Some Final Thoughts from #JPM25 (on Meeting the Moment and Hospital Finances)

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Today is probably the last day to write about last week’s #JPM25 meeting without it seemingly weirdly out-of-date, so I wanted to make sure that I captured a couple of thoughts about the meeting before it’s too late. 

First, it’s worth reading this STAT story on Alignment Healthcare, the only health insurer to show up at the conference. I’m not here to laud their courage in attending but rather to highlight the story as a good example of what can happen when a company is prepared to talk about the broader context in which it operates. 

I have no idea if Alignment lives up to its principles, but it was refreshing to hear from a health care company that had clearly thought about the environment more broadly and the baby steps needed to be taken to restore some of the public faith in the health care system. 

We’re all still reeling from the murder of United’s Brian Thompson, and I admire a company that is willing to openly acknowledge the reality of how health care is perceived in 2025. 

The fact that there wasn’t more of this at JPM25 was a missed opportunity. 

Second, I mentioned in a JPM25 preview that the best way to spend the first couple of days of the conference was to attend the nonprofit track, where hospitals gave a peek into their thinking. Unfortunately, those presentations were not publicly available. 

But -- thankfully -- some elements of those presentations are floating around, namely these slides from a big nonprofit hospital system, AdventHealth. I grabbed it from Blake Madden’s Hospitology newsletter.**  

There is danger in making too much of a single, isolated set of numbers (again, this is why I’m bummed I wasn’t able to sit in on this track, in person or virtually). 

But … the narrow takeaway here is that the AdventHealth financials -- as presented to the money people who attend JPM -- look strong. The system includes 340B providers, but these numbers do not paint the picture of a hospital system where 340B is the difference between life and death for AdventHealth. 

So, more broadly, we’re about to have a critical debate about 340B that is oriented around the simple question of how best to use transferred wealth from the pharmaceutical industry. Right now the answer to that question is “make the rich richer,” and I’ll be curious to see how long that’s a viable response. 

 ** If any of you have the slides for other nonprofit hospitals that presented this week, I’m all ears.

If you like reading legal filings about 340B, I have excellent news. 

A number of lawsuits are kicking off in the next two weeks. Those cases include the legal effort by Sagebrush Health to push back on a HRSA effort to strip Sagebrush affiliates of their 340B status. 

Also about to crest is a wave of cases from pharmaceutical companies pushing back on HRSA opposition to a 340B rebate model. Separate cases from Lilly, J&J, BMS, and Sanofi all have briefing schedules. 

This list is likely to grow: Novartis has a rebate-model case that doesn’t yet have a timeline, and there is also a lawsuit filed by drug companies over Sagebrush that also hasn’t formally moved forward yet. And this list doesn’t include the somewhat-related Kalderos litigation, which revs back up on Feb. 3. 

So buckle up. The lawyers are busy. 

• January 24: HRSA brief on Sagebrush’s request for a temporary restraining order due

• January 27: Sagebrush reply due

• January 29 to 31: HRSA/Sagebrush hearing. (Exact time TBD)

• February 3: Lilly, J&J, and BMS motions for summary judgment due

• February 20: Sanofi motion for summary judgment due

• March 3: HRSA opposition and cross-motion for summary judgment in the Lilly/J&J/BMS cases due

• March 13: HRSA cross-motion for summary judgment in Sanofi case due

• March 17: Lilly, J&J, and BMS opposition to the HRSA motion due

• March 24: Sanofi's opposition to the HRSA motion due

• March 31: HRSA reply in support of their cross-motion in the Lilly/J&J/BMS/Sanofi cases due

• May 1: BMS’ requested date for a court decision (to allow the company time to “submit its plan for effectuating the MFP price under the Inflation Reduction Act”)

• This is a fantastic overview by Axios of the current state of the Trump health policy positioning: opaque at best. I’ve been making “nobody knows” jokes for weeks now, but Axios really captures why it is that nobody knows. (Also noteworthy from the piece: "Pharma is whistling past the graveyard," said one source who's working on the health nominee confirmations. Hmmmm.)

• Interesting Twitter thread on the possibility that the Trump administration could re-think the 15 medicines up for Medicare “negotiations.” It’s all legal theory right now, coming from folks who aren’t actually in the new administration. But it’s noteworthy that big-name Republicans are willing to float some fairly radical ideas.

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