People in all parts of the country are keeping close watch over their health care dollars, particularly in light of recent policy and political changes. Many SmartBrief readers are in the same boat, clicking often on stories about rising drug and health care costs, likely wondering what it will take to stay afloat. Here are some of the May 2025 stories that captured the most interest.
Drug directives
What happened: In mid-May, President Donald Trump issued an executive order aimed at lowering US drug prices while allowing manufacturers to charge more for their medicines overseas. The “Most Favored Nation” order targets drugs with the highest cost differences between the US and other developed countries, and it requires HHS to establish price reduction targets. Trump warned that if drugmakers did not abide by the new rules, the “power of the federal government” would be deployed to ensure US prices are comparable to other countries. He set a 30-day deadline for costs to be lowered and said that by forcing other nations to pay higher prices for drugs, the initiative will lessen research and development costs shouldered by the American consumer.
What’s next: This month, at the 30-day mark, the administration urged drug makers to start negotiations on lowering prices. “Under President Trump’s direction, HHS is demanding that pharmaceutical companies end their obstruction and come to the table—just as they already do with nearly every other economically comparable nation—to negotiate fair, transparent pricing for Americans,” a spokesperson for the agency said in a report by STAT.
GLP-1 growth
What happened: Positive health news for the month included new data on employer coverage of GLP-1 drugs like semaglutide and tirzepatide for diabetes and weight management. A Benefits Pro article detailed International Foundation of Employee Benefit Plans research showing that 36% of US employers now offer coverage of the drugs for those uses, a 2 percentage-point rise over 2024. More than three-quarters of employers said they compensate for the medications’ high costs through methods such as prior authorization and refill authorization rules, physician-led approaches, prescriber limitations and patient health-based criteria.
What’s next: A Society for Human Resource Management analysis, published in June, said that claims for both uses of the drugs have continued to increase. IFEBP Vice President Julie Stich noted employees’ “sustained interest in these drugs,” which typically cost between $1,000 and $1,500 per month. Evernorth data indicated that GLP-1s are responsible for an unprecedented uptick in traditional drug spending, causing it to surpass specialty drug spending for the first time.
GLP-1 supply
What happened: In related news, May brought a new FDA ban on the production and sale of compounded semaglutide and tirzepatide. Compounded versions of the drugs had been sold to thousands of patients who couldn’t otherwise get them due to cost or shortages. Manufacturers had claimed that the shortages of the drugs had ended and compounding should not be allowed, but some areas still may encounter supply problems, and people who relied on the less-expensive versions may face access barriers.
What’s next: Dr. Jody Dushay of Beth Israel Deaconess Medical Center noted in a CNN interview that people who can no longer get the compounded versions of the weight-loss drugs may have to restart treatment with low initial doses of the brand medications prescribed by a health care provider. That could create serious pressure on the supply of these doses, Dushay said.
Health plan satisfaction
What happened: J.D. Power’s US Commercial Member Health Plan Study found that the member satisfaction gap between high- and low-performing health insurance plans is getting larger, with overall enrollee approval taking a slight dip from last year. The best-performing plans appear to be improving, while the worst-performing ones are falling even further behind, according to a HealthLeaders Media analysis. “Leading plans are setting themselves apart by delivering clarity, digital convenience and member-first communication. Others are falling behind as trust erodes, digital tools go underutilized, and members struggle to understand their coverage,” J.D. Power executive Caitlin Moling said in a release.
What’s next: Report authors noted that plan members who have a thorough handle on their out-of-pocket costs and out-of-network coverage are likely to experience higher satisfaction, fewer claim denials and better care access than others. Full results of the J.D. Power analysis can be found here.
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