From transcontinental telesurgery to AI-powered procedures, tech is reshaping how and where surgery happens.

Robot-assisted surgery, which allows physicians to control a mechanical arm equipped with surgical instruments and a high-definition camera, has been a big part of this transformation.

The first robot platform was used on a human patient in 1985, though the field didn’t really take off until Intuitive Surgical’s da Vinci system for minimally invasive surgery launched in 2000. By 2018, 15.1% of US general surgery procedures involved robotic surgery, a 2020 JAMA Network Open study found.

Some studies suggest this technology makes minimally invasive surgery easier for physicians, reduces the length of hospital stays, and improves patient outcomes for procedures like prostatectomies and pancreatectomies. Countries including the UK are working toward using it for most minimally invasive surgeries, according to a June statement from the National Health Service in England.

But some experts question the cost effectiveness of robotic surgical systems.

See the latest in our Quarter Century Project here.—CC

With medication costs in the US still about nearly 3x higher than some other countries, the Trump administration has made it a mission to cut drug prices.

One of its initiatives to do so includes TrumpRx, a public-private program created to dispense certain drugs through a standardized marketplace directly to patients’ homes. Pfizer was the first to join the platform in September, and AstraZeneca announced its own deal soon after.

Pfizer’s stock shot up 6.8% and AstraZeneca’s rose 10% following the deal announcements. The program works through direct-to-consumer (DTC) platforms, which companies like Eli Lilly and Novo Nordisk already have. Other biotechs like Amgen, Bristol Myers Squibb, and Novartis launched DTC platforms in response to the new program, which means they could be added to the TrumpRx site when it goes live in 2026.

However, experts previously told Healthcare Brew DTC may not move the needle much on cutting costs for patients due to the fact that DTC programs work mostly out of pocket rather than through insurance. While there may be some cases where patients can use insurance, the programs are designed to be an option for people without insurance, who want out-of-pocket discounts, or whose plan doesn’t cover certain drugs. Some drugs, even at a discount, still cost hundreds of dollars out of pocket.

So, what does this mean for Big Pharma and patients?—CM

Normally, you want more customers, right? Apparently not if you’re a health insurance company and those customers come with high medical costs.

With enrollment now underway for next year’s Medicare Advantage (MA) and Affordable Care Act (ACA) marketplace plans, major payers are spiking prices and reducing benefits—an approach they hope strategically curbs growth amid elevated medical costs, according to those companies’ Q3 earnings calls.

Backtracking on MA. Annual enrollment for MA began Oct. 15. The average beneficiary has 32 MA prescription drug plans available in 2026, fewer than this year (34) but higher than the majority of years the program has been around, per KFF.

Payers like UnitedHealth and Humana look to be very invested in reducing and shifting MA enrollment.

After receiving another year of poor star ratings, Humana President and CEO Jim Rechtin said in an Oct. 2 update the payer wouldn’t be “actively selling” most plans in its largest MA contract, which currently has 3.5 stars. Instead, it’s trying to shift its MA members into plans with four or more stars.

Here’s what payers are up to these days.—CC