The cost-effectiveness threshold used by the National Institute for Health and Care Excellence in Britain may soon be raised. Here, I describe what's going on and what the implications may be for prescription drug spending. www.forbes.com/sites/joshua...

As we've entered open enrollment season, there's sticker shock in both the ACA/Obamacare and commercial health insurance markets. www.forbes.com/sites/joshua...

The price deals cut on obesity drugs will have a negligible effect on Medicare beneficiary access. Same holds for other patients. And the agreement raises a series of unanswered questions which we won't find answers to, given the confidential terms of the negotiations. www.forbes.com/sites/joshua...

Republicans appear to have more than just "concepts of a plan" on healthcare. A GOP plan taking shape to redirect Obamacare subsidies to individuals who can use them for health savings accounts could erode the foundation of the Affordable Care Act. www.forbes.com/sites/joshua...

The Trump administration's announced price cuts for weight loss drugs are certainly interesting. But what's been released to the public raises more questions than answers. www.forbes.com/sites/joshua...

As states form coalitions to counter what they view as detrimental public health policy emanating from the Trump administration, I'm reminded of one of our nation's founding principles: Federalism. This piece is about that, using the state alliances as an illustration. www.forbes.com/sites/joshua...

The British government is considering raising the level of a cost-effectiveness threshold used as a benchmark to determine whether a healthcare intervention provides value for money for the National Health Service. www.forbes.com/sites/joshua...

Democrats introduced a bill that would repeal the orphan-only drugs exemption included in the One Big Beautiful Bill. As is almost invariably the case with legislation, this repeal effort as well as the orphan-only drugs exemption itself entail tradeoffs. www.forbes.com/sites/joshua...

Biosimilar access in the U.S. is improving. But barriers have prevented these lower-priced versions of originator biologics from truly flourishing. FDA is addressing approvals, but two often bigger hurdles - patent disputes and payer reimbursement - remain. www.forbes.com/sites/joshua...

I sense some skepticism in the commentary around the health insurer Cigna's policy announcement this week. While I'm not sold on the idea that this heralds the end of rebates that don't get passed through to patients, it's a step in the right direction. www.forbes.com/sites/joshua...

On health insurance, the media and politicians in Washington DC tend to focus on federal government spending in programs such as Medicaid and Obamacare. This ignores, however, the much larger subsidies given in the commercial sector. www.forbes.com/sites/joshua...

Like many Americans, I found out this morning how large the spike in health insurance premiums will be in 2026. In my case, 16% (over $100 per month more than in 2025). Americans are paying much more in premiums each year for worsening coverage. It's absurd. www.forbes.com/sites/joshua...

It's that time of year again: Open enrollment, when many Americans select health plans for the upcoming year. Across the Obamacare exchanges, monthly premiums are rising by as much as 30% on average. And this doesn't account for the expiring subsidies. www.forbes.com/sites/joshua...

Direct-to-consumer advertising of prescription medications is ubiquitous. The Trump administration is addressing what it sees as a "public health crisis." But will things change with respect to these commercials? undark.org/2025/10/27/d...

On this rainy day in Boston, my piece on the sun (its benefits), sunscreen (its protective properties), and the anti-sunscreen movement, is out. undark.org/2025/10/13/a...

Kennedy’s repeating refuted (or at least disputed) links isn’t a one-off. He has often done this regarding exposure to substances such as acetaminophen, thimerosal and aluminum salts that he thinks are tied to autism. www.forbes.com/sites/joshua...

“Yellow, Orange, Both?” “Delicious autumn! My very soul is wedded to it, and if I were a bird I would fly about the earth seeking the successive autumns." ~ George Eliot Shot With: iPhone 12 Pro Max. #Fall. #Trees. #Yellow. #Nature. #Orange. #Autumn. #October. #Photography.

Without critical details, it's hard to evaluate the impact of Trump's most favored nation initiative on drug pricing for patients and Medicaid. www.forbes.com/sites/joshua...

Is Trump's most favored nation initiative consequential? Well, not for the vast majority (>90%) of U.S. patients. It could be meaningful for Medicaid payers, but even that remains to be seen. For now, the impact on Medicaid is shrouded in opacity. www.forbes.com/sites/joshua...

Florida Surgeon General Joseph Ladapo's stance opposing vaccine mandates stands in stark contrast to longstanding (current and past) U.S. immigration policy. www.forbes.com/sites/joshua...

While many MAHA ideas are problematic, improving diet and exercise is laudable. Our diet in the US is really quite poor. I've lived overseas for decades. Generally, diet is much better outside the US. Perhaps one way to address the problem is adding nutrient warnings. www.forbes.com/sites/joshua...

Why canceling a federal government survey on hunger and food insecurity matters. www.forbes.com/sites/joshua...

There are many problematic ideas in the MAHA movement. But paying closer attention to diet (and exercise) is a welcome feature. Americans' dietary habits can be poor. Perhaps MAHA could push for adding nutrient warning labels as is done in other nations. www.forbes.com/sites/joshua...

Many rural hospitals and nursing homes have been operating in the red or close to it for years. The One Big Beautiful Bill will greatly exacerbate this longstanding problem. In anticipation of cuts in 2026, some hospitals and clinics are already closing their doors. www.forbes.com/sites/joshua...

Leucovorin is being touted by FDA Commissioner Makary as a treatment for individuals with autism who have cerebral folate deficiency. It may have modest promise, but the science is far from being settled. www.forbes.com/sites/joshua...

Ever since moving back to the US on a more or less permanent basis in 1995, I've never understood the farce of federal government shutdowns. What's particularly troubling is the real fallout. Here I describe the role of Obamacare subsidies in the current standoff. www.forbes.com/sites/joshua...

It's hard to overstate what the reaction outside the U.S. (by regulatory agencies and healthcare systems) has been to President Trump's "Don't take Tylenol" message. Here, I lay out the degree to which it's been rebuked. www.forbes.com/sites/joshua...

Political violence is contagious. It’s spreading. It’s not confined to one side or belief system (but it is related to extremism). STOP POLITICAL VIOLENCE NOW! STOP GUN VIOLENCE NOW!

Rolling the dice on a vaccine preventable illness is never the better option. Subacute sclerosing panencephalitis is a rare and fatal complication of measles that can occur several years after the original infection. This is sad, this is avoidable. Vaccinate kids! www.nbcnews.com/health/healt...

Health insurance premiums and healthcare costs have been rising inexorably for 25 years. But the projected increase in 2026 will be the largest - across all markets - in 15 years. This is going to take a big bite out of people's paychecks. MUCH more than eggs do. www.forbes.com/sites/joshua...

Charlie Kirk called me a ‘lunatic’ and a ‘prostitute’ and demanded I be deported. Nothing, *nothing*, justifies killing him, or robbing his kids of their dad. We don’t know the identity or motive of the shooter but murder can *never* be the response to political disagreements.

It's amazing that ICE can use the color of your skin to profile for your arrest, but universities can't use it to understand the background that you grew up in.

By not releasing a major study on the harms of alcohol, which include multiple chronic diseases, the Trump administration is signaling it isn't a MAHA priority. This is odd, given that alcohol (mis)use is among the top 3 preventable causes of death in the U.S. www.forbes.com/sites/joshua...

Florida surgeon general Ladapo's move to end all vaccine mandates in his state, including childhood vaccinations, reflects a growing anti-vaccine sentiment that has permeated the federal and state governments. It also highlights a red/blue state divide. www.forbes.com/sites/joshua...

GLP-1s used for weight loss alone do not lead to medical cost savings in the short term. At the same time, there's some encouraging news from recent studies on both improved patient persistence and potential long-term cost offsets for GLP-1 uses across all indications. www.forbes.com/sites/joshua...

An oral weight loss pill is intriguing for many reasons, one of which is convenience. But challenges remain, including ones that face the injectables: Issues with patient persistence (due to side effects) and price/insurance coverage once drug is approved. www.forbes.com/sites/joshua...

The 180-degree turn the Trump II administration has taken compared to Trump I re: the mRNA vaccine platform is baffling. Under RFK Jr and Bhattacharya, the mRNA platform is being undermined. Ostensibly due to public distrust. But a lot of the distrust was manufactured. www.forbes.com/sites/joshua...

Patient persistence is critical when it comes to GLP-1 drugs for weight loss. It's important therefore to find ways to lower discontinuation rates that involve appropriate nutrition and exercise counseling as well as side effect management. undark.org/2025/09/01/w...

Sticker shock is coming to the health insurance markets this fall. It's part of a long-term (25 year) trend but is exacerbated this year by Trump administration rule changes. Premiums in the Affordable Care Act exchanges will especially be impacted. www.forbes.com/sites/joshua...

The purge at CDC has major implications for the agency's future and the nation's public health apparatus, particularly when seen against the backdrop of massive cuts in funding of all the agencies under RFK Jr.'s command. www.forbes.com/sites/joshua...

New limits on eligibility for Covid-19 vaccines raise access questions. For those ineligible but still wish to get vaccinated, there are considerable hurdles. And even for some who are eligible, access will be (severely) limited in the short-term. www.forbes.com/sites/joshua...

Demetre Daskalakis' resignation letter. One for the history books. www.hopiumchronicles.com/p/the-resign...

Hard to tell which happened: 1) Putin didn't say this, he wouldn't make the embarrassing error of "no country has mail-in voting" when many countries like Germany and UK allow it for all voters. 2) Putin really did tell Trump this knowing Trump would repeat it and humiliate the U.S. even more. 🤷‍♂️

I really do feel awful for Ukrainians watching this. Putin kidnapped 20,000 of their children and forced them through "re-education" camps and the future of their country depends on his ability to flatter the softest ego imaginable

The latest executive order issued by Trump is an affront to (academic) research in America on so many levels. www.forbes.com/sites/joshua...

Medicaid coverage of weight loss drugs continues to be a major hurdle. And things could deteriorate in the short term before possibly getting better in the long term. www.forbes.com/sites/joshua...

The dismantling of USAID and cuts to PEPFAR (along with a plan to transform the initiative) could lead to massive loss of life overseas. Developing nations depend on U.S. food and medical aid. Much of that assistance is in jeopardy. www.forbes.com/sites/joshua...

RFK Jr. has a blind spot when it comes to vaccines. His latest salvo takes aim at mRNA vaccine research at BARDA. In the case of the research cuts, I'm having trouble imagining which "experts" he talked to or the "science" he followed prior to his decision. www.forbes.com/sites/joshua...

had Biden randomly wandered on the White House roof shouting at reporters about nuclear weapons, Jake Tapper would drop everything to pitch a new series of books and Hannity would anchor ongoing special coverage until 2029 but when Trump does it it's just Trump being Trump!

There appears to be more movement (a two-pronged approach) towards Medicare coverage of weight loss drugs. It's a slow, arduous process. But I think we may see at least some (targeted) reimbursement by 2027. www.forbes.com/sites/joshua...