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The past 18 months opened many Americans' eyes to the ways racial inequality affects health. Throughout the pandemic, Black and Hispanic people have died from COVID-19 at higher rates than their white neighbors. And public protest shone a light on the disproportionate impact of police violence on Black people. There's a growing awareness of the many reasons people of color experience poor health outcomes, including the stresses of racism itself. But one area of racial health disparity isn't often discussed: the lack of equitable access to prescription drugs. (Kevin B. Kimble, 1/3)

As small businesses across the country buckle up for another possible winter of COVID-19, they suffered an avoidable blow in Washington, D.C., this month on meaningful and much-needed prescription drug reform for their employees. The stalled Build Back Better Act (BBB), which includes key health care and prescription drug reforms small businesses have long been clamoring for, would bring down onerous health care costs, provide relief to consumers, and spur job growth and higher wages for employees on Main Streets across America. But now the bill’s uncertain fate is throwing yet another wrench in the gears for small businesses who are working tirelessly to keep their doors open. (Dr. Erika Gonzalez, 12/28)

Build Back Better may be dead, but its proposed drug price controls will likely reappear: negotiating prices for high-cost drugs in Medicare and price controls for most drugs limiting price increases to the annual inflation rate. President Biden insists such controls are needed because pharmaceutical companies are “jacking up prices on a range of medicines.” He promises “to end the days when drug companies could increase their prices with no oversight and no accountability.” Yet while inflation has skyrocketed under Mr. Biden, drug prices are lower than when he took office. As the consumer-price index over the past year rose 6.8%, the largest increase in 39 years, prescription-drug prices fell 0.3%. (Joel Zinberg, 12/26)

Astellas Pharma, a drug company headquartered in Japan, is charging U.S. patients $156,000 a year for the prostate cancer drug Xtandi (enzalutamide) — more than three to five times what it charges residents of other wealthy countries, and five times more than it charges in Japan. Adding insult to injury, Xtandi was discovered by scientists at the University of California, Los Angeles, with grants from the National Institutes of Health (NIH) and the U.S. Army. (Peter Arno, Robert Sachs and Kathryn Ardizzone, 1/3)

The Food and Drug Administration last week authorized two oral antiviral medicines for the early treatment of Covid-19. But don’t get too excited. The U.S. will still have a meager treatment arsenal this winter. The U.S. has been relying on monoclonal-antibody treatments, but most don’t hold up against the Omicron variant. One, by GlaxoSmithKline and Vir Biotechnology, does better at neutralizing the variant, but supply is limited. Pfizer’s newly authorized antiviral pack Paxlovid will also have to be rationed. There will be more of Merck and Ridgeback Biotherapeutics’ newly authorized antiviral, molnupiravir, but patients may be reluctant to take the drug. Some scientists worry it could cause DNA mutations in people, though the FDA determined that the likelihood of this was low when used on a short-term basis. (Allysia Finley, 12/28)

Since last summer, Medicare has been evaluating whether to pay for a newly approved, exorbitantly priced drug to treat Alzheimer’s disease. Its decision was always going to be fraught: The data on the drug’s potential benefits are ambiguous at best, and its risks are considerable. About 40% of patients who have taken it have suffered swelling or bleeding in the brain. Others have experienced disabling nausea, dizziness, headaches and confusion. Biogen, the manufacturer, is investigating a patient death. Then there is the price: $28,200 a year for the average patient. (This is half the drug’s original cost, which Biogen cut to deflect widespread anger.) It’s one reason that Medicare increased its annual premium for 2022 by more than $250. (Peter B. Bach and Rita F. Redberg, 1/3)