It targets pharma margins, PBM fees, and insurance subsidies to slash costs, which could redefine pricing power and consumer choice across the industry.

Starting next year, Novo Nordisk and Eli Lilly will sell their weight loss shots directly to employers, cutting out pharmacy benefit managers, per Bloomberg. This move further signals drugmakers’ push into direct sales, both to consumers and employers. More businesses will likely cover obesity drugs for their workers if they can achieve greater cost control of their offered benefits. And pharma supply chain middlemen could feel mounting pressure to shift further away from the prescription drug rebate model that so many in the industry decry.

Cigna will eliminate prescription drug rebates for many of its commercial health plans and instead offer discounts directly to consumers beginning in 2027. Cigna’s decision marks a big shift in the way prescription drugs are priced and paid for, and could pressure CVS and UnitedHealth to follow. Patients are beginning to see some lower drug prices online and at the pharmacy counter, but they’re also facing more complexity and responsibility. Healthcare and pharma marketers need to engage these more empowered and potentially overwhelmed consumers with clear, actionable communications.

The news: President Trump sent letters to 17 pharma companies, demanding they take action to lower drug prices in the US within 60 days. Our take: We think it’s unrealistic to expect pharma companies to willingly cut their profits despite Trump’s escalated demands. Drugmakers called out in the letter will likely wait out Trump’s deadline and see what he threatens next, knowing they could always legally challenge the most-favored nation order. We also expect more pharma companies to make some of their medicines available through the D2C channel, perhaps seeing it as a reasonable good-faith concession that they hope will get Trump to back off the most-favored nation pricing.

The news: The Trump administration recently met with leading retailers, including Amazon and Walmart, to explore ways in which more US consumers can get their prescription medications directly from pharma manufacturers, according to a Bloomberg report. Our take: It’s unrealistic to expect pharma’s middlemen to be cut out anytime soon, as they are so deeply rooted in the US healthcare infrastructure.

CVS, Cigna sue Arkansas to stop PBM-owned pharmacies ban: Owning both PBMs and pharmacies give them a lopsided advantage over independent pharmacies. It may be tough to push against the specter of more rural “pharmacy deserts.”

Novo, Lilly, and PBMs take steps to reduce GLP-1 drug prices: Players in the weight loss drug market are likely OK with cutting back on prices considering the potential to reach tens of millions of patients.

The walls are closing in on the largest pharmacy benefit managers: Vertically integrated healthcare conglomerates may soon have to separate their pharmacy operations from their PBM businesses.

UnitedHealth Group’s Optum Rx changes pharmacy reimbursement model: It will pay pharmacies more to dispense brand-name drugs. But that’s not enough to thwart off the Trump administration’s heat on pharmacy benefit managers like Optum.

UnitedHealth Group’s shares fall after mixed Q4 earnings: While the healthcare titan will have to contend with potential changes to how its pharmacy benefit manager does business, its reaffirmed outlook for 2025 suggests it’s not too concerned.

Drugmakers plan price hikes on over 250 branded medications in US: Facing a hit under the Inflation Reduction Act, they’re taking matters into their own hands to offset lost revenue.

Trump plans to “knock out” pharma’s middlemen: His comments sent shares of the three largest pharmacy benefit managers down in a sign of what’s to come under the incoming administration.

Big 3 pharmacy benefit managers countersue FTC: They allege the FTC's case against them over insulin prices is unconstitutional. While it might be a savvy legal tactic, it shouldn’t divert attention from PBMs’ role in rising prescription drug costs.

Pharmacy benefit managers confuse consumers and employers alike: Employers must gain a better understanding of their PBM contracts so they can steer their workers toward lower-cost drugs.

Employers don’t know how their Rx drug benefits are managed: They’re nearing their wits’ end with pharmacy benefit managers and the legal liabilities that arise from the mismanagement of prescription drug benefits.

FTC sues drug middlemen for artificially inflating insulin prices: FTC Chair Lina Khan is coming after pharmacy benefit managers while delivering a shot across the bow to the entire pharmaceutical industry.

Express Scripts sues the FTC: The pharmacy benefit manager is demanding the retraction of an agency report critical of pharma’s middlemen. Even if that happens, the damage to PBMs’ reputation is done.

Anthem, Humana JV could be a golden distro channel for DTx makers: The payers are developing a cloud-based pharmacy benefits management platform,—we unpack why its pricing transparency feature makes it a good choice for DTx vendors trying to get their therapies on drug formularies.