U.S. Labor Department Pushes for Drug Pricing Transparency
Written by Emily J. Thompson, Senior Investment Analyst
Updated: 6d ago
0mins
Source: Benzinga
- New Drug Transparency Regulation: The U.S. Department of Labor has proposed a regulation requiring Pharmacy Benefit Managers (PBMs) to fully disclose their compensation to self-insured health plans, impacting approximately 90 million Americans, aimed at eliminating hidden fees and enhancing transparency in the healthcare system.
- Targeting Hidden Fees: The regulation specifically addresses PBMs' practices such as spread pricing, rebates, and clawbacks, aiming to reduce improper profits made by PBMs in drug transactions by mandating disclosure of these fees to protect employers and patients' interests.
- Market Reaction: Following the announcement of a mere 0.09% increase in Medicare payments, the market reacted sharply, with Humana's stock dropping over 13% and UnitedHealth nearly 9%, reflecting investor concerns about the industry's outlook amidst rising costs.
- Long-term Profit Pressure: For companies like CVS, UnitedHealth, and Cigna, PBM services are a significant revenue driver; the new regulation may compress their profit margins, leading to prolonged earnings pressure for these healthcare giants.
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Analyst Views on UNH
Wall Street analysts forecast UNH stock price to rise over the next 12 months. According to Wall Street analysts, the average 1-year price target for UNH is 397.82 USD with a low forecast of 330.00 USD and a high forecast of 444.00 USD. However, analyst price targets are subjective and often lag stock prices, so investors should focus on the objective reasons behind analyst rating changes, which better reflect the company's fundamentals.
19 Analyst Rating
16 Buy
3 Hold
0 Sell
Strong Buy
Current: 268.550
Low
330.00
Averages
397.82
High
444.00
Current: 268.550
Low
330.00
Averages
397.82
High
444.00
About UNH
UnitedHealth Group Incorporated is a healthcare and well-being company. Its segments include Optum Health, Optum Insight, Optum Rx, and UnitedHealthcare, which includes UnitedHealthcare Employer & Individual, UnitedHealthcare Medicare & Retirement and UnitedHealthcare Community & State. Optum Health offers comprehensive and patient-centered care, addressing the physical, mental, social, and financial well-being. Optum Health delivers primary, specialty and surgical care; helps patients and providers navigate and address complex, chronic and behavioral health needs. Optum Insight connects the healthcare system with services, analytics and platforms that make clinical, administrative and financial processes simpler and more efficient for all participants in the healthcare system. Optum Rx offers a range of pharmacy care services through retail pharmacies, through home delivery, specialty and community health pharmacies and the provision of in-home and community-based infusion services.
About the author
Emily J. Thompson
Emily J. Thompson, a Chartered Financial Analyst (CFA) with 12 years in investment research, graduated with honors from the Wharton School. Specializing in industrial and technology stocks, she provides in-depth analysis for Intellectia’s earnings and market brief reports.
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- Cautious Stance on UnitedHealth Group: Although Berkshire purchased 5 million shares last year, the stock has fallen from $350 to around $280 due to lower-than-expected Medicare payment increases, prompting investors to think twice before buying the dip given the potential for further multiple compression.
See More
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- Strong Earnings Performance: DaVita's latest quarterly results exceeded expectations, with projected earnings per share between $13.60 and $15 for 2026, resulting in a current price-to-earnings ratio of only 9 times, indicating potential for future growth and attracting investor interest.
- Stock Price Rebound: Since the earnings release, DaVita's stock has surged over 30%, reflecting market recognition of its performance and potentially providing room for multiple expansion, as it previously traded at 13 to 14 times forward earnings.
- Buffett's Investment Strategy: Despite Berkshire Hathaway's losses on its Kraft Heinz investment, currently valued at around $7.5 billion, the planned split into two entities may present opportunities for new investors, especially as Kraft Heinz trades at a mere 9 times forward earnings, below peers.
- Healthcare Sector Challenges: UnitedHealth Group's stock has fallen from $350 to around $280, primarily due to the U.S. government's lower-than-expected Medicare payment increases; although Buffett had previously purchased shares, the current 16 times forward earnings ratio indicates market concerns about its growth trajectory, warranting caution for investors.
See More
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- Drug Cost Reduction: Thanks to the Inflation Reduction Act, retirees will see significant reductions in prescription drug costs starting in 2026, with price negotiations for the first ten drugs taking effect on January 1, 2026, alleviating financial burdens and improving overall financial health for retirees.
- Rising Medicare Costs: The standard Medicare Part B premium will increase from $185 to $202.90 in 2026, while the annual deductible will rise by $26 to $283, negatively impacting retirees' disposable income, especially as Social Security cost-of-living adjustments may not keep pace with these increases.
- Impact on High-Income Retirees: High-income retirees will face a 9% increase in the income-related monthly adjustment amount (IRMAA) in 2026, with income thresholds rising by about 3%, meaning more retirees will encounter higher healthcare costs, further straining their financial resources.
- Medicare Advantage Market Turmoil: Major insurers like Humana and UnitedHealth have withdrawn Medicare Advantage offerings in hundreds of counties, leading to reduced services and limited networks, with CEOs warning that future payment increases may have a “profoundly negative impact” on seniors' benefits and access to care.
See More
Overview of Medicare Changes for Retirees in 2026
- Lower Drug Costs: Starting in 2026, the CMS can negotiate prices for the first time under the Inflation Reduction Act, potentially lowering costs for retirees on 10 key prescription drugs, particularly those for diabetes and heart conditions, thereby alleviating some financial burdens on retirees.
- Rising Premiums and Deductibles: The standard Medicare Part B premium has increased from $185 to $202.90 in 2026, with the annual deductible rising by $26 to $283, leading 54% of Social Security recipients to feel that the 2.8% COLA is insufficient to offset these increases, which may heighten financial stress for retirees.
- Impact on High-Income Retirees: High-income retirees will face a 9% increase in the income-related monthly adjustment amount (IRMAA) in 2026, with income thresholds rising by about 3%, further straining their healthcare budgets and reducing disposable income.
- Medicare Advantage Chaos: Major insurers like Humana and UnitedHealth have withdrawn Medicare Advantage offerings in hundreds of counties, reducing benefits for additional services; CEOs warn that the proposed 0.9% payment increase for 2027 could have a profoundly negative impact on seniors' benefits and access to care.
See More
CVS Health Earnings Outlook Analysis
- Earnings Release Date: CVS Health is set to report its latest earnings pre-market on February 10, and while market focus on its 2026 guidance may impact stock price, the company has consistently exceeded earnings expectations over the past four quarters, indicating resilience in profitability.
- Medicare Payment Impact: Following the latest Medicare Advantage payment news, CVS shares have fallen over 14%, which could negatively affect investor sentiment post-earnings, particularly regarding updates to the 2026 guidance.
- Earnings Expectation Shift: Analysts forecast CVS's non-GAAP earnings for Q4 2025 at $0.99 per share, a decline from $1.19 in Q4 2024; however, expectations for a potential earnings beat remain, which could lead to a stock rebound.
- Long-Term Growth Potential: Despite pressures from Medicare payment rates, CVS's retail pharmacy and pharmacy benefits management units generate a larger share of revenue, maintaining a positive long-term growth outlook, especially when compared to UnitedHealth's valuation, which presents a more attractive investment opportunity.
See More
CVS Health Set to Release Earnings and Guidance
- Earnings Preview: CVS Health is set to release its quarterly results on February 10, with consensus expecting non-GAAP earnings of $0.99 per share, reflecting a decline from $1.19 in Q4 2024; however, optimism remains regarding potential earnings beats.
- Medicare Policy Impact: Investors will closely monitor updates to CVS's 2026 guidance, particularly the implications of the recently proposed Medicare Advantage payment rates, especially after CVS shares fell over 14% due to this news.
- Market Reaction Expectations: Despite significant volatility following the Medicare news, analysts suggest that if CVS delivers
See More
