Trump's previous views negotiations in the price of Medicare medications

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.

The Trump administration is already preparing for another round of Medicare drug price negotiations, but this time it will look a bit different.

The US centers for Medicare and Medicaid services issued a new orientation draft for that third cycle, since the second round of negotiations is underway. The process was established under the Law on Inflation Reduction of Administration Biden as a way of controlling high medical care costs for major Americans.

CMS plans to announce a list of 15 drugs eligible for the third round of price conversations in February 2026, which will then start months and forth between the government and manufacturers if they agree to participate. The new negotiated prices for these products will enter into force in 2028.

But here are the biggest changes this time:

• Medicare part B Medicines – For the first time, the list would include medications payable under part B of Medicare, which covers the medications administered in a medical office or hospital, in addition to the prescription medications covered by the Medicare D.
• Renegotiation process – CMS can choose to renegotiate the prices of certain medications that already had established prices for the first and second cycles of conversations, including those with new uses or changes approved in the “monopoly state”. The agency will announce any medication selected for the first renegotiation cycle, with reviewed prices for those products in force in 2028.
• Transparency – CMS aims to increase transparency around the process, looking for public comments on issues such as how the agency determines an initial price offer for an medication.

“This draft of the guide is essential to create a transparent, competitive and fair medication market that puts American patients first,” said Medicare Director Chris Klomp in a statement.

But Wall Street analysts focus on another part of the guide that could cause problems Merck, Bristol Myers Squibb and some other pharmaceutical companies.

The guidance document suggests that the Trump administration could end a solution that these companies are using to drag the income of the best cancer medications, such as Merck Keytruda and Bristol Myers Squibb's opdive.

The plan had been to change patients to new injectable, or subcutaneous versions, their cancer medications and continue to charge the highest prices of Medicare for them, even after their original intravenous versions are subject to new prices negotiated under the program. Medication manufacturers have been depositing in these subcutaneous versions as a way to cushion the income that would lose medicine price negotiations of Medicare, along with the next expiration of patents for the original forms of their drugs. For example, key patents for Keytruda begin to expire in 2028.

According to current rules, complex medications known as biological products are eligible for the negotiation process after 13 years, but the clock is restarted for a new version of the drug, as a subcutaneous form, which adds an additional active ingredient.

The subcutaneous versions of medications such as OPDIVO are combined products that include an additional ingredient, allowing them to quickly inject instead of slowly infused themselves as the original intravenous form.

But on Monday, CMS said it is “requesting comments” on how “could” group these medications combined with their original versions, if the additional ingredient does not affect how the medicine treats the underlying disease. In other words, the agency is considering counting two versions of a medicine as a single product in certain cases.

That seems to be “somewhat addressed” to products such as Keytruda and Opdivo Subcutaneos, JPMorgan analysts said in a note on Monday. They said that the guide leads to “at least the potential for inclusion” of these drugs in future negotiations.

Even so, there are still no final changes, so it can be too early to predict the impact on drug manufacturers such as Merck and Bristol Myers Squibb.

Do not hesitate to send any advice, suggestion, stories ideas and data to Annika in [email protected].

It is not unusual for CEO to transform their companies back into leadership when things fader.

This week, the president of the Unitedhealth group, Stephen Hemsley, took a page of the Bob Iger's play book in Disneyand recovered the position of the CEO in the company after the abrupt departure of Andrew Witty.

The last six months have been challenging for Witty, after the murder of the CEO of Unitedhealthcare, Brian Thompson, and the disappointing profits of the first quarter. The actions reached a minimum of four years in recent weeks, since it became clearer than the United Advantage's companions had done a better pricing work due to high costs in Medicare this year.

During the 11 -year mandate of Hemsley as CEO, the actions of UnitedHealth rose more than 300%, since the company turned into a medical care giant. After mass growth, the company and the industry as a whole have faced waves of regulatory pressure and public scrutiny of their businesses.

For Hemsley, it is a completely new environment to navigate while trying to correct the ship.

Do not hesitate to send any advice, suggestion, stories ideas and data to Bertha in [email protected].

Operai launched a new evaluation tool called Healthbench on Monday, a reference point that will help to test how artificial intelligence models perform in realistic medical care scenarios.

“If they develop and implement effectively, large language models have the potential to expand access to health information, support doctors in the outline of high quality care and help people advocate their health and that of their communities,” Openii said in a blog post. “To get there, we need to make sure the models are useful and safe.”

The company said that Healthbench developed along with 262 doctors from 60 countries. It is based on 5,000 conversations that simulate interactions between individual or medical users and AI models. Discussions are divided into seven different themes, including global health, emergency situations and uncertainty management.

When a model responds to a notice, each answer is classified against a set of “rubric criteria written by the specific doctor of that conversation,” Openai said. Healthbench contains 48,562 unique rubric criteria.

Operai included an example in which a user said he found his 70 -year -old neighbor who did not respond on the floor. The AI ​​model in that case told the user to take action immediately and included eight steps they could follow. Healthbench gave this response 77% based on their rubric criteria.

Openai said that Healthbench's responses were evaluated against responses written by doctors to understand how the model compared to their clinical judgment. The company discovered that Healthbench “is closely aligned” with the qualification of doctors.

Operai said Healthbench used to evaluate several existing models, including his own O3, GPT-4.1, O1, GPT-4O and GPT-3.5 Turbo, XAI's Grok 3, Gemini 2.5 Pro from Google, Claude 3.7 Sonnet and goal Maverick of Meta 4.

The company discovered that O3 exceeded other models, and said its models have improved by 28% in Healthbench.

Openai said the complete evaluation set and the underlying data for Healthbench are available in their Github repository.

“We hope that this supports shared progress towards the use of AI systems to improve human health,” said the company.

Read the full publication of the blog here.

Do not hesitate to send any advice, suggestion, stories ideas and data to Ashley at [email protected].