�鶹Ů��

Humana has agreed to pay $90 million to settle a whistleblower lawsuit by one of its former actuaries accusing the health insurer of overcharging the U.S. government for prescription drugs, the whistleblower's lawyers announced on Friday. The whistleblower, Steven Scott, said that Humana, which contracts with the federal Medicare program to administer prescription drug benefits, misrepresented its true costs in order to get a more lucrative contract. It is the first settlement with any insurer over allegations of fraud tied to Medicare's prescription drug contracting process, according to the law firm Phillips & Cohen, which represents Scott. (Pierson, 8/16)

The government’s announcement confirmed what companies had been telegraphing in second-quarter results calls: The initial hit to earnings from the Inflation Reduction Act, which allows Medicare to directly negotiate the prices of some drugs, is going to be mild. There are a few reasons for that. For one, many drugs were already going off patent soon and therefore were set to face price erosion anyway. Secondly, the drugs are already discounted in order to be placed on pharmacy-benefit managers’ formularies. (Wainer, 8/16)

As the Federal Trade Commission scrutinizes the pharmaceutical industry, there is growing debate about whether the regulator may next target a deal that some experts say could make it easier for Novo Nordisk to boost production of a key drug — at the expense of competitors. (Silverman, 8/19)

Ozempic and other GLP-1 drugs were supposed to revolutionize the battle against obesity. But evidence shows big economic and racial disparities in access. (Cha, 8/19)

Though appendectomies have been the gold standard of care since before the turn of the 20th century, doctors have been treating appendicitis with antibiotics since the 1950s, as soon as they became available — a “dark secret” in the surgery world, says David R. Flum, professor of surgery and director of the Surgical Outcomes Research Center at the University of Washington. (Dattaro, 8/17)

In huge numbers, older people are taking gabapentin for a variety of conditions, including itching, alcohol dependence and sciatica. “It’s crazy,” one expert said. (Span, 8/17)