Articles related to HEALTHCARE COSTS

Retina practices are adjusting after Good Days funding limitations reduced copay support for some patients requiring chronic anti-VEGF therapy. Medicare Advantage patients appear especially exposed to affordability pressure.

Across 14 health-system specialty pharmacies, pharmacist interventions were associated with an estimated $3.6 million in avoided medication costs over six months. The analysis used a structured attribution method to assess the likelihood that individual interventions altered treatment trajectories.

A cost-efficiency analysis found that ophthalmic ambulatory surgery centers may face growing financial pressure when performing procedures with high direct material costs under current Medicare reimbursement schedules.

ASHP urged HRSA in a June 2 letter to take immediate enforcement action against Eli Lilly after the manufacturer gave an initial group of 340B-covered entities five business days to submit detailed claims-level data or lose access to discounted pricing across its full drug portfolio, including in-house hospital pharmacy dispensing and medically administered products; as of mid-June, the threatened cutoffs had not yet taken effect for many affected entities.

US prescription drug expenditures reached $915.2 billion in 2025, with utilization growth rather than price increases accounting for the majority of the 12.7% rise, and clinic-sector spending projected to outpace hospital spending by a factor of three in 2026.

CMS finalized a four-code complexity-based structure replacing legacy radiation oncology G-codes effective January 1, 2026, consolidating image guidance and treatment delivery under codes 77387, 77402, 77407, and 77412.