Latest news with #DavidWhitrap
01-05-2025
- Health
Lilly star weight-loss drug Zepbound faces coverage challenge from CVS Health
Eli Lilly's stock wobbled Thursday after a looming coverage hit was detailed for its blockbuster weight-loss drug Zepbound. CVS Health said the drugs Wegovy and Saxenda from rival drugmaker Novo Nordisk will become the preferred options on its standard formulary, or list of covered drugs, as of July 1. Zepbound will be excluded. This could complicate access to a drug that many patients cannot afford to pay for on their own. The formulary is maintained by CVS Health's pharmacy benefits management business, which runs prescription drug coverage for millions of people. Employers and insurers — who pay most of the prescription bill — use the formulary to decide which drugs get coverage. They can customize their coverage plans to include Zepbound. But CVS Health spokesman David Whitrap said most employers wind up using the standard formulary because of the discounts negotiated for them. Patients taking Zepbound will be able to switch to Wegovy if the Lilly drug is excluded from their coverage, Whitrap said. CVS Health also said Thursday that it will start selling Wegovy at a discounted price of about $500 monthly at thousands of drugstores for people without coverage. Novo had announced its new lower price last month. Wegovy and Zepbound are part of a wave of obesity medications known as GLP-1 receptor agonists that have soared in popularity due to the amount of weight people lose while taking the injections. Coverage of these drugs has been patchy due to in part to their cost and the wide swath of patients who could take them. Shortages of the drugs also have made access challenging, but those have eased recently. That allows pharmacy benefit managers to pit the products against each other to negotiate lower prices in exchange for inclusion on a formulary. Lilly may have to make some price cuts to restore formulary access, said Daniel Barasa, who follows the company for Gabelli Funds. But he said he thinks big employers will still include both treatments on their lists of covered drugs, leaving the choice on what to use up to patients and doctors. Lilly said late last year that a head-to-head study of the two drugs showed that Zepbound helped patients drop more pounds. Zepbound has emerged as one of Lilly's top sellers. Its sales jumped to $2.3 billion in the recently completed first quarter. That's up from $517 million a year ago, during the drug's first full quarter on the market. Lilly shares shed more than $90 in value, falling nearly 11% to $804.06 Thursday afternoon. Broader indexes, meanwhile, rose slightly.
Yahoo
01-05-2025
- Business
- Yahoo
US Alleges Medicare Insurers, Brokers Used Illegal Kickbacks
(Bloomberg) -- The US Department of Justice sued top health insurance companies and brokers alleging they used illegal kickbacks to steer members into certain private Medicare Advantage plans. NJ Transit Urges Commuters to Work Remotely If Union Strikes NYC Lost $9 Billion of Income to Miami, Palm Beach in Five Years New York City Transit System Chips Away at Subway Fare Evasion NYC's Congestion Toll Raised $159 Million in the First Quarter The Last Thing US Transit Agencies Should Do Now The complaint names units of CVS Health Corp., Elevance Health Inc. and Humana Inc., along with broker companies eHealth, Inc., GoHealth, Inc., and SelectQuote Inc. The government lawsuit, which was initiated by a whistleblower in 2021 and unsealed Thursday, alleges that brokers told their agents to sell Medicare Advantage based on the kickbacks and blocked the sale of insurance plans that didn't pay. The complaint, which covers behavior from 2016 through 2021, further alleges that Aetna and Humana pressured brokers to enroll fewer disabled people in their plans. Medicare Advantage is a private version of Medicare, the government health plan mostly for people in the US aged 65 and older. Over half of the Medicare population are enrolled in these private plans. They often enroll in plans with the help of a broker, who may be paid commissions by insurance companies. Congress has investigated these payments before. EHealth, GoHealth, and SelectQuote previously disclosed that they received subpoenas from the US Attorney's Office in Massachusetts in 2022 regarding their arrangements with insurers. That office is one of several involved in the lawsuit unsealed Thursday. 'We are still reviewing the complaint, but disagree with the allegations, and intend to defend the case vigorously,' CVS spokesperson David Whitrap said. Shares of all the insurers and broker companies fell after the news was announced. Representatives from Elevance and Humana did not respond to requests for comment. Emails to eHealth, GoHealth, and SelectQuote were not immediately returned. (Updates throughout.) Made-in-USA Wheelbarrows Promoted by Trump Are Now Made in China As More Women Lift Weights, Gyms Might Never Be the Same Can the Labubu Doll Craze Survive Trump's Tariffs? The Mastermind of the Yellowstone Universe Isn't Done Yet Healthy Sodas Like Poppi, Olipop Are Drawing PepsiCo's and Coca-Cola's Attention ©2025 Bloomberg L.P.
The Hill
01-05-2025
- Health
- The Hill
Lilly star weight-loss drug Zepbound faces coverage challenge from CVS Health
Eli Lilly's stock wobbled Thursday after a looming coverage hit was detailed for its blockbuster weight-loss drug Zepbound. CVS Health said the drugs Wegovy and Saxenda from rival drugmaker Novo Nordisk will become the preferred options on its standard formulary, or list of covered drugs, as of July 1. Zepbound will be excluded. This could complicate access to a drug that many patients cannot afford to pay for on their own. The formulary is maintained by CVS Health's pharmacy benefits management business, which runs prescription drug coverage for millions of people. Employers and insurers — who pay most of the prescription bill — use the formulary to decide which drugs get coverage. They can customize their coverage plans to include Zepbound. But CVS Health spokesman David Whitrap said most employers wind up using the standard formulary because of the discounts negotiated for them. Patients taking Zepbound will be able to switch to Wegovy if the Lilly drug is excluded from their coverage, Whitrap said. CVS Health also said Thursday that it will start selling Wegovy at a discounted price of about $500 monthly at thousands of drugstores for people without coverage. Novo had announced its new lower price last month. Wegovy and Zepbound are part of a wave of obesity medications known as GLP-1 receptor agonists that have soared in popularity due to the amount of weight people lose while taking the injections. Coverage of these drugs has been patchy due to in part to their cost and the wide swath of patients who could take them. Shortages of the drugs also have made access challenging, but those have eased recently. That allows pharmacy benefit managers to pit the products against each other to negotiate lower prices in exchange for inclusion on a formulary. Lilly may have to make some price cuts to restore formulary access, said Daniel Barasa, who follows the company for Gabelli Funds. But he said he thinks big employers will still include both treatments on their lists of covered drugs, leaving the choice on what to use up to patients and doctors. Lilly said late last year that a head-to-head study of the two drugs showed that Zepbound helped patients drop more pounds. Zepbound has emerged as one of Lilly's top sellers. Its sales jumped to $2.3 billion in the recently completed first quarter. That's up from $517 million a year ago, during the drug's first full quarter on the market. Lilly shares shed more than $90 in value, falling nearly 11% to $804.06 Thursday afternoon. Broader indexes, meanwhile, rose slightly.
Yahoo
01-05-2025
- Health
- Yahoo
Lilly star weight-loss drug Zepbound faces coverage challenge from CVS Health
Eli Lilly's stock wobbled Thursday after a looming coverage hit was detailed for its blockbuster weight-loss drug Zepbound. CVS Health said the drugs Wegovy and Saxenda from rival drugmaker Novo Nordisk will become the preferred options on its standard formulary, or list of covered drugs, as of July 1. Zepbound will be excluded. This could complicate access to a drug that many patients cannot afford to pay for on their own. The formulary is maintained by CVS Health's pharmacy benefits management business, which runs prescription drug coverage for millions of people. Employers and insurers — who pay most of the prescription bill — use the formulary to decide which drugs get coverage. They can customize their coverage plans to include Zepbound. But CVS Health spokesman David Whitrap said most employers wind up using the standard formulary because of the discounts negotiated for them. Patients taking Zepbound will be able to switch to Wegovy if the Lilly drug is excluded from their coverage, Whitrap said. CVS Health also said Thursday that it will start selling Wegovy at a discounted price of about $500 monthly at thousands of drugstores for people without coverage. Novo had announced its new lower price last month. Wegovy and Zepbound are part of a wave of obesity medications known as GLP-1 receptor agonists that have soared in popularity due to the amount of weight people lose while taking the injections. Coverage of these drugs has been patchy due to in part to their cost and the wide swath of patients who could take them. Shortages of the drugs also have made access challenging, but those have eased recently. That allows pharmacy benefit managers to pit the products against each other to negotiate lower prices in exchange for inclusion on a formulary. Lilly may have to make some price cuts to restore formulary access, said Daniel Barasa, who follows the company for Gabelli Funds. But he said he thinks big employers will still include both treatments on their lists of covered drugs, leaving the choice on what to use up to patients and doctors. Lilly said late last year that a head-to-head study of the two drugs showed that Zepbound helped patients drop more pounds. Zepbound has emerged as one of Lilly's top sellers. Its sales jumped to $2.3 billion in the recently completed first quarter. That's up from $517 million a year ago, during the drug's first full quarter on the market. Lilly shares shed more than $90 in value, falling nearly 11% to $804.06 Thursday afternoon. Broader indexes, meanwhile, rose slightly.
Associated Press
01-05-2025
- Health
- Associated Press
Lilly star weight-loss drug Zepbound faces coverage challenge from CVS Health
Eli Lilly's stock wobbled Thursday after a looming coverage hit was detailed for its blockbuster weight-loss drug Zepbound. CVS Health said the drugs Wegovy and Saxenda from rival drugmaker Novo Nordisk will become the preferred options on its standard formulary, or list of covered drugs, as of July 1. Zepbound will be excluded. This could complicate access to a drug that many patients cannot afford to pay for on their own. The formulary is maintained by CVS Health's pharmacy benefits management business, which runs prescription drug coverage for millions of people. Employers and insurers — who pay most of the prescription bill — use the formulary to decide which drugs get coverage. They can customize their coverage plans to include Zepbound. But CVS Health spokesman David Whitrap said most employers wind up using the standard formulary because of the discounts negotiated for them. Patients taking Zepbound will be able to switch to Wegovy if the Lilly drug is excluded from their coverage, Whitrap said. CVS Health also said Thursday that it will start selling Wegovy at a discounted price of about $500 monthly at thousands of drugstores for people without coverage. Novo had announced its new lower price last month. Wegovy and Zepbound are part of a wave of obesity medications known as GLP-1 receptor agonists that have soared in popularity due to the amount of weight people lose while taking the injections. Coverage of these drugs has been patchy due to in part to their cost and the wide swath of patients who could take them. Shortages of the drugs also have made access challenging, but those have eased recently. That allows pharmacy benefit managers to pit the products against each other to negotiate lower prices in exchange for inclusion on a formulary. Lilly may have to make some price cuts to restore formulary access, said Daniel Barasa, who follows the company for Gabelli Funds. But he said he thinks big employers will still include both treatments on their lists of covered drugs, leaving the choice on what to use up to patients and doctors. Lilly said late last year that a head-to-head study of the two drugs showed that Zepbound helped patients drop more pounds. Zepbound has emerged as one of Lilly's top sellers. Its sales jumped to $2.3 billion in the recently completed first quarter. That's up from $517 million a year ago, during the drug's first full quarter on the market. Lilly shares shed more than $90 in value, falling nearly 11% to $804.06 Thursday afternoon. Broader indexes, meanwhile, rose slightly.
