Medicare beneficiaries are facing wide price discrepancies for prescription drugs, with the same medication costing vastly different amounts, depending on the plan and location,The Wall Street Journal reported Nov. 26.
Here are five key reasons why costs can vary significantly:
Pharmacy benefits managers negotiate prices for Medicare, but they do so differently across health plans. For example, CVS Caremark has 643 different prices for generic versions of Zytiga, while Express Scripts has 500 and Optum Rx has 445. By comparison, Capital Rx, a smaller PBM, only has two prices for the same drug pegged to the U.S. government's national average drug acquisition cost.
The price for prescription drugs can also vary widely depending on where the beneficiary lives. A recent analysis found that generic versions of Zytiga cost about $815 per month in northern Michigan, but $3,356 in another part of the state. Similarly, Xarelto prices vary across Florida, ranging from $456 to $884 per month across different Medicare plans.
Medicare's drug pricing plan is complicated, with prices often varying depending on the region and the PBM managing the drug plan. Medicare divides the U.S. into 34 regions, with health plans submitting separate bids for each. Prices are not uniform even within the same region because of different deals negotiated by PBMs with drugmakers and pharmacies.
Even if the same PBM is managing different Medicare plans, prices can still differ significantly. For example, Medicare pays 67 different prices for Xarelto in a single Florida county even though the same PBM (Express Scripts) is managing the plan. This shows how the same PBM can negotiate different rates for the same drug across various health plans.
The price variations can also result in significant out-of-pocket costs for Medicare beneficiaries. Due to the complex pricing system, seniors may face significantly higher costs for the same medication, depending on which plan they choose.
As hospitals and health systems seek to integrate AI into healthcare operations, many are establishing dedicated AI centers to test and develop new AI tools.
Here are four hospitals and health systems that have announced the development of AI centers, as reported by Becker's in 2024:
New York City-based Mount Sinai opened the Hamilton and Amabel James Center for Artificial Intelligence and Human Health. The center will focus on developing AI tools to improve diagnosis, treatment, and overall patient care.
BJC Health System and Washington University School of Medicine, both based in St. Louis, have established a joint Center for Health AI.
In March, Nashville, Tenn.-based Vanderbilt University Medical Center announced the creation of the AI Discovery and Vigilance to Accelerate Innovation and Clinical Excellence center. This center will focus on artificial intelligence.
In February, Hartford (Conn.) HealthCare announced the creation of the Center for AI Innovation in Healthcare. This center will focus on the research and development, education and training, collaboration and partnerships, and ethical and regulatory guidelines of artificial intelligence.
As several pharmaceutical companies challenge their role in the 340B drug pricing program, Bristol Myers Squibb filed a lawsuit Nov. 26 against the HHS agency that oversees the federal program.
Since the 340B program's inception in 1992, Bristol Myers Squibb has used a discount model to offer medications at cheaper prices to safety-net healthcare facilities, according to court documents. In its lawsuit, BMS said the program has "become rife with abuse" and "has grown at a rapid clip and strayed from its mission to support the care of uninsured, low-income patients."
The New Jersey-based pharmaceutical company is requesting a federal judge to regard its 340B rebate plan as lawful and to bar HHS from constraining the rebates through enforcement actions.
Other drugmakers are making the same case.
After Johnson & Johnson announced a plan in August to offer rebates to 340B-covered entities, rather than offering upfront discounts for two drugs, the Health Resources and Services Administration spurned the plan. The HRSA deemed it illegal, and J&J revoked the plan's implementation before filing a lawsuit in November to challenge HRSA's decision.
Eli Lilly then filed a similar lawsuit over its 340B rebate plan, while Sanofi plans to require 340B entities to share claims data to prove program eligibility. Safety-net facilities deemed eligible will then be allotted weekly cash credits for about 20 medicines.
A recent study using data from the UK BioBankhighlightedthe extended risk of major adverse cardiac events in individuals who have recovered from COVID-19.
The research, conducted by scientists from the University of Southern California in Los Angeles and Cleveland Clinic and published Oct. 9 in Arteriosclerosis, Thrombosis, and Vascular Biology, underscores the long-term cardiovascular impact of the virus, particularly for those who were hospitalized.
Here are four key findings:
COVID-19 patients face an elevated risk of MACE, including heart attack, stroke and all-cause mortality, that persists for more than two years after infection. The study found that the risk of MACE remained significantly higher for COVID-19 patients compared to the general population, even beyond 1,000 days post-infection.
For individuals hospitalized with COVID-19, the risk of MACE was found to be similar to that of patients with existing coronary artery disease. Notably, the risk of a heart attack or stroke was higher for COVID-19 patients without a history of cardiovascular disease than for individuals with cardiovascular disease who had not been infected with the virus.
The study identified a significant genetic interaction between the ABO blood group locus and COVID-19. Individuals with blood types that were not Type "O" had a higher risk of thrombotic events.
The use of antiplatelet medications in primary care patients who were hospitalized for COVID-19 and had no history of cardiovascular disease appeared to reduce the risk of myocardial infarction and stroke, researchers found.
As millions of Americans prepare for record-setting air travel this holiday season, the Senate Permanent Subcommittee on Investigations (PSI) released a report on Nov. 26 detailing the growing reliance of major airlines on ancillary fees.
These charges, sometimes referred to as “junk fees,” have become a vital revenue stream for the airlines while travelers “confront more and increasingly complex fees and fewer options for avoiding them,” according to the report.
The report, led by the chairman of the subcommittee, Sen. Richard Blumenthal (D-Conn.), examines practices by American Airlines, Delta Airlines, Frontier Airlines, Spirit Airlines, and United Airlines.
It highlights the use of dynamic pricing, incentive programs, and other strategies the committee said are used to generate revenue from services that were previously included in ticket prices.
“Our investigation has exposed new details about airlines exploiting passengers with sky high junk fees,” Blumenthal said in a statement accompanying the report. “As we head into the Thanksgiving weekend, we regret that travelers will be charged millions of dollars in fees that have no basis in cost to the airlines but simply fatten their bottom lines.”
Among the findings, the report revealed that Spirit and Frontier paid $26 million to gate agents and personnel between 2022 and 2023 for enforcing baggage policies.
These incentives were designed to identify passengers who exceed baggage allowances, often leading to additional fees, the report stated. Frontier agents, for example, can earn up to $10 per bag flagged for a fee at the gate.
The report also explored how airlines use algorithms to adjust ancillary fees based on customer data. This approach allows fees for services like seat selection to vary significantly, even on the same flight.
Between 2018 and 2023, the five airlines generated $12.4 billion in seat fee revenue, with some charges reaching as high as $899 for premium seats.
The subcommittee further noted that these fees are not consistently tied to the airlines’ costs of providing the associated services. Airlines reported that they do not maintain granular cost data to calculate the expenses of baggage handling or seat assignments, raising questions about fee transparency.
In some cases, airlines classify charges as “optional” services to avoid federal transportation taxes, which are applied to the airfare. The report found that such practices create inconsistencies in how services are taxed across carriers, potentially complicating price comparisons for travelers.
Executives from the five airlines are scheduled to testify before the subcommittee on Dec. 4 during a hearing titled “The Sky’s the Limit—New Revelations About Airline Fees.” Topics for discussion include consumer complaints about fee practices and potential measures to improve transparency and fairness in airline pricing.
Delta and American Airlines referred The Epoch Times to industry lobbyist group Airlines for America (A4A) for a comment, who said they were deeply disappointed in the report.
“The report demonstrates a clear failure by the subcommittee to understand the value the highly competitive U.S. airline industry brings to customers and employees,” A4A told The Epoch Times. “Rather, the report serves as just another holiday travel talking point.”
A4A defended the use of ancillary fees, stating that these charges provide consumers with greater flexibility and affordability.
The lobbyist group said that modern air travel is more accessible than ever, a development they attribute to pricing models that allow travelers to pay only for the services they need.
A4A further noted that airlines fully disclose fees at the time of purchase and comply with all laws and regulations, including those governing taxes and fees, which can comprise over twenty percent of ticket prices. They described any suggestions of noncompliance as “uninformed and inaccurate.”
Delta in a separate emailed statement said: “Delta looks forward to the continued dialogue with the Subcommittee including appearing at next week’s hearing. For more than a year, Delta has voluntarily responded to the Subcommittee’s sweeping requests, including providing documents and information, responding to numerous rounds of requests and follow-ons, and providing a senior level employee and subject matter expert at the Subcommittee’s request for a lengthy interview to discuss ancillary fees.”
Spirit Airlines told The Epoch Times that the company has “a long history of offering affordable, low-fare flights, which has made travel more accessible for the public.”
“We are transparent about our products and pricing, our airport policies ensure Guests are treated fairly and equally, and we comply with all tax laws and regulations. We respectfully disagree with numerous statements and conclusions contained in the report.”
Spirit said they look forward to explaining their position at the December hearing and believe that it’s “time to come together and discuss meaningful initiatives that would even the playing field between larger and smaller airlines to benefit all travelers, including those who rely on airlines like Spirit.”
United Airlines declined to comment to The Epoch Times. Delta and Frontier Airlines did not respond to a request for comment from The Epoch Times.
South Korea's export growth slowed for a fourth-straight month in November, to the weakest level in 14 months, as shipments to the United States and China fell amid tariff uncertainty, trade data showed on Sunday.
Exports out of Asia's fourth-largest economy rose 1.4% in November from a year earlier, after a gain of 4.6% in October, to $56.35 billion.
It was the 14th-straight month exports rose in annual terms but the slowest rate for the sequence, also missing a median forecast of a 2.8% increase tipped in a Reuters poll of economists.
Last month, U.S. President-elect Donald Trump pledged to impose a 25% tariff on imports from Canada and Mexico, which is expected to affect South Korean firms as well, and "an additional 10% tariff, above any additional tariffs" on China, South Korea's biggest trading partner.
Shipments to the United States fell 5.1%, their first decline since July 2023, while those to China were down 0.6%, after eight consecutive months of gains. Exports to the European Union were up 0.9%.
Sales of semiconductors rose 30.8%, the weakest growth in 11 months, while car sales fell 13.6%, their biggest drop since June 2020, due to strikes at major auto parts makers and shipping delays amid bad weather.
"The government will team up with the private sector and utilise all available resources to export even a dollar more by the end of the year," said Trade Minister Ahn Duk-geun.
Imports fell 2.4% to $50.74 billion, compared with gains of 1.7% in the previous month and 0.4% expected by economists. It was the first decline in five months.
The country posted a trade surplus of $5.61 billion in November, wider than a $3.15-billion surplus in October.
President-elect Donald Trump has selected Kash Patel to lead the FBI, closing one of the last remaining presidentially appointed positions available two months before taking office.
“Kash is a brilliant lawyer, investigator and ‘America First’ fighter who has spent his career exposing corruption, defending Justice, and protecting the American People,” Trump wrote on Truth Social Saturday night.
“He played a pivotal role in uncovering the Russia, Russia, Russia Hoax, standing as an advocate for truth, accountability, and the Constitution,” he continued.
“This FBI will end the growing crime epidemic in America, dismantle the migrant criminal gangs, and stop the evil scourge of human and drug trafficking across the Border. Kash will work under our great Attorney General, Pam Bondi, to bring back Fidelity, Bravery, and Integrity to the FBI.”
Patel brings a wealth of experience as a former public defender and later attorney for the US Justice Department’s national security division, and served in multiple intelligence and national security roles in the president-elect’s first administration.
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He’d been considered a frontrunner among the MAGA camp, who hope he can shake up the bureau and reverse its record of targeting conservatives in the Trump era.
The New York native is known for deep loyalty to Trump — which has made him a target of the left despite serving as a National Security Council official, senior adviser to the acting Director of National Intelligence, and later, chief of staff to the acting United States secretary of defense.
AP
That loyalty has enraged Democrats, with countless talking heads appearing on left-leaning networks to disparage him.
Former FBI deputy director Andrew McCabe on CNN Thursday warned the audience of Patel, telling anchor Kaitlan Collins that “no part of the FBI’s mission is safe with Kash Patel in any position of leadership in the FBI.”
“It’s inconceivable to me that an outsider with no experience in the organization, no knowledge of the work and the scope of authority that’s involved there could perform adequately,” seethed McCabe, who Trump boldly canned from his position just 26 hours before his 2018 retirement.
McCabe — who butted heads with the 45th president over the FBI’s Trump-Russia collusion probe, pursued the debunked Steele dossier and was fired as acting director of the bureau for leaking sensitive case information to a journalist — cautioned against Patel Thursday, telling CNN that “no part of the FBI’s mission is safe with Kash Patel in any position of leadership in the FBI.”
Those warnings initially caused some concern over his confirmability in media reports, but Patel’s supporters point to his long list of credentials within the Justice Department and national security realm as proof that he is best suited for the job.
“Despite media reports that there are concerns on confirmation, he’s accomplished in counterterrorism, defense, intelligence and the law,” one source close to the transition team told The Post. “Just look at his resume; this is pretty solid person for this job.”
Patel won the early support of Trump confidant and soon-to-be co-head of the new administration’s Department of Government Efficiency Elon Musk, who issued his support in a post to X said that suggested Patel for the role after he suggested there should be a full-time “declassification office” to increase transparency in the federal government.
“Good idea,” replied the Tesla, SpaceX and X owner.
Still, the pick of the sometimes controversial figure may send shockwaves through Washington, which last week seethed at Trump’s selection of former Rep. Matt Gaetz (R-Fla.) for attorney general before removing himself from consideration following meetings on Capitol Hill.
Missouri Attorney General Andrew Bailey, former Rep. Mike Rogers (R-Mich.) and former acting director of national intelligence Richard Grenell had also been considered for the FBI director slot.
The Post has reached out to the Trump-Vance transition team for comment.
