Senators from both parties signaled support for 340B reform. They pushed for clearer transparency, stronger guardrails on how hospitals use savings, and better alignment with patient benefit. They also warned about unintended damage to safety net providers if reforms cut too deep.

Why it matters: Advocacy teams should treat this as a live-fire drill. Map your hospital and clinic partners, identify who relies most on 340B, and prepare concrete stories that show how reforms can protect patients instead of clip them.

The FTC signaled concern over Novo Nordisk’s plan to buy Metsera and expand its obesity pipeline. Regulators worry about further consolidation in a market that already struggles with access and affordability for GLP-1 drugs.

Why it matters: Antitrust fights now sit at the heart of drug access. Advocates who track pipeline deals and speak to competition, not just cost, gain more credibility in these debates.

Nonprofit hospitals and clinics raised alarms over a new drug rebate structure tied to Medicare programs. They fear revenue hits that could cut into uncompensated care and safety net services.

Why it matters: When rebate rules shift, so does the money that funds charity care. Advocacy teams should ask hospital partners explicit questions about how rebate changes will affect patient programs, financial assistance, and access to specialty meds.

Federal ACA enrollment opened, but lawmakers did not extend enhanced premium subsidies. Plans still exist, but the political decision to skip subsidy action invites premium shock for some enrollees next year.

Why it matters: Outreach teams must prepare to explain rising net premiums and keep vulnerable enrollees from dropping coverage. This story sets the context for every navigator and community-based organization on the ground.

Medicare finalized a physician fee schedule that cuts rates for many specialists next year. Specialty practices warn that the cut will hit rural and underserved communities hardest and could shrink access to complex care.

Why it matters: Advocacy leaders should collect examples of threatened closures, longer wait times, and reduced specialist access. Those details drive stronger arguments for payment adjustments or targeted fixes.

New tariffs, Most-Favored-Nation style pricing ideas, and a surge in direct-to-consumer channels keep pressure on the US drug market. The piece shows how these forces interact and how easily blunt policy tools can backfire on patients.

Why it matters: Your policy narrative should not stop at “lower prices.” It should show how certain tools protect patients while others shift costs or limit availability. ELAVAY’s Advocacy Intelligence framework gives teams that nuance.

Senators Crapo and Wyden signaled their intent to reintroduce a bipartisan PBM reform package. Proposals include more transparency, limits on spread pricing, and requirements that PBMs pass through more rebates.

Why it matters: PBM reform now counts as bipartisan safe ground. Advocacy teams should prepare position statements, coalition letters, and patient stories that push for real pass-through to patients, not just cleaner balance sheets.

KFF reported a 6 percent jump in family premiums for employer coverage. Average family coverage now costs over twenty thousand dollars a year, with workers paying about $6,850 of that. Deductibles climbed to nearly $1,900, and almost one third of covered workers now sit in HSA-linked plans.

Why it matters: “Covered” no longer equals “protected.” Advocates should treat high deductibles and HSA enrollment as underinsurance signals and build arguments that tie benefit design directly to delayed care.

A new study showed UnitedHealth and its Optum-owned physician groups receive about 17 percent higher payments than outside practices. The analysis mapped how vertically integrated systems can tilt payment and steer patients inward.

Why it matters: When one company controls the plan, the PBM, and the clinic, patients lose leverage. Advocacy teams should map this consolidation in their markets and call out how it affects access and negotiating power.

Policy analysts laid out options beyond strict government price caps. They highlighted value-based contracts, transparency, and targeted reforms that aim to lower prices without collapsing innovation.

Why it matters: Patients feel the price crisis, but they also need viable pipelines. Advocates who understand these alternatives can push for reforms that cut waste and profit games without choking off breakthrough therapies.

Mark Cuban’s Cost Plus platform introduced a biosimilar version of J&J’s Stelara with simple, transparent pricing. The move undercuts traditional pricing layers and exposes how middlemen profits inflate costs.

Why it matters: This gives advocates a live case study. You can compare traditional specialty pharmacy pricing to Cost Plus and show, in hard dollars, how different models treat patients.

A Health Affairs study mapped UnitedHealth’s reach across insurance plans, PBM services, and provider groups. The findings showed how much influence one company holds over prices, networks, and care pathways.

Why it matters: When advocates walk into a policy or payer meeting, they need a clear picture of who actually pulls the strings in their market. This study hands you that map.

Cuban called out PBMs for capturing rebates while patients still pay list prices during deductible phases. He argued that real reform requires routing rebate dollars directly to the people at the pharmacy counter.

Why it matters: Advocacy teams can borrow this framing. “Who gets the rebate” lands much harder on a Hill staffer or employer than vague talk about “drug pricing.”

A new West Health and Gallup survey found that almost half of adults worry they cannot afford health care next year. One in three already skipped or delayed care in the past year because of cost.

Why it matters: This is your opening slide material. Cost anxiety now counts as a mainstream reality, not an edge case. Use that data to frame cost-of-care arguments in every executive meeting.

The Lancet piece argued that time itself functions as a social determinant of brain health. People in lower income and structurally marginalized groups have less discretionary time for sleep, movement, meal prep, and cognitive engagement that protect against dementia.

Why it matters: When you design “brain health” campaigns, you cannot just tell people to exercise and meditate. You must address work schedules, caregiving burdens, and structural time poverty.

A Black physician laid out how biased science and underrepresentation of Black men in research lead to missed diagnoses, poor treatment protocols, and avoidable deaths. The article tied inequities to systemic choices, not individual behavior.

Why it matters: Advocacy teams should treat representation in research as a core quality metric, not a side issue. That includes how you pressure sponsors, IRBs, and investigators.

A CF-focused paper showed how deeper patient advocacy involvement can reshape research questions, study endpoints, and trial logistics. It argued for full partnership rather than token seats at advisory tables.

Why it matters: This gives you a positive case study. You can show executives what real co-creation looks like and how it accelerates more relevant evidence for patients.

A mixed-methods study captured how people with chronic conditions experience health insurance design. Many participants reported that coinsurance, step therapy, and opaque rules forced them to trade off medications, food, and rent. They wanted simpler, more predictable benefit structures.

Why it matters: Advocacy teams can quote this research when they push back on complex benefit designs that look clever on paper but punish patients in real life.

Lawmakers pushed back on proposed CMS payment changes for diabetes technology, including CGMs and related supplies. They warned that some changes could limit access or shift more costs onto patients, even as the tech itself improves outcomes.

Why it matters: Diabetes tech shows what happens when innovation outruns payment policy. Advocacy teams should track these fights and build coalition messages that link device access directly to equity and complication rates.