The president of the United States, Donald Trump, speaks with the media during the annual Easter eggs of the White House, on the southern grass of the White House in Washington, DC, USA UU., April 21, 2025.
Leah Millis | Reuters
A version of this article appeared for the first time in the Healthy Bulletin returns from CNBC, which brings the latest medical care news directly to its entrance tray. Subscribe here To receive future editions.
After what was felt as an endless streak of bad news, drug manufacturers finally took a break last week.
President Donald Trump issued an executive order that is partly addressed to a key provision of the inflation reduction law that allows Medicar to negotiate the prices of medications with manufacturers. He proposed a change that the pharmaceutical industry has looked for a long time.
In the order of broad scope, Trump addressed the Secretary of Health and Human Services Robert F. Kennedy Jr. to work with Congress to modify a part of the Medicare drug prices negotiation rules, which differentiate between drugs from small molecules and biological medications.
Currently, the law essentially saves biological products such as new negotiated prices vaccines for 13 years after receiving approval from the United States, compared to only nine years for small molecule medications that come in the form of a pill or tablet. The industry argues that the discrepancy, or what drug manufacturers call the “penalty of the pill”, discourages companies to invest in the development of small molecule medications, which are generally cheaper, easier to manufacture and more convenient for patients.
Trump's executive order expressed those concerns, saying that the discrepancy “threatens to distort innovation.” Legislators on both sides of the hall could be receptive to the proposed change, especially after some bipartisan legislation introduced last year that also seeks to eliminate the difference.
It could have huge implications for medication manufacturers, patients and Medicare spending on prescription medications.
An analysis of the Health Policies Research Organization, KFF, said the change would mean that small molecule medications would be on the market longer before they are eligible for negotiations, which could lead to an increase in the expense of Medicare prescription medications, higher and higher medication prices more pronounced in the plans of the Medicare D.
Changing the law “would reach a cost for Medicare and beneficiaries when giving the pharmaceutical companies 4 additional years to establish their own prices in these medications before being eligible for the negotiation of the federal government, unless combined with other changes to avoid a greater expense,” the analysis said.
More than half of the drugs, 13 of 25, in the first and second round of negotiations would not have been eligible at the time they were selected if the discrepancy between the treatments of small molecules and the biological products did not exist, according to KFF. Those 13 medications represented about two thirds of the total Medicare Expenditure part D in the 25 treatments, or $ 61 billion of $ 91 billion, Kff said.
Which includes the fine of lazy eliquis of Bristol Myers Squibb and Pfizeras well as the treatment with type 2 diabetes, Jardiance of Eli Lilly and Boehringer Ingelheim.
Novo Nordisk It would be “among the biggest beneficiaries” if the penalty of the pill is eliminated, according to a Thursday note of the TD Cowen analyst, Michael Nedelcovych. In the upper part of the list of medications selected in the second round of conversations are the successful injection of the company's diabetes, Ozempic, the weight loss fired Wogovy and the Rybelsus diabetes pill, which are considered a product for the good of the negotiations, since all share the same active ingredient, semagglutide.
Without the so -called penalty of the pill, Ozempic, Wegovy and Rybelsus would not be eligible until 2031, which is just a year before the expiration of the patent in the United States, Nedelcovych said.
Trump's executive order was not good news for the pharmacist. The analysts pointed out that it contained other proposals that the pharmaceutical industry has strongly opposed.
For example, it appeals to the administration of food and medicines that open a route for more import imports in Canada, where prescription medications are much cheaper. That was an element of Trump's first period agenda, and seems to collide with its planned tariffs on pharmaceutical products.
In a note on Tuesday, the BMO capitalist Markets Evan Seigerman added that “we are not out of the forest on rates, FDA or the potential for a greater drug price reform.” It refers to the massive review of the FDA and other federal health agencies under Robert F. Kennedy Jr., who now leads the Department of Health and Human Services.
“While they encourage us with this [executive order,] We are cautious about what comes next of the Trump administration for biopharm, “said Seigerman.
We will make sure to cover any of Trump's other movements, so be attentive.
Do not hesitate to send any advice, suggestion, stories ideas and data to Annika in [email protected].
The advantage of UnitedHealth in Medicare could be fading
United Group reported last week a rare fault of profits and income for the first quarter, since medical costs in their Medicare Advantage business weighs the results.
UnitedHealth has sailed the reimbursement pressure of the Biden era on Medicare's plans better than his teammates in recent years, but as rivals as rivals Human and Rye Reduce their footprints this year, UnitedHealth picked up new members who have required much more outpatient attention than expected. In contrast, Elevation health He reported the medical costs of the first amounts below the estimates of analysts.
Executives said they are seeing high medical costs in Medicare, but those have a price of their premiums. As the shakes in Medicare continue, bigger may not be a great advantage.
Do not hesitate to send any advice, suggestion, stories ideas and data to Bertha in [email protected].
The latest in medical care technology: Epic is moving in the public eye with a new presence in social networks, Podcasts
The homonym sign outside the epic headquarters in Verona, Wisconsin.
Source: Yiem through Wikipedia CC
For readers such as this health health reporter who spend a lot of time thinking, researching and talking about the United States's medical care system, it may be easy to forget that epic systems is not a family name for most Americans.
Many people are familiar with EPIC due to their Mychart patient portal, but most of them are not so aware of the central role that their technology plays within the broader medical care industry. Epic software is used by more than 65,000 clinics and 2,900 hospitals, including the vast majority of the main health systems in the United States.
The company is a giant of medical care technology, but it is notoriously private, and that is largely by design. Epic does not have a marketing department and does not announce, according to his CEO and founder Judy Faulkner. He has never done it.
To give him an idea of how the company feels about marketing, Epic declared that he would replace all its developers with marketing staff as an April Fools joke for a year.
“During his 43 years of history of creating awarded health software, Epic has been proud to have a staff very focused on research and development and not focused on marketing. But times are changing, and Epic needs to keep up,” the false announcement reads.
Faulkner rarely makes appearances in the media, and for the most part, Epic has tried to a large extent of keeping his head down over the years.
In recent weeks, however, the company seems to have begun to change its position. Epic began publishing on the social media platform X, casually, April Fools day. The company confirmed the authenticity of the account to CNBC.
Seth Hain, Senior Vice President of Research and Development of Epic, participated in a podcast with Julie Yoo, general partner of the Risk Capital firm Andreessen Horowitz, which was published last week. Andreessen Horowitz is one of the most high profile companies in Silicon Valley, but Epic has never accepted any investment of risk capitalists.
And on Monday, the “Acquired” podcast, which tells the stories of the companies and their founders, launched an episode of four hours over Epic. The podcast is the technology program No. 1 in Apple Podcasts and Spotify and reaches more than 1 million listeners, according to their website. It is difficult to know exactly how epic he helped with the investigation for the episode, but the hosts mention that the company confirmed some facts.
Taken together, these developments suggest that Epic is at least exploring a person oriented to the public. To a certain extent, the company's innocent day joke of the company could actually be true: “Times are changing and Epic needs to keep up.”
Do not hesitate to send any advice, suggestion, stories ideas and data to Ashley at [email protected].
