Healthcare Brew covers pharmaceutical developments, health startups, the latest tech, and how it impacts hospitals and providers to keep administrators and providers informed.

Healthcare Brew

Will Peischel

Healthcare Brew delivers the latest news and trends in healthcare.

healthcare-brew.com

A mountain of pharmaceutical pills in front of the US capital building

Could march-in rights drive down drug costs?

The Biden administration’s quest for lower drug costs may lead to a 1980 law.

Could this federal guideline drive down drug costs?

Maia Anderson

Shelves filled with brightly covered products

Nearly a third of independent pharmacies at risk of closure in 2024 

The pharmacies are feeling the strains of a CMS rule that went into effect at the start of the year. 

Shannon Young

A pharmacist measures someone's blood pressure

How the role of pharmacist has changed

Pharmacists take on a lot more clinical responsibility today, like vaccinations and prescribing certain medications. 

Pharma

illustrated headshot of caroline catherman, healthcare brew reporter

Caroline Catherman

There’s a multibillion-dollar game of tug-of-war happening between drugmakers, hospitals, and Medicaid over a popular drug discount program, and everyone says they’re fighting for the greater good.

According to a new report funded by trade group PhRMA (aka the pharmaceutical industry’s lobbyist squad), the 340B program reduced the amount rebated to managed care beneficiaries by $6.5 billion in 2024.

 requires drugmakers that participate in Medicaid to give drug discounts to hospitals and clinics; these “covered entities” treat a large proportion of low-income, uninsured patients.

The idea is for medical centers to use these discounts to help serve their communities and 

. But critics have accused some providers, especially large nonprofit health systems, of using program savings 

 rather than reinvesting them into costly community care.

In 2023, 340B covered entities purchased a record 

 in drugs, up from $53.7 billion the year before, according to government data.

“It’s a massive program that’s impacting what patients, employers, and taxpayers are all paying for prescription drugs,” Robby Zirkelbach, PhRMA’s chief public affairs officer and head of strategic initiatives, told Healthcare Brew.

Bharath Krishnamurthy, director of health policy and analytics at trade group the American Hospital Association (AHA), a big-time hospital industry lobbyist, said these discounts are necessary to combat 

 price hikes by pharmaceutical companies—a fact “this drug industry-funded report conveniently ignores.”

 found drug companies are less likely to be in compliance with 340B’s rules than hospitals are. The association is pushing for more program oversight of Big Pharma, rather than hospitals.

The new report from PhRMA, conducted by the Berkeley Research Group, examines states that use private managed care organizations (MCOs) to operate their Medicaid programs.

Basically, when a Medicaid patient gets a drug, the drug manufacturer typically has to give money back to states. This type of discount is called a rebate. For most brand-name drugs, the rebate is at least 23.1%. 

But drugmakers don’t have to give Medicaid a discount if the drug gets one through the 340B program. So, as 340B grows, states and the federal government miss out on more money, but participating clinics and hospitals get more.

“It’s a discount that the state would be getting that is instead going to hospitals,” Zirkelbach said.

 by AHA found the rebates given through 340B in 2023 only equaled about 7% of drug companies’ US revenue.

Using each state’s specific 340B and Medicaid policies, this new report claimed that if the 340B program hadn’t exempted certain prescriptions from Medicaid rebates, drugmakers would have handed over $6.5 billion more to Medicaid in 2024, including $4.2 billion to the federal government and $2.3 billion to states.

Hospitals use the money saved to invest in their community, said Krishnamurthy in his statement, which cited a 2020 

 that found 340B hospitals provided $84.4 billion in community benefits like patient financial assistance and contributions to local groups.

, however, suggested hospitals didn’t seem to start investing more in the community after they joined the program.

The Trump administration recently proposed moving oversight of this program from the Health Resources and Services Administration to the Centers for Medicare and Medicaid Services, which has a history of 

Percentage with arrows pointing down crack

PhRMA report finds 340B program lost states $6.5b in rebates last year

Welcome to the latest installment in Big Pharma vs. Big Hospital. 

Sarepta Therapeutics is laying off 36% of staff—500 employees—a move expected to be “substantially completed” by the end of Q3, it announced in a July 16 

As part of these changes, the company is scrambling its C-suite:

The company is terminating Dallan Murray, EVP and chief customer officer, though he will remain a consultant through January 2026.

Ian Estepan, former EVP and CFO, is now president and chief operating officer.

Former president and CEO Douglas Ingram will solely be CEO from now on.

Ryan Wong has taken over Estepan’s old positions.

Louise Rodino-Klapac is now the company’s president of R&D and technical operations. She was previously EVP and chief scientific officer, and headed R&D.

Sarepta will also add a black-box warning—the most serious kind—for acute liver injury and failure for Elevidys, per the FDA’s request. Elevidys, the company’s most profitable product, is the only FDA-approved gene therapy for deadly muscle-wasting disease Duchenne muscular dystrophy.

Elevidys has been somewhat controversial since its June 2024 approval.

Then-director of the Center for Biologics Evaluation and Research Peter Marks overruled his staff to give the drug full approval for ambulatory patients ages 4+ and accelerated approval to nonambulatory patients.

This happened even though the FDA’s clinical and clinical and clinical pharmacology review team wrote it had “no satisfactory data to support effectiveness claims for all ages and for nonambulatory patients,” 

In the year since the drug’s approval, two nonambulatory patients taking Elevidys died of acute liver failure. One case was disclosed in 

After the second death, Sarepta announced it was pausing shipping Elevidys to nonambulatory patients.

Sarepta added in its July 16 update that an internal expert committee has devised an “enhanced immunosuppressive regimen” for nonambulatory patients to take in order to reduce their chances of acute liver failure.

The company plans to submit that to the FDA and start gathering evidence on how to safely resume the treatment in patients who can’t walk.

In total, more than 900 people have taken the drug worldwide, according to the company.

the Sarepta Therapeutics company logo is seen displayed on a smartphone screen.

Sarepta to cut 36% of staff, add black-box warning to Elevidys

The layoffs come after two deaths of patients who had taken its most profitable product, Elevidys. 

Karen Fischer

Though UK-based pharmaceutical company Compass Pathways reached its primary endpoint from its June 23 Phase 3 trial to use synthetic psilocybin for treatment-resistant depression (TRD), investors were seemingly underwhelmed. That same day, shares plunged 46% to a record low of $2.35 a share for the biotech firm.

But Kabir Nath, CEO of Compass, defends the results of the trial, telling Healthcare Brew the team isn’t focused on share prices. The results are significant, he said, and ample bipartisan support in 

 means this changes nothing about the quest for more research into psilocybin to treat certain mental health disorders.

The psychedelic healthcare market has been ramping up since June 2023 when the FDA 

 for biopharmaceutical firms interested in pursuing research on psychedelic drugs to treat psychiatric and substance use disorders. The three main drug compounds of interest were psilocybin, LSD, and MDMA. 

Trial participants were patients with TRD—a diagnosis given after first-line treatments such as antidepressants fail two or more times to manage symptoms—and were living with multiple episodes of chronic depression for an average of three years. 

“This was a population with a high-level of suicidal thinking [in the past],” Nath said. 

The first of Compass’s two Phase 3 trials started with patients completing a Montgomery-Åsberg Depression Rating Scale (MADRS). This is a common way of 

 in adults through a seven-point scale response rate.

Patients were then randomized into two groups: one that received a placebo in the form of a sugar pill and the second that was given a single 25mg dose of psilocybin on the first day. Researchers checked on patients for safety the following day and again two weeks later, then administered another MADRS test six weeks after the first dose.

Study results showed that after one dose of psilocybin, patient symptoms improved with an average 3.6-point decrease in MADRS scores, which is positive from both clinical and trial perspectives. 

The subsequent stock drop can be attributed to the fact that investors had their sights set on a five-point MADRS decrease, which would be a stronger finding for a new field of study, even with 

Psychedelics are an effective alternative to traditional pharmaceuticals for mental health disorders, according to the 

, because they can target serotonin receptors and forge fresh neural pathways in people with severe depression. Over the last decade in the US, the CDC reports that rates of depression have increased 60%, and 1 in 10 adults have taken medication to combat it.

By 2031, the global psychedelics market is 

—Compass, Jamaica-based Minerco, and Canada-based Numinus Wellness—are working on developing psilocybin-based products. Minerco and Numinus are developing raw psilocybin materials or manufacturing processes to produce pharmaceuticals while Compass is actively developing a therapeutic for TRD.

Aside from other common treatments like SSRIs, Spravato (an esketamine nasal spray) by Johnson & Johnson is another drug in the US market used for treating TRD. It received initial FDA approval in 2019 and was approved as a standalone treatment for major depressive disorder and suicidal ideation in January. (There’s 

 over its status as a psychedelic drug, however.)

But psychedelics have been hit hard by roadblocks to FDA approval. In August 2024, pharma company Lykos Therapeutics’s MDMA therapy to treat PTSD and other mental health disorders was 

. According to Lykos, this came following questions about its efficacy as a new body of research and whether existing interventions already address the need for this population, Healthcare Brew previously reported.

Compass has a second Phase 3 trial underway with preliminary results expected sometime in the second half of 2026. Psilocybin doses will be administered twice at three weeks apart, and the dosages will vary between 1mg, 10mg, and 25mg.

Nath is optimistic about the existing and growing bipartisan support for alternative treatments to depression, including 

 from Health and Human Services Secretary Robert F. Kennedy, Jr.

Lynn Marie Morski, president of the Psychedelic Medicine Association, is also optimistic about the future of psilocybin research, even if these trial results were not what investors expected.

“[Psilocybin] is being investigated for such a wide range of indications that I believe it will still eventually get FDA approval for one or more of those, and show itself as a very versatile and safe option,” she told us.

Across the field, Morski said she has her eye on psychedelic therapies like biotech MindMed’s LSD-based therapy for generalized anxiety as well 

person with hands in their lap on left, brain and a hand holding mushrooms on right

Support for psychedelic treatments means full steam ahead at Compass, despite stock drop

Investors were seemingly not satisfied with psilocybin trial results, but the psychedelic health community disagrees.

Drug and medical device companies paid at least $13.2 billion to medical professionals in 2024, according to CMS data released June 30.

There’s been steady growth in these payments over the last few years, which include everything from research payments to free meals to promotional or conference fees. Drug and medical device companies paid out $13.1 billion in 2023, $13.1 in 2022, and $12.6 in 2021.

If you’re a medical provider, you’ve probably gotten one of those perks from a drug or medical device company and thought it wouldn’t affect your decision-making. But 

 suggests physicians are more likely to prescribe drugs from companies that pay them, with some studies specifically associating this with drugs that are 

“Really well-trained people who affirm an oath to do no harm can be influenced, and are,” Neil Jay Sehgal, associate professor of health systems and population health at the University of Washington School of Public Health, told Healthcare Brew.

Most of last year’s payout—$8.5 billion—was for research.

“The research payments are what you want to see. You want to see industry and academia working together,” Joseph Ross, an MD and Yale School of Medicine professor of medicine and of public health, told us.

But the companies also doled out $3.3 billion in “general payments,” which are not associated with a study.

The American Medical Association emphasizes in guidance on its website that physician–industry relationships don’t “automatically mean…professional judgment has been influenced inappropriately.” This funding advances medical knowledge and promotes the education of medical professionals, the website notes.

Sehgal countered that “the industry wouldn’t be doing this if they weren’t getting good value for their spend.”

The data shows certain companies have outsized influence. The top five medical device companies by market cap, for instance, paid out a cumulative $379 million in general payments last year to physicians and nonphysician practitioners like physician assistants, nurse practitioners, and clinical nurse specialists.

Abbott: $38 million in general payments, $51 million in research payments

Boston Scientific Corporation: $60 million general, $30 million research

Stryker Corporation: $135 million general, $5 million research

Medtronic: $118 million general, $61 million research

Edwards Lifesciences Corporation: $28 million general, $65 million research

The five largest drug manufacturers, also ordered here by market cap, paid a cumulative $327 million.

Eli Lilly and Company: $8 million in general payments, $626 million in research payments

Lilly USA: $46 million general, $5 million research

Janssen Biotech: $31 million general, $600,000 research

Janssen Pharmaceuticals: $15 million general, $729,000 research

Janssen Research & Development, LLC: $5 million general, $340 million research

AbbVie: $156 million general, $428 million research

Merck & Company (Merck Sharp & Dohme LLC): $21 million general, $498 million research

Amgen Inc: $45 million general, $198 million research

*J&J has eight different companies listed on the Open Payments portal under the Janssen name. We have listed the top three based on the amount paid out.

This data has been published since 2014, thanks to the Physician Payments Sunshine Act—part of the 

—which requires certain medical professionals and teaching hospitals to report any industry gifts or money to the federal government, including payments for research and promotion or consulting work.

In addition to keeping medical professionals and industry accountable for the exchange of smaller gifts and illuminating outliers, Open Payments data can also illuminate instances of bribes or 

 a working group to investigate those incidents on July 2.

A pharmaceutical drug pill cracked open with stacks of money spilling out of it

Drug, medical device industry paid physicians $13.2b in 2024

The five largest medical device companies paid a total $379 million, not including research funds. 

When you think of direct-to-consumer erectile dysfunction (ED) treatment, you might think of platforms like Hims or Roman. Now GoodRx, perhaps best known for offering prescription drug discounts, wants a piece of the nearly $3 billion ED drug market.

In June, the company announced an ED telehealth treatment service that includes a virtual consult, prescriptions, and “discreet delivery” of medications to most states, starting at $18 per month.

This will be the company’s first-ever “conditions-specific” subscription service. It decided to step into this market after its in-house research found a gap in the ED care market, and plans to leverage brand loyalty and trust in order to grow, Katelyn Pelak, VP and head of product management at GoodRx, told Healthcare Brew.

“We chose ED as our starting point because it represents a high-demand, high-barrier condition where we know we can make a meaningful impact,” Pelak said.

Of 1,332 men surveyed by GoodRx in early 2025, nearly 30% reported ED challenges but only 14% sought treatment. Those who didn’t get treatment cited concerns about cost, side effects, and stigma. A 2024 

 in the Journal of Sexual Medicine found a similar result: Of 1,822 men, about 24% said they had ED symptoms but only 8% had ever been diagnosed.

There’s clearly room for this market to grow given how many people go untreated, and GoodRx can capitalize on that, Chris Lew, VP of commercial strategy and innovation at health research and consulting firm Rock Health, told us.

“In my view, it’s really less about competing with existing players in the space for a share of patients that are already being treated [and more about] competing for that pool of untreated patients,” Lew said. “That’s really about raising awareness of treatment options and lowering access barriers for medication like cost, convenience, affordability.”

 Pelak is confident GoodRx can stand apart because it already has such strong recognition with its 30 million consumers annually. Its paid discount and drug delivery subscription program, GoodRx Gold, launched in 2018 and had 680,000 members at the end of Q1 2025.

“We have that trust. We’ve proven we can do it at scale. We’ve proven we can do it in an affordable way for customers,” she said.

Lew echoed this point. GoodRx’s pricing for this model is “highly competitive,” he said. “Given both its broad existing reach with those 30 million consumers and its core business…I think that could translate in really interesting ways, some of which could be drug price advantages that it can pass on to consumers or lower consumer acquisition cost,” he said.

It’s also a good time to be a direct-to-consumer healthcare brand, he added. The global healthcare e-commerce market was valued at $310 billion in 2022 and is expected to reach $614 billion by 2026, according to consulting firm Ernst & Young.

“We’re really seeing a moment in consumer-driven healthcare,” Lew said.

In this photo illustration, the GoodRx Holdings logo is seen displayed on a smartphone screen.

GoodRx is betting on men’s health with ED subscription service

The brand hopes to reach the 30 million consumers that already use the platform for drug discounts. 

Nicole Ortiz

 is a tried-and-true tradition in the TV and marketing worlds. Healthcare? Not so much.

But that hasn’t stopped point-of-care digital health company PatientPoint from participating in the annual event the last two years.

Typically, upfronts include a presentation from major media networks and then a commercial commitment component from companies interested in advertising with that media company’s programming, Kasha Cacy, chief media officer at full-service agency Known, told Healthcare Brew. Often these presentations are full of glitz and glam, 

At traditional upfront presentations, the goal is to lock in Q4 TV inventory, get a competitive price advantage, and find advertisers for popular programming like live sports and events. “Those three factors tend not to be as strongly at play in a healthcare space as they are in electronics or some of the other spaces,” Cacy said.

, a healthcare influencer known as “Dr. Mike” and a family practice provider who’s known for being outspoken online in an effort to debunk misinformation, to the stage. The company’s presentation also featured a conversation about marketing channels with the Point of Care Marketing Association (POCMA) and media agency IPG Mediabrands Health, as well as a panel by marketing research and tech company Circana.

Though when it came to the commercial engagement element of an upfront, “what it seems like PatientPoint was doing was the first [presentation] part,” Cacy said.

PatientPoint is featured on waiting room and exam room screens at more than 30,000 locations, according to the company, and its main advertisers are major pharma companies. So entering into a marketing event where advertisers try to catch the eye of companies that use a screen to reach audiences (or patients, in this case) doesn’t feel like a total stretch, Cacy said.

That reach PatientPoint offers advertisers as well as its “behavior-changing content” that’s sponsored by pharma companies and pharmacies is what makes tapping into upfronts such an enticing opportunity, Chief Marketing Officer Kyle Barich told us.

“The most important thing for us to do is to be where our customers are and where their concerns are,” he said. “All of these [advertising] folks are looking for new ways of getting quality audiences. They need to target audiences, need to get outcomes. So they’re going to upfronts to try to find new ways of doing that.”

Plus, point-of-care—which is defined as when a patient interacts with providers for care, according to POCMA—is a growing segment in healthcare, and PatientPoint is one of its major players. An April 

 from POCMA showed point-of-care revenue for 17 of its members has grown 171% since 2019, reaching $803+ million in 2023.

So, with a company like PatientPoint finding value in upfronts, could we see more healthcare companies flocking to make presentations in years to come?

Cacy said it’s still a “very specific category,” where it makes most sense for Big Pharma companies looking to advertise on screens.

“If I look at what PatientPoint did, I think it was less of an upfront and more of what I would describe as an innovation day, like, ‘here’s what our product road map is, here’s what our new products are,” she said. “That doesn’t specifically scream upfront to me.”

Though that doesn’t discourage Barich, who’s planning to make next year’s upfront presentation “bigger and better.”

“It’s Disney and Amazon and YouTube—and now PatientPoint,” he said.

Mashup of a woman with a microphone on the left, a doctor pointing to an x-ray on the top right, and people clapping on the bottom right

This healthcare company takes part in marketing upfronts. Is it working?

PatientPoint is using the TV industry’s favorite pitch forum—upfronts week—as a marketing tool. 

Getting pregnant can be more expensive than a new car. Don’t believe us? Ask someone who’s done in vitro fertilization (IVF).

According to fertility education site FertilityIQ, a single IVF cycle is $23,000+ depending on location and whether services like medication and pre-implantation genetic screening are included. Patients complete an average of 2.3 to 2.7 cycles, which can total up to $50,000.

And it’s a growing industry: The US fertility industry is set to increase from $5.3 billion in 2023 to $8.7 billion by 2033, according to market research and consulting firm Precedence Research.

, and offer programs that provide refunds if IVF is unsuccessful.

San Francisco-based startup Future Family offers both. The company introduced an insurance program in February with a “baby or your money back” guarantee. If a patient using the company’s IVF insurance doesn’t have a live birth after two cycles, they can file a claim and get a refund up to their coverage limit. Depending on the policy, that can be $15,000, $30,000, or $50,000.

“If you fail two cycles, you could lose $40,000–$50,000. It’s a huge amount of money, and it sets you back when you’re starting your family. So it’s really important that we can insure IVF and make sure that if someone does fail, they have an opportunity to try again, or at least get the money back if they’re going to go a different path,” Claire Tomkins, founder and CEO of Future Family, told Healthcare Brew. 

Founded in 2016, Future Family has raised over $148 million in venture capital funding from firms such as Aspect Ventures, Portfolia, and Correlation Ventures. Following the launch of its insurance program, the company announced in April it had secured a $400 million financing program from Clear Haven Capital Management to expand its lending platform.

The price of Future Family insurance is individualized based on each patient’s health information. Patients who are more likely to conceive due to factors like age and lifestyle pay lower premiums, but on average, insurance through Future Family is about 20% of the cost of treatment, Tomkins explained.

“So if you were doing IVF for $40,000 for two cycles, then you’d pay about $8,000 for insurance. But the good news is your $40,000 is protected completely,” she said.

The cost of that insurance premium can also be paid through financing, she added.

There are caveats, though. For instance, the insurance has a time limit: Patients have 20 months to complete two cycles of IVF and transfer viable embryos and 30 months of total coverage, according to the company’s website. For reference, one full cycle of IVF takes about four to six weeks, and most treatment centers recommend waiting at least another four to six weeks between IVF cycles, according to Cleveland Clinic. 

The website also notes there are restrictions on who qualifies. Patients 38 and older can’t get coverage unless they’re using donor eggs, nor can patients who have already started an IVF cycle or have failed to conceive after an IVF cycle in the past.

Separate from this new insurance product, Tomkins says Future Family has also given out $200 million in credit to 10,000 patients through its fertility financing program.

Patients pay $300 to $500 a month on their loans on average, Tomkins added. Interest rates vary and depend on factors like credit score, income, and the loan’s size.

Though it’s not a fertility clinic, Future Family has a nationwide network of fertility clinics it works with.

“People are struggling to figure out the best way to pay for fertility treatment, and then on top of that, they’re trying to figure out, if it’s not successful, what happens next? And so now we’re able to really address that and help consumers,” Tompkins said.