The Trump administration announced lower Medicare prices for 15 prescription drugs via the Medicare drug price negotiation program. The new prices will take effect starting January 1, 2027. The biggest hit will fall on pharma companies with drugs selected in both rounds of Medicare negotiations. Revenue impacts will vary depending on each product’s time on the market and how far the negotiated price falls below prior net sales after rebates and discounts. For the government, savings on these drugs will be significant, but broader program savings won’t materialize until far more than 25 drugs see price cuts.

Medicare plans to pay health tech companies for wearables, apps, and telehealth technology that improves patient outcomes via a new pilot program aimed to begin in July 2026. The government’s willingness to pay for digital health solutions signals a meaningful shift toward making these tools part of standard clinical care. But health tech makers need to prove their tools improve patient outcomes to make it into the pilot program.

The three health insurers with the largest Medicare Advantage (MA) footprint (UnitedHealth Group, Humana, and CVS) are cutting membership in 2026 and rolling back plan offerings in certain regions. Many seniors who were lured by aggressive MA marketing promising extra benefits and free perks must now find a new MA plan or switch to traditional Medicare. The Medicare annual enrollment period is underway, offering insurers a chance to rebuild trust with seniors by providing online tools and live support to help them understand their options and switch plans if needed.

Novo Nordisk and Eli Lilly struck a deal with the Trump administration to lower GLP-1 prices in exchange for expanded Medicare and Medicaid coverage. It’s by far the most consequential pharma agreement to date For Novo and Lilly, it’s a tradeoff: lower prices for higher patient and prescription volume—a bet that should pay off over time, especially since tariff relief is part of the deal.

House Democrats introduced a new healthcare bill on Thursday aimed at expanding prescription drug price negotiations and extending Medicare benefits to consumers covered by private insurance. The proposal is unlikely to advance out of the House, but it adds fuel to the ongoing debate over drug pricing, and increases the pressure on pharma companies.

Eli Lilly and Novo Nordisk are closing in on deals with the Trump administration that would exchange deep discounts on their weight loss drugs for coverage under Medicare, per Endpoints News. Millions of Medicare recipients could become new weight-loss drug customers with the federal program on the hook for the cost.

The COVID-19 flexibilities that provided doctor reimbursement for virtual care expired on September 30. Healthcare providers and their marketers who deliver telehealth to Medicare members must keep their patients up to speed with how their care might be affected due to Congressional inaction. They should contact seniors by phone or text to confirm medication refill needs and be available for any additional questions. Practices could turn to social media platforms like Facebook for more general messaging, such as resources that connect seniors with low-cost transportation services or mobility assistance programs that may help folks get to a doctor’s office.

AstraZeneca reached a deal with the US government to lower prescription drug prices in exchange for a three-year tariff reprieve. If more Big Pharma deals with Trump mirror Pfizer’s and AstraZeneca’s, it signals the sector views the terms as favorable, since core revenue drivers remain largely untouched. Still, pricing pressure won’t subside anytime soon, with more drugs expected to be up for Medicare price negotiations. Big Pharma shouldn’t view these latest agreements as the end of the line, but rather as important learning moments for which drug pricing concessions will appease the administration.

The news: Medicare and Medicaid could cover GLP-1s for weight loss as part of a proposed five-year government experiment, according to a report in The Washington Post. Our take: The pilot, albeit not finalized, is a significant about-face from the Trump administration—particularly its top health official, Kennedy. It could be a signal that CMS Administrator Dr. Mehmet Oz is behind the plan, since he’s a bigger proponent of the meds. Still, we’re dubious about how many health plans will commit considering GLP-1s' high costs are a top concern for most insurers.

Amazon Pharmacy expands medication services for caregivers and Medicare users: Healthcare service providers and pharmacies can earn customer loyalty by appealing to often overlooked caregivers with services that make their roles easier.

UnitedHealth Group faces reported criminal investigation over Medicare billing fraud: The DOJ may have gathered enough evidence against UnitedHealth, such as allegedly giving doctors kickbacks. Other top players in the Medicare Advantage market should be worried.

UnitedHealth Group CEO Andrew Witty steps down: New leadership will aim to straighten out the company’s Medicare Advantage business to appease Wall Street. But we’re also keeping an eye on what they’ll do to improve UHG’s sinking reputation.

Trump considers reviving a proposal that cuts US drug prices to international levels: It could be another blow to the drug industry, on top of ongoing drug price cuts in Medicare and looming tariffs set to hit the sector.

Health insurers’ digital tools lack basic capabilities: Medicare Advantage insurers must improve the digital experience since members can switch plans each year.

Medicare and Medicaid won’t have to cover GLP-1s for weight loss: The Trump administration rejected a proposal that would have improved access to the drugs for millions of Americans. The consequences will be greater for patients than for Big Pharma.

Senate confirms Dr. Oz to lead CMS: Reducing Medicare Advantage overpayments could be a priority for Oz and his team. Looming cuts to Medicaid will be tougher to justify.

Medicare drug spending totaled almost $145 billion for the 55.5 million people enrolled in Rx coverage under Medicare Part D in 2023. Our take: While the Trump administration has distanced itself from many Biden-era policies, the IRA drug price negotiations fit its goals of cutting drug prices for government and consumer savings.

President Trump tried to get rid of manufacturer rebates paid to Medicare during his first term, and has resurfaced criticism in this second term, vowing to “knock out” PBMs. In June, Centers for Medicare & Medicaid Services’ administrator Dr.

Separately, Ozempic and Wegovy are subject to forthcoming price cuts in Medicare as part of the government’s drug price negotiation program. But any price cut would only apply to diabetes patients who take GLP-1s since Medicare doesn’t currently cover the drugs for weight loss. Our take: It’s unlikely that brand-name GLP-1s will cost $150 anytime soon.

It seems that seniors with chronic conditions were becoming too costly for CVS’ Medicare Advantage business (Aetna) to manage, or that operating costs were too high to justify keeping some locations open. The bigger picture: Oak Street’s struggles are another example where a retail healthcare player’s primary care investment did not pay off.

Healthcare stakeholders push Congress to make Medicare coverage of telehealth permanent: It’s set to expire at the end of March. We explore what’s at stake for seniors, many of whom are used to getting care remotely.

Pfizer also will invest an additional $70 billion in US manufacturing and R&D, sell new drugs to Medicare at “most favored nation” prices, and in return, receive a 3-year reprieve on tariffs. Amgen launched its own D2C effort AmgenNow last week, and noted it will make the platform accessible through the TrumpRx website.

Diabetes disproportionately affects seniors, and Medicare plans commonly cover Ozempic for this condition. Novo could be hoping that younger consumers will ante up for cash-pay Ozempic, but that depends on doctors’ willingness to prescribe the drug for off-label use (as opposed to Wegovy, which is approved for weight loss).

DOJ will examine UnitedHealth’s Medicare billing practices: The Trump administration has made “waste, fraud, and abuse” a rallying cry. Now, we find out how serious they are about it.