Health

Let’s say you’re the CEO of a health plan. A new drug just received approval to treat patients with lung cancer. The drug’s clinical trial examined how well the the drug worked on third line (3L) patients and patients with good funcional ability (e.g., performance status ECOG score of 0 or 1). FDA approved the…

Biosimilars aim to be lower cost options for biologic therapies after loss of exclusivity. A key question is whether these cost savings get passed through to patients via lower out-of-pocket costs. A paper by Dayer et al. (2026) aims to answer this question using 2011-2023 Merative MarketScan Commercial claims data. The authors observed: …significant patient…

One of the central tensions in pharmaceutical policy is the gap between what a drug is worth and what it actually costs. In theory, a drug’s price should reflect its value — its ability to improve health outcomes relative to the next best alternative. In practice, list prices are set by manufacturers, net prices are shaped by opaque…

Transparency and PBMs. Moral hazard of HAART. Accents and social hierarchy. What is a community healthcare worker? RJK, Jr. vs. Gavi

In May 2025, CMS’s Center for Medicare & Medicaid Innovation (CMMI) unveiled it’s “Make America Healthy Again” vision. CMMI models focus on not only “protecting the federal taxpayer,” but also (i) promoting evidence-based prevention, (ii) empowering people to achieve their health goals, and (iii) driving choice and competition for people. CMMI has introduced a number…