Managed Care Cast News Roundup: January 13, 2026

J&J Agreement Brings 15 of 17 Pharma Companies Into Trump's Drug-Pricing Effort

Johnson & Johnson has joined a voluntary drug-pricing agreement with the Trump administration aimed at lowering costs and improving access to medicines, becoming the 15th of 17 major pharmaceutical companies to sign on. Under the deal, the company will sell most of its drugs to Medicaid at prices comparable to those in Europe and participate in TrumpRx.gov, a direct-to-consumer platform allowing Americans to purchase certain medicines at discounted rates, in exchange for a 3-year exemption from potential pharmaceutical tariffs. The agreement is part of a broader administration strategy that pairs voluntary industry commitments with the possibility of future regulation. Alongside the pricing deal, Johnson & Johnson highlighted its ongoing $55 billion investment in US manufacturing, research, and development through 2029, including major biologics and cell therapy facilities in North Carolina and Pennsylvania, which the company says will support access, innovation, and domestic job growth.

House Votes to Extend ACA Subsidies, Eyes Turn to Senate

The House of Representatives has passed legislation to extend Affordable Care Act health insurance subsidies, which were set to expire in early 2026 and could otherwise raise premiums and increase uninsured rates for millions of Americans. The bill advanced after a Democratic discharge petition forced a vote, with limited Republican support driven in part by political concerns, and ultimately passed 230-196 with 17 Republicans joining all Democrats. However, the measure faces significant hurdles in the Senate, where it lacks the 60 votes needed to overcome a filibuster, prompting bipartisan negotiations on possible compromises such as a shorter 2-year extension, income caps, health savings account provisions, and abortion-related restrictions. As talks continue, the fate of the subsidies remains uncertain, underscoring their importance to affordability and coverage for ACA enrollees as lawmakers weigh competing priorities heading into 2026.

Nimbus Therapeutics, Eli Lilly Partner to Develop Novel Oral Metabolic Drug

Nimbus Therapeutics has entered a multiyear research collaboration with Eli Lilly and Company to develop a novel oral small-molecule therapy for obesity and other metabolic diseases, expanding on a prior partnership launched in 2022 focused on AMP-activated protein kinase (AMPK) activators. Announced January 6, 2026, the agreement leverages Nimbus’ computational chemistry and structure-based drug design capabilities to address longstanding challenges in targeting AMPK, a key regulator of energy metabolism, with the goal of improving treatment options in obesity care. Under the deal, Nimbus will receive $55 million in upfront and near-term milestone payments and is eligible for up to approximately $1.3 billion in additional development, commercial, and sales milestones, along with tiered royalties. Both companies emphasized that a novel oral therapy could help overcome current barriers related to cost, access, and low uptake of existing obesity treatments, potentially expanding equitable access for patients with metabolic diseases.

CDC Reduces US Childhood Immunization Schedule From 17 to 11 Diseases

Federal health officials have announced sweeping revisions to the US childhood immunization schedule, reducing routine coverage from 17 diseases to 11, a move that public health experts say departs sharply from the long-standing, evidence-based process that has guided vaccine policy. Issued by CDC Acting Director Jim O’Neill under HHS Secretary Robert F. Kennedy Jr, the changes maintain universal recommendations for measles, polio, and pertussis but limit or condition vaccines for other diseases, including respiratory syncytial virus, influenza, rotavirus, and hepatitis A, prompting concern amid an already severe respiratory season. Experts and former CDC officials criticized the lack of transparency, scientific review, and involvement of the Advisory Committee on Immunization Practices, whose members were removed in 2025, warning the overhaul could increase confusion, reduce vaccine uptake, and endanger child health. The revisions follow a directive from President Trump to align US policy with other high-income countries, though critics argue such comparisons ignore key epidemiologic differences, and legal scholars have questioned whether the administration has the authority to enact the changes without formal rulemaking, despite assurances that insurance coverage for vaccines will remain unchanged.

OpenAI for Healthcare Aims to Streamline Clinical Workflows, Reduce Administrative Burden

OpenAI has launched OpenAI for Healthcare, a suite of GPT-5.2–powered, HIPAA-supportive artificial intelligence (AI) tools—including ChatGPT for Healthcare and its API—aimed at reducing administrative burden, supporting clinicians, and enabling custom clinical workflows, as the platform rolls out to major health systems such as AdventHealth, Memorial Sloan Kettering, and Cedars-Sinai. The tools offer capabilities ranging from chart summarization and documentation support to evidence synthesis with citations and integration of institution-specific policies, while maintaining governance controls and data protections. OpenAI also introduced ChatGPT Health, a consumer-facing tool designed to help patients better understand health information and prepare for care without replacing clinical decision-making. As adoption expands, experts have emphasized the need for careful implementation, highlighting both AI’s potential to accelerate evidence generation and personalize care and the ethical risks, particularly bias and inequity, that require rigorous validation, oversight, and responsible governance.