Just to make you not feel depressed @yogao , here’s some recent wins & loses:
WINS:
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Congress just made a move. This is the government moving at rocket speed. Small efforts take 5 years. Large efforts take 20. How this will work, in reality, is that it requires action from every major player within gov.
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We had action out of Congress via the Appropriations Bill (see Rep Buddy Carter’s work). FTC has settled with 2 out of the 3 large PBMs. The executive branch acted on the GPOs (people are currently fighting on if they can bring that action down). GPOs are the large multinational companies exercising control over drug pricing.
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Congress is probably going to be the actor to break up the companies, should we chose to do that. There is a bipartisan bill called Break up Medical Monopolies Act. U.S. Senator Elizabeth Warren | Warren, Hawley Introduce ...
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Department of Labor is on the move. https://www.statnews.com/2026/01/30/pbm-drug-rebate-transparency-proposed-rule-department-of-labor/
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We setup drug manufacturing plants as leverage. That took less than 10 years. That’s fast. They purchased a facility and might be up and running. That was really a joint effort between government, diabetics, and doctors at the Mayo.
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FTC and DOJ seek public feedback.
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DOJ has a new branch of enforcement that is specifically designed for enforcement efforts in healthcare. Justice Department’s antitrust division forms task force on health care monopolies and collusion
This took 18 years to bring about. This is a drug costs fight, not a fix the entire healthcare system fight (although that is certainly in the back of our minds and we are working that direction). We haven’t gotten around to that yet. It’s no small achievement to provoke the entire government into hunting the PBMs. Of course, the other side has had big wins too. Their wins are our loses.
LOSES:
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The judiciary has been a flop. They overturned Chevron doctrine. That weakens agency power across the board. We have done a lot of work thru the agencies, so that is bad for us.
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They recently revoked FTC’s ability to do anything about mergers. https://www.beckershospitalreview.com/legal-regulatory-issues/federal-judge-vacates-ftc-premerger-rule-5-things-to-know/ Maybe that responsibility falls back on the states who lack the resources, historically, to handle it. Every state is different. Some are bulking up their antitrust capabilities, but some only employ only antitrust lawyers. That’s not helpful at all.
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The large medical monopolies just keep expanding. Cigna acquires CarepathRx, a major pharmacy used by hospitals | STAT