Trump's Ozempic tariffs, Zepbound on Medicare, and rising drug prices: Pharma news roundup

The cost of prescription drugs is set to climb in 2025 and beyond, according to TD Cowen’s 30th Annual Drug Pricing survey. The investment bank polled 27 health maintenance organizations, pharmacy benefit managers, and hospitals during the fourth quarter of 2024, post-election. This group was responsible for about one-fourth of total U.S. drug spending in 2024 — about $179 billion. The respondents expressed a general consensus that drug prices are likely to continue rising steadily, fueled by a pipeline of high-cost treatments.

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Denmark is the latest in a series of countries that President-elect Donald Trump has threatened with tariffs — joining a list that includes the 26 other nations of the European Union, as well as Canada and Mexico. However, if he follows through with imposing tariffs on imports coming from Denmark, it could drive up the already expensive cost of one of America’s fastest-growing obsessions: weight-loss drugs.

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A Silicon Valley software engineer is leveraging her technological expertise to help patients use AI to fight back against health insurance claim denials — some of which may have been driven by AI themselves. Holden Karau built FightHealthInsurance.com, a free website that helps patients draft appeals for denied insurance claims, following her own experiences dealing with claim denials.

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Sales of blockbuster weight-loss drugs have surged in 2024 and are projected to continue rising in the coming years. The medications, which belong to the class of drugs called GLP-1s and were popularized by the diabetes treatment Ozempic, help regulate blood sugar levels and suppress appetite. However, the drugs’ high prices and limited insurance coverage have made them inaccessible for some patients. Additionally, recent shortages have further complicated access. These challenges have opened the door for telehealth companies and online pharmacies to exploit existing drug regulations by offering cheaper, off-brand versions of the medications. Here are the most and least expensive weight-loss drugs on the market.

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El Lilly’s (LLY) blockbuster weight-loss drug Zepbound is now eligible for Medicare coverage. The news could significantly expand access to the popular yet costly treatment. CMS rules prohibit coverage of weight-loss drugs for the sole use of losing weight, but guidance issued last March allows for anti-obesity medications approved “for an additional medically accepted indication” to be considered for coverage under that specific use. Zepbound met that new criteria last month after the FDA approved it as the first prescription medication to address moderate-to-severe obstructive sleep apnea (OSA) in adults with obesity.

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The millennial-focused digital health company Hims & Hers (HIMS) has donated $1 million to President-elect Donald Trump’s inauguration fund. It joins the growing ranks of corporate donors to the fund, including Facebook parent company Meta (META), Amazon (AMZN), OpenAI, Uber (UBER), and Bank of America (BAC).

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Google’s (GOOGL) anti-aging company Calico released disappointing trial results of its first-ever drug. Calico’s fosigotifator was tested for amyotrophic lateral sclerosis (ALS), a fatal neurodegenerative disease that affects nerve cells in the brain and spinal cord and leads to paralysis. The treatment failed to slow disease progression or improve respiratory function and quality of life better than the placebo group.

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Over the past few years, the health insurance industry has experienced a series of major mergers and acquisitions, further consolidating power into the hands of a few dominant companies — leaving Americans with fewer options. As of 2023, just four health insurers control a staggering 50% of the market, while six companies account for 30% of all healthcare spending in the United States. Here is a ranking of the largest health insurance companies by market share

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