The retailer is sidestepping in-person medical care and insurance complexities in hopes of turning pharmacy traffic into weight loss drug customers.

Rising demand clashes with high costs, no insurance coverage, and doctors’ reluctance to validate outside results.

It targets pharma margins, PBM fees, and insurance subsidies to slash costs, which could redefine pricing power and consumer choice across the industry.

News on drugmaker deals, weight loss drug coverage, medication price hikes, and health insurance to kick off the New Year.

Most people who get their health coverage through the ACA marketplace anticipate being unable to afford rising premiums if enhanced tax credits lapse, with many expecting they’ll have to forgo insurance, per a just-released KFF survey. Unaffordable insurance—or no coverage at all—will force people into difficult choices, such as delaying care and treatment or cutting other essentials to pay for healthcare. With coverage gaps possible as soon as next month, insurers will need to help members navigate changing eligibility and costs to avoid losing them.

Among patients newly prescribed GLP-1s for obesity, 90% either never start therapy or discontinue within a year. Novo and Lilly are using their direct-to-consumer online pharmacies to improve adherence, giving them clearer insight into why patients don’t fill or refill prescriptions to offer targeted support. Beyond that, drugmakers should work with their telehealth partners and pharmacies to give patients resources on managing side effects, navigating insurance issues, and understanding why maintenance dosing remains important after achieving some weight loss.

Health insurance outranks all other factors when people consider their next career move, according to a recent survey from Talker Research and Oscar Health. While employers are unlikely to take on more healthcare costs soon due to their own financial strain, they must prioritize worker retention and use open enrollment for transparent communication on cost increases and plan adjustments

House Democrats introduced a new healthcare bill on Thursday aimed at expanding prescription drug price negotiations and extending Medicare benefits to consumers covered by private insurance. The proposal is unlikely to advance out of the House, but it adds fuel to the ongoing debate over drug pricing, and increases the pressure on pharma companies.

CVS Health’s Aetna is adding conversational generative AI (genAI) to its insurance website and mobile app. Aetna’s move highlights how insurers can use genAI to become more attractive to employer benefit packages.

Most consumers aren’t too familiar with the CDC’s recent COVID-19 vaccine guideline changes, and those who have heard about them say the updates are unlikely to affect their decision to get the shot, according to an October 2025 Pew Research Center survey. Vaccine makers can partner with medical groups and pharmacies to disseminate information through traditional and digital media. Communication shouldn’t challenge CDC guidance or politicize the issue, but should explain where to get the shot, note any insurance changes, and outline special considerations for people with certain medical conditions.

The average cost of employer-sponsored health insurance is expected to surpass $18,500 per US worker in 2026, according to a Mercer survey released this week. That would represent a 6.7% jump from 2025—the largest increase in 15 years. Employers must conduct due diligence of vendors that offer healthcare cost-containment solutions to ensure the products are effective and deliver actual savings. Companies will also want to thoroughly evaluate their contracts with pharmacy benefit managers to better understand their prescription drug benefits, while limits on GLP-1 coverage, especially as upcoming oral versions and new condition approvals drive up demand.

47% of US adults are worried about how they’ll pay for necessary healthcare expenses next year, according to a West Health and Gallup study published today. Consumer anxiety over rising insurance premiums, drug prices, and co-pay costs is accelerating, while geographic disparities are widening the gap in who can access and afford care.

The US Senate is moving to end the government shutdown, but the compromise deal leaves out guarantees to extend the Affordable Care Act (ACA) healthcare tax credits. Without ACA subsidies, younger and healthier consumers will likely drop out of the insurance pool, leaving older and higher-risk enrollees behind. That would drive up premiums and further reduce plan enrollment, putting pressure on insurers and shrinking consumer choice.

Consumers lack familiarity with direct-to-consumer (D2C) pharma services, but many are open to purchasing prescription medications from drugmakers. Pharma companies entering the D2C market must boost awareness of the channel. Pharma brands and marketers should inform pharmacists and doctors of drugmakers' latest D2C options, since they’re key sources for patients with medication cost and coverage questions. They should also create clear educational materials showing how consumers can save on D2C prescriptions, backed by data on limited insurance coverage for certain drug categories.

President Donald Trump remarked late last week that the cost of brand-name GLP-1 drugs could drop to $150 in the US. Trump didn’t detail which insurance markets the lower-cost GLP-1s would apply to, or how he plans to force Novo Nordisk and Eli Lilly to drop their prices. With prescriptions surging, GLP-1 drugmakers must prepare for tougher scrutiny and calls from the government, doctors, and patients alike to make treatments more affordable. Pharma marketers should intensify messaging around their weight loss drugs being cost-effective over the long haul by preventing more serious chronic diseases.

Novo Nordisk lost its federal appeals court challenge of the prescription drug price negotiation program in the Biden-era Inflation Reduction Act (IRA) prescription drug price negotiation program, which could open the door for even more price checks. We see a path where the current administration revamps, or simply rebrands, IRA price negotiations as CMS negotiations to save taxpayer money and help consumers. Brands under pressure to drop prices through the IRA and executive orders should continue those good–faith efforts but also encourage the administration to put the same pressure on insurance companies and pharmaceutical benefit managers to lower healthcare costs.

Prescription drug prices along with other healthcare costs like hospital services and nursing homes, are growing faster than overall inflation, but slower than consumer costs like housing, food, and coffee, per GoodRx Research’s latest data. Pharma marketers need to use empathy to connect with the growing group of underinsured consumers. They should be transparent about prices and acknowledge the frustration consumers feel around the complexity of the US healthcare and insurance system. Proactively highlight help offered for consumers like financial assistance, savings tools, and patient support programs.

Novo Nordisk is partnering with Costco to offer the retailer’s members Ozempic and Wegovy for $499 per month, or about half off what the medications cost patients without insurance. Novo tapping into Costco’s customer base of over 100 million US cardholders is a savvy play, especially considering that Costco members skew toward higher-income compared with shoppers generally. Novo and Costco can specifically market to new mothers and families broadly who may be struggling with weight gain due to their busy lives.

More than three-fourths (78%) of US adults support extending federal funding tax credits for ACA insurance, according to a new KFF survey. That includes 57% of Republicans who support President Donald Trump. The tax credits are a key part of the current Senate stopgap funding negotiations. If subsidies are not extended, insurers need to prepare customer-friendly strategies to retain price-conscious enrollees, such as flexible plan options or help switching plans. They should also offer new digital health perks (or highlight existing ones) like mental health support and health-related discounts.

America’s Health Insurance Plans (AHIP) released a statement that its member health insurers will cover vaccines that were previously recommended by the CDC’s advisory committee with no cost-sharing for patients through the end of 2026. AHIP’s commitment is the first real market signal that major insurers will keep paying for children’s immunizations, as well as updated formulations of COVID-19 and flu vaccines, even if the government’s vaccine advisory panel changes its recommendations. Insurers should partner up with medical associations, pharmacies, and vaccine makers to disseminate information at a local level that makes folks aware of their right to vaccine coverage under their health plan.

Hemsley announced the plan in a prepared statement ahead of a Thursday congressional hearing where five “big health insurance” CEOs (the other four being from Elevance Health, CVS Health, Cigna, and Blue Shield parent company Ascendiun) were grilled by senators over insurers’ role in rising healthcare costs.

The trend: Nearly one-quarter of patients (24%) who are pleased with the quality of their recent medical care may still change doctors in the next 6 months, according to a new survey from Huron Consulting Group. Our take: People used to have limited options for healthcare and just went with whatever was in their insurance network. But things are changing, and providers can no longer bet on this. To compete with new tech-savvy healthcare companies, traditional clinics and health systems need to adapt. While they may not be able to match them completely, they should at least adopt some of the features that patients want.

As AI tools steer more healthcare decisions, providers and insurers must target high-value use cases, carefully vet vendors, and lock in governance early.