to all the Democrats talking about high deductibles, drug costs, and insurance companies as they campaign around the country. Or you can tell by reading all the public-opinion surveys in which voters consistently rank health care as one of their top concerns. But if you really want to know why this is a health care election, your best source isn’t the politicians or the pollsters. It’s the people on the front lines. One of them is Raymond Rion, a family medicine physician and executive director of Packard Health, a small network of clinics spanning Ann Arbor and Ypsilanti on the western outskirts of the Detroit metro area. Packard is what’s known as a Federally Qualified Health Center, where anybody can get care regardless of income or insurance status. And like similar safety-net providers all over America, for the past decade it has benefited directly from the Affordable Care Act. “We almost went bankrupt in 2011,” Rion told me in a conversation last week, recalling how in the old days staff at Packard would work the phones furiously to get supplies and find specialists who would take referrals. Now many more patients have either Medicaid or private coverage they’ve purchased through HealthCare.gov, the online marketplace that the law created, so that the proportion of uninsured patients has fallen from around one in three to one in ten. It’s a lot easier to find referrals for these insured patients, though thanks to the infusion of paying customers Packard can do much more on its own. In particular, Rion said, the organization has opened two new branches, started a pharmacy, begun offering prenatal services, and vastly expanded behavioral health care by bringing on a half-dozen new doctors, nurses, and case workers. Now a retrenchment is underway. Coverage options on the HealthCare.gov marketplace got more expensive because Donald Trump and the Republicans refused to renew temporary subsidies that had been reducing the price of insurance. On top of that, the first cuts to Medicaid as part of last year’s “One Big Beautiful Bill” are starting to take effect. Rion told me Packard has already laid off a provider in anticipation of less revenue next year.1 Patient volume is down, he went on to explain, in part because uninsured patients sometimes avoid care altogether out of fear a single visit will lead to more treatments with more bills. And postponing care in that way can have serious medical consequences, as his colleague Ron Romero told me. “So you have somebody with diabetes, their chronic condition isn’t getting cared for,” said Romero, who like Rion is a family physician. “Their sugars rise, and they end up having other medical problems. Their kidneys start to get damaged. They start to have eye damage. They increase risk for heart attacks and strokes. . . . They end up in the emergency room.” And things are likely to get worse. Partly that’s because next year most of the remaining Medicaid cuts will take full effect, throwing more people off coverage. And partly it’s because forces that have nothing to do with Trump or Republican actions are making medical care more expensive for everyone, including those with employer insurance and Medicare. That will lead to still more people delaying or skipping care, ending up in the emergency rooms, and putting yet more cost pressure on providers. Rion wasn’t taking a position on the election or political parties, he made clear. He was just describing the reality he sees around him: “The whole system is being pressured. Nobody is immune to this stuff.” He’s right. And here’s the thing: This has all happened before. We know happens next.
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