• Maryland: According to a new ASHP report, U.S. prescription drug spending increased 12.7% to $915.2 billion in 2025 and is expected to exceed $1 trillion in 2026. U.S. spending on prescription drugs continues to significantly outpace other countries, with per capita costs reaching around $2,000 in 2022. Medicaid drug spending has also increased by 46% over the last five years, in part due to high-cost GLP-1 medications and specialty therapies. Spending on GLP-1 drugs totaled $131.9 billion in 2025, accounting for 14% of overall U.S. drug spend. Oncology drugs also continued to be the largest and fastest-growing drug spending category across different settings. Overall, U.S. drug spend is expected to increase between 10% and 12% this year, with clinics expected to see higher growth than hospitals. (Jeffries, Becker's Hospital Review, 4/30)  
• North Carolina: Premier has named Emad Rizk as its new president, CEO, and board chair. Rizk succeeds Michael Alkire, who served as Premier's president from 2019 and its CEO from 2021. Alkire will serve as a senior advisor to the company for at least six months as Rizk steps into his new roles. Most recently, Rizk was chair, CEO, and president of Cotiviti, a healthcare analytics company. Before that, Rizk was president and CEO at revenue cycle management company RI, and he has previously held leadership roles at McKesson Health Solutions and Deloitte Consulting. In an interview, Rizk said he sees big potential for Premier to use data intelligence to improve operational efficiency, reduce expenses, and inform advisory services. "I've seen healthcare from so many different angles," Rizk said. "The underlying issue in the country has been really around data, and how do we use data as a foundation for decision-making processes, and how do we eliminate the waste and the high cost in our healthcare system?" (Hudson, Modern Healthcare, 5/5)
• Pennsylvania: Pennsylvania has filed a lawsuit against Character.AI, alleging that the company's chatbots claim to be licensed medical professionals, including psychiatrists. According to the complaint, Character.AI engaged in the "unlawful practice of medicine and surgery" since the system can create characters that "purport to be healthcare professionals." In one instance, one of the company's chatbots told a state investigator who made an account that it was licensed as a doctor in Pennsylvania and provided a fake license number. "We will not allow companies to deploy AI tools that mislead people into believing they are receiving advice from a licensed medical professional," said Gov. Josh Shapiro (D). "Pennsylvania will continue leading the way in holding bad actors accountable and setting clear guardrails so people can use new technology responsibly." In a statement, a Character.AI spokesperson said the company's "highest priority is the safety and well-being of our users" and that it adds "robust disclaimers making it clear that users should not rely on Characters for any type of professional advice." Previously, several families sued Character.AI, alleging that it contributed to their children's mental health problems or suicide. Kentucky also filed a lawsuit against the company earlier this year, claiming that it has a record of "encouraging suicide, self-injury, isolation, and psychological manipulation." (Weixel, The Hill, 5/5)

Drug spend is unsustainable, and the strategies purchasers have used to try and manage that spend are out of juice. Where do we go from here?