Healthcare news for October 23, 2026
New medicines now launch at a typical price of $257,000 a year, and many Medicare claims for them get turned down at first A new report from the Institute for Clinical and Economic Review (ICER) and West Health finds the median yearly net price of a newly launched drug reached $257,000 in 2025, up 35% from 2022 after adjusting for inflation. About a quarter of new drugs launched at more than $500,000 a year, and only about one in three that ICER reviewed was priced in line with the health benefit it delivers. Getting the drugs can be hard too: for new outpatient medicines, only about a third of prescriptions were filled within 30 days, and people on Medicare ran into the most coverage rejections. The drug industry's trade group disputes the report's methods. If your doctor prescribes a newly approved drug, ask whether your plan covers it, whether prior approval is needed, and what you'd pay. If a claim is denied, you have the right to ask for an exception or appeal.
In 30 seconds
- Prescribed a brand-new drug? Before you fill it, ask your plan if it's covered and whether it needs prior approval. If you're denied, ask your doctor to help you request an exception or file an appeal.
- Blue Cross Blue Shield of Texas is ending its Medicare Advantage and stand-alone drug plans on Jan. 1. If you got a letter, pick a new plan by Dec. 31 to avoid a gap, and remember Original Medicare needs a separate Part D plan for drugs.
- Bought raw oysters lately? Toss any from Virginia's Little Wicomico River harvested Sept. 18 to Oct. 8. They're tied to a Salmonella outbreak, and adults 65 and older are at higher risk of serious illness.
- Using compounded tirzepatide from Apothecary Pharma? Check your vial against the recall, stop using affected lots, and call your prescriber. Get care if the shot site turns red, swollen or painful, or you run a fever.
Medicare & Seniors
Blue Cross Blue Shield of Texas is leaving Medicare Advantage and drug plans
Its Medicare Advantage, Dual Care Plus and stand-alone MedicareRx plans end Jan. 1. MedicareRx members will be moved to a HealthSpring drug plan; others need to choose new coverage. Those returning to Original Medicare can buy certain Medigap policies without health questions through March 4.
Medical DailyFewer Medicare Advantage plans and a higher drug deductible for 2027
The average person on Medicare can choose from 35 Advantage plans next year, down from 39, KFF finds. The standard Part D deductible climbs from $615 to $700, and a temporary program that held down drug plan premiums is ending. Compare plans before Dec. 7.
ABC News
Insurance & ACA
Employers look for new ways to blunt rising health costs
With family coverage now averaging $28,303 a year, employers are adding onsite clinics, contracting directly with hospitals, steering workers to cheaper mail-order generics and varying copays by provider. Experts warn more costs could shift to workers if the job market weakens.
AxiosAmazon, Google and other big employers back faster electronic prior approvals
Amazon, Google, Meta, Oracle and Axon pledged to invest in electronic prior authorization for their self-funded health plans, joining insurers' 2025 promise to speed up approvals. Self-funded plans cover about 180 million Americans.
Fierce Healthcare
Medicines & FDA
Compounded tirzepatide vials recalled over sterility concerns
North Carolina's Apothecary Pharma recalled 22 lots of compounded tirzepatide, a GLP-1 weight-loss drug, plus one lot of NAD+ injection, because sterility can't be assured. FDA rates it Class II and no illnesses have been reported. Check your vial and call your prescriber.
FOX 5 New YorkExperimental Roche pill cuts MS relapses by more than half in big studies
In two late-stage trials, Roche's fenebrutinib lowered the yearly relapse rate in relapsing multiple sclerosis by 55% compared with teriflunomide, an existing MS pill, over about two years. It is still experimental and not yet approved by FDA.
Roche
Staying Well
Raw Virginia oysters linked to Salmonella outbreak
At least 27 people have been sickened and five hospitalized. Little Wicomico Oyster Co. recalled shellstock oysters harvested Sept. 18 to Oct. 8, which went to restaurants and stores in many states and D.C. Don't eat them; throw them out and clean surfaces they touched.
FOX 5 DCFlesh-eating screwworm found in a Texas elk
USDA and Texas wildlife officials confirmed New World screwworm in a hunter-harvested elk in Pecos County, a sign the pest has spread to wild animals in the U.S. The parasite mainly threatens livestock, and health officials consider the risk to people very low.
Axios
Policy & Law
New Jersey warns federal Medicaid cuts could cost it $3.7 billion a year
State officials told lawmakers that up to 330,000 people could lose their current coverage. About 540,000 adults on NJ FamilyCare will need to show work, school or volunteering starting in January and renew every six months instead of once a year.
New Jersey MonitorMissouri prepares for Medicaid work rules affecting about 360,000 adults
Adults in Missouri's Medicaid expansion group will need to log 80 hours a month of work, school or approved volunteering and verify twice a year. People with disabilities and families with children are exempt. Keep pay stubs and records, and update your contact info.
St. Louis Public Radio
Hospitals & Business
Oklahoma's Integris Health to join Kaiser Permanente's Risant Health
Integris, with 20 hospitals and the state's largest physician network, will keep its name and leadership under Risant, which already owns Geisinger and Cone Health. The deal needs regulatory review and could close in early 2027.
Fierce HealthcareAbbott to spin off the business behind Ensure, Similac and Pedialyte
Abbott plans to split off its roughly $8.5 billion nutrition unit as a separate public company by the end of 2027. Abbott says the move lets it focus on medical devices and diagnostics.
MedTech Dive