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Medicare Advantage 2027 updates boost payment updates near 5%, but risk rules and prior auth reforms force plans to rethink benefits and strategy.

HealthDyne is one of the dispensing pharmacies for the Lilly Employer Direct program that the company launched in March. HealthDyne executives expect their skyrocketing growth in its new direct-to-employer business.

HealthDyne’s Sarah Thomas and David Skomo say that direct-to-patient arrangements eliminate opacity in drug pricing and allow employers to offer drug coverage with a certainty about the budget required.

Even for high-priced specialty drugs, direct-to-patient (DTP) sales could help with access and affordability, say HealthDyne’s David Skomo and Sarah Thomas. Payers can lower out-of-pocket costs for members by funding health reimbursement arrangements, money that can be used to buy DTP drugs.

A high-touch specialty pharmacy program that combines pharmacist support, telehealth and value-based care reduced medical costs and improved outcomes for patients with diabetes, according to presenters at the Asembia Specialty Pharmacy Summit.

Andrew Mellin, M.D., discusses Surescripts’ pilot program for prior authorization system, which pulls clinical data from EHRs and matches it against payer criteria.

There have been tremendous advances in specialty drugs, but those advances have also brought a lot of complexity for payers. Payers are considering new strategies for their specialty benefit.

In this clip, Lindsay Greenleaf, J.D., MBA, discusses the latest news concerning the 340B Drug Pricing Program, calling out what she believes is “abuse” within the program.

Drugs with $10 billion in sales are dominating the pharmaceutical market, says Luke Greenwalt, MBA.

PBM reform intensifies in 2026 as transparency laws, FTC pressure and experts including Jeffrey Hogan, Stacie B. Dusetzina, Ph.D., and Chad Worz, Pharm.D., spotlight pricing, rebates and patient costs.

Coramitug is designed to clear toxic protein deposits from the heart, offering a new approach to treating ATTR cardiomyopathy.

The FDA has assigned a Prescription Drug User Fee Act (PDUFA) target action date of Feb. 27, 2027, for zipalertinib to treat patients with locally advanced or metastatic non-small cell lung cancer epidermal growth factor receptor (EGFR) exon 20 insertion mutations

A pharmacist-led specialty pharmacy care model presented at AXS26 shows improved A1C control, fewer hospital visits and lower total costs by expanding support beyond medications to include lifestyle, social needs and care coordination for high-risk patients.

A specialty pharmacy model presented at AXS26 shows how expanding pharmacist roles into care management can improve outcomes and support shared savings in value-based care.

In this clip, Mike Ciarametaro, managing director of policy at Avalere Health, explains all the “moving pieces” that could affect the health policy landscape in the coming months.

Ahead of Asembia’s 2026 Specialty Pharmacy Summit, Avalere Health's Mina Allo and Mike Ciarametaro discussed the potential impact of PBM reform on the employer market and the likelihood of partisan legislative gridlock ahead of the upcoming elections.

IQVIA's Luke Greenwalt, MBA, and Lucille Accetta, RPh, M.P.H., MBA, chief pharmacy officer and head of CVS Specialty, are speaking at tomorrow's general session. Lindsay Greenleaf, J.D., MBA, of ADVI Health, and Will Shrank, M.D., co-founder and CEO of Aradigm, also have speaking slots during the meeting.

Rebates aren’t disappearing, but PSG's 2026 survey suggests payers increasingly favor lower net costs, biosimilars and price transparency over traditional specialty drug rebate programs.

This action follows an Executive Order issued earlier this week to speed review of psychedelic drugs that have shown potential to treat serious mental health issues

A UC Health system-wide hypertension medication algorithm improved blood pressure control across tens of thousands of patients and was associated with estimated reductions in strokes, heart attacks and deaths.

Major health insurers say they have cut prior authorizations, but the AMA says physicians report that the burden of prior authorization remains high.

The resistome is the term for resistance genes present in both harmful and nonharmful bacteria. In the lung, this genetic reservoir can be shaped by factors such as repeated antibiotic exposure, chronic inflammation and changes in the airway environment.

Regeneron is making Otarmeni, which treats patients with biallelic variants in the OTOF gene, available at no cost. This is the second therapy that was approved under the FDA’s new National Priority Voucher program.

Skin cells can actively help the rabies virus multiply and pass into nearby nerve cells, explaining how even small bites or scratches, particularly from bats, can lead to infection.

The FDA has approved Merck’s once-daily single-tablet HIV treatment Idvynso (doravirine/islatravir) for virologically suppressed adults, based on phase 3 trials showing high rates of maintained viral suppression and generally manageable safety outcomes.

$50M fuels Cleveland Clinic AI efforts, launching a "Digital Front Door" to guide patients to the right care, cut ER crowding and improve access.

A study in JAMA Dermatology found that people using an AI tool were more accurate and confident in identifying skin conditions than those using standard methods, though it did not improve their understanding of next steps for care.

The pulmonary manifestations of antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis is well recognized. This research fills in gaps about the prevalence and prognostic impact of interstitial lung disease in people with the autoimmune disease.