For years, P.B.M.s took payments from opioid manufacturers, including Purdue Pharma, in return for not restricting the flow of pills. As tens of thousands of Americans overdosed and died from prescription painkillers, the middlemen collected billions of dollars in payments. The details of these backroom deals — laid out in hundreds of documents, some previously confidential, reviewed by The Times — expose a mostly untold chapter of the opioid epidemic and provide a rare look at the modus operandi of the companies at the heart of the prescription drug supply chain. The P.B.M.s exert extraordinary control over what drugs people can receive and at what price. The three dominant companies — Express Scripts, CVS Caremark and Optum Rx — oversee prescriptions for more than 200 million people and are part of health care conglomerates that sit near the top of the Fortune 500 list. The P.B.M.s are hired by insurers and employers to control their drug costs by negotiating discounts with pharmaceutical manufacturers. But a Times investigation this year found that they often pursue their own financial interests in ways that increase costs for patients, employers and government programs, while driving independent pharmacies out of business. Regulators have accused the largest P.B.M.s of anticompetitive practices. The middlemen’s dealings with opioid makers reveal a lesser-known consequence of this pay-to-play system: Seemingly everything — including measures meant to protect patients and curtail abuse — can be up for negotiation.
McKinsey and Company will pay $650 million over work it did for Purdue Pharma that federal prosecutors say helped fuel the opioid crisis. The settlement resolves criminal and civil Justice Department investigations into McKinsey's work helping Purdue increase sales of powerful opioids despite concerns about addiction.
The much-anticipated launch of Blue Shield of California’s drug benefit venture with Amazon Pharmacy and the pharmacy benefit manager Abarca will debut in January, executives involved say.
Across the U.S., at least 7,000 pharmacies have closed since 2019, The Associated Press reported, citing data from the University of Pittsburgh. Of those, roughly half were independent drugstores.
The availability of safe, effective COVID vaccines less than a year into the pandemic marked a high point in the 300-year history of vaccination, seemingly heralding an age of protection against infectious diseases. Now, after backlash against public health interventions culminated in President-elect Donald Trump's nominating antivaccine activist Robert F. Kennedy Jr. to be the nation's top health official, health experts and vaccine advocates say a confluence of factors could cause renewed, deadly epidemics of measles, whooping cough, meningitis, or even polio.
In the first head-to-head test, Eli Lilly's Zepbound obesity drug helped people lose significantly more weight than its main competitor, Novo Nordisk's Wegovy.
The details
People taking Zepbound lost 20.2% of their body weight on average after 72 weeks of treatment in the Lilly-sponsored study, compared with a 13.7% loss for Wegovy patients, Lilly said Wednesday.
That translated into an average 50-pound loss for people who took Zepbound, while Wegovy users lost 33 pounds.
The significance
Lilly's new study is the first randomized clinical trial to demonstrate that Zepbound could induce more weight loss than Wegovy in head-to-head testing.
Previous studies sponsored by Lilly and Novo Nordisk found that each of the drugs helped people who are obese lose significant amounts of weight, but those trials didn't compare Zepbound and Wegovy against each other.
Lilly will probably cite the results from its new study in the company's Zepbound marketing. It could give Lilly an edge with doctors and patients in one of the fastest-growing and most lucrative prescription-drug markets.
Novo Nordisk responded by saying Wegovy is the only anti-obesity medicine proven to reduce the risk of heart attacks and strokes in people with heart disease and obesity.