• California: California will begin selling its own low-cost insulin to patients in January, making it the first state to do so. According to Politico, insulin pens will be provided through the CalRx program, an initiative launched by Gov. Gavin Newsom (D) that allows the state to contract with manufacturers to produce generic pharmaceuticals. Through CalRx, pharmacies will be able to purchase a five-pack of insulin pens for $45 and sell them to patients at a suggested retail price of $55 — much lower than the $89 to $411 that similar brand name products would cost. "California didn't wait for the pharmaceutical industry to do the right thing — we took matters into our own hands," Newsom said in a statement. "No Californian should ever have to ration insulin or go into debt to stay alive — and I won't stop until health care costs are crushed for everyone." Aside from insulin, California has also contracted with manufacturers to provide a cheaper version of the opioid overdose medication naloxone. Newsom has also announced plans to work on purchasing asthma medication in bulk. (Bluth, Politico, 10/16)
• Maryland: FDA has awarded new priority review vouchers to nine drugs, which will allow them to go through the agency's approval process more quickly. The nine drugs include those for type 1 diabetes, nicotine vaping addiction, blindness, pancreatic cancer, and fertility. Some of the selected drugs are already FDA-approved, meaning that the priority review is only for approval of a new use. According to Axios, FDA is proactively identifying drug candidates for its expedited review process instead of waiting for drugmakers to submit applications for priority review vouchers. "We are not taking a receive-only mode," said FDA Commissioner Marty Makary. "We are going into the [FDA] divisions asking them tell us what you think is potentially amazing … and then let's reach out to the companies." Makary noted that FDA is also aiming to use the vouchers to increase U.S. manufacturing and address a "large unmet medical need." (Sullivan, Axios, 10/16)
• Ohio/Pennsylvania: Trinity Health System, which is owned by CommonSpirit Health, and UPMC have signed a non-binding letter of intent to pursue integration. According to Fierce Healthcare, Trinity and UPMC have collaborated clinically for over 20 years, working together to bring UPMC's cancer treatment and advanced orthopedic services to Trinity's patients and communities. Under the proposed deal, Trinity's hospitals and other healthcare facilities would merge into UPMC's network, providing UPMC with entry into the Ohio market. Over the next several months, both entities will work toward a definitive agreement, pending customary regulatory review and approvals. "Trinity Health System and UPMC leaders hope to complete the affiliation as soon as possible," the organizations wrote. (Muoio, Fierce Healthcare, 10/15; Vogel, Healthcare Dive, 10/16)

Explore our deep dive into the forces reshaping the healthcare industry in 2025 and beyond. In this session, we break down the key trends in pharmacy services, share the cost management strategies providers are using to balance cost and access, and unpack the tensions putting PBMs, manufacturers, and specialty pharmacies in conflict with one another — and how to mitigate them.