Now that the US government is negotiating drug prices directly with manufacturers, states want to get in on the action, too.

These efforts vary by state, but generally involve creating a board to review drugs’ affordability and sometimes setting upper price limits (UPLs). While none have implemented UPLs as of April, as the idea gains momentum, there are questions about UPLs and boards’ legality, practicality, and whether they will actually lower costs for patients.

A legal first. Colorado, for instance, enacted legislation to establish a prescription drug board in 2021, and drug prices have continued to rise since then. Over the last year, that board reviewed five drugs and declared three unaffordable, including biopharmaceutical company Amgen’s Enbrel, a biologic which treats autoimmune disorders like rheumatoid arthritis. The state then moved to set a UPL for “all purchases and payer reimbursements” in February 2024.

Enbrel can cost about $8,000 a month without insurance, according to GoodRx, and cost insurers in Colorado $46,772 per patient in 2022, according to the Colorado All Payer Claims Database—though Amgen advertises a co-pay program promising insured patients can pay “as little as $0 out-of-pocket for each dose.”

Learn more about states’ role in drug price negotiations.—CC

It’s December 2019, and the world has not yet been rocked by the Covid-19 pandemic. N95 masks cost an estimated 44 to 70 cents per unit. And talks of tariffs are everywhere, as President Donald Trump prepares to issue a 7.5% tariff on medical supplies after denying an exemption.

The first cases of Covid-19 were detected soon after, and the need for personal protective equipment (PPE) like N95s, with costs shooting up to $12 per mask, became even more apparent, hitting hospital bottom lines hard.

In 2025, there’s a sense of déjà vu. Trump is back in office and tariffs are back on the table (though some have been paused for now). And according to many experts, like Jenn Kerfoot, chief strategy and growth officer at health tech company Duos, it’s not a matter of if there’s another global pandemic, but when. Between possible tariffs and the Trump administration's measures to defund and cut staff at public health agencies, experts are concerned preparations for the next public health emergency may be compromised.

“Tariffs under normal circumstances are moderate and uncomfortable,” Kerfoot said, and that gets even worse “when you increase the demand [for tariffed supplies] exponentially, like a global health crisis.”

NYC-based experts share based on their Covid-19 experiences.—CM

UnitedHealth Group’s Q1 2025 earnings seemed less like a routine checkup and more like a triage.

While care patterns for commercial and Medicaid members were “as expected,” care activity in Q1 2025 for Medicare Advantage (MA) members increased at twice the rate of 2024, particularly for physician and outpatient services, UnitedHealth Group CEO Andrew Witty said during a Thursday morning earnings call. And as a result, United—the country’s largest MA provider—is taking a hit.

Plus, Optum, the company’s typically reliable healthcare services business, is struggling with unanticipated changes in its value-based care membership.

“This is far from the performance we expect from ourselves,” Witty said.

Get the rundown on United’s earnings here.—CC