Now, we are going to try to make one area of insurance a little easier to understand: Medicare Advantage Special Needs Plans (SNPs).

As Medicare Advantage (MA) is Medicare’s private alternative to traditional Medicare, SNPs take it a step further by giving members who have extra needs access to specific benefits (more on this later). The first SNPs were offered all the way back in 2006, though it took some legislative work to make them a permanent MA offering by 2018.

KFF reported that SNPs now make up 21% of all MA enrollees as of 2025, compared to 13% in 2018. This bump has transcended into MA growth generally, as enrollment increased 1.1 million to 35+ million MA members between February 2025 and February 2026, KFF also reported. (For reference, total MA membership was only 8 million in 2007.)

“Allowing plans to specialize in certain populations [enables] plans to better coordinate care and specialize the benefits, tailor the benefits to these populations,” Gretchen Jacobson, VP of Medicare at the nonprofit Commonwealth Fund, told Healthcare Brew.

Let’s break it down.—CM

CVS is suing Tennessee over a recently passed PBM law. But advocates for independent pharmacies say it could be the lifeline they’ve been waiting for.

The state’s FAIR Rx Act, signed into law by Gov. Bill Lee on May 22, tackles vertical integration by prohibiting companies that own a pharmacy benefits manager (PBM) or a health insurance issuer from having more than 5% ownership interest in a pharmacy in the state. (The original bill called for a full ban.)

CVS—which owns an insurer (Aetna), a PBM (Caremark), and the largest retail pharmacy chain in the country—filed a lawsuit that same day, arguing the law protects in-state pharmacies while discriminating against them, and violates a US Constitution clause that prohibits states from “discriminating against or unfairly burdening out-of-state businesses,” CVS spokesperson Amy Thibault told us in an emailed statement.

The law is intended to take effect Jan 1, 2028. If it does, it could level the competition for independent brick-and-mortar stores, regional pharmacy chains, and even national pharmacy chains or chains owned by grocery stores, Anthony Pudlo, CEO of professional group the Tennessee Pharmacists Association, told us. In other words, he said, “just about everybody that is not a vertically integrated pharmacy.”

Anyone else feeling a sense of déjà vu?—CC

Novo Nordisk raised its annual guidance after the Danish company’s Wegovy pill sold even better than expected, racking up 1.3 million prescriptions in the first three months of the year, totaling 2.26 billion kroner in sales (about $243 million). That’s a fraction of Novo’s total sales…for now. Sales of the oral option are anticipated to grow significantly once pending regulatory approvals open up markets outside the US in the second half of 2026.

Meanwhile, sales for Wegovy’s injectable treatment also jumped 12% year over year, disproving worries that a pill could cannibalize the pen. Overall, Novo’s Q1 sales soared 32% on a constant currency basis, while operating profits ballooned by 65%.

Shareholders applauded, boosting the company’s stock 1.96% today.

Meanwhile, rival Eli Lilly’s own obesity pill, Foundayo, which launched in April, sold 6,000 prescriptions in its first three weeks on the market. But it has some catching up to do: The Wegovy brand currently commands 65% of all new prescriptions in the US.

Keep reading on Brew Markets.—JD