Summit Lens

GLP-1 proved the science could work. The harder test began once patients tried to get it. In this episode, we follow GLP-1 from the pharmacy counter into the real world of American healthcare: insurance coverage, compounding pharmacies, PBM formulary decisions, employer benefit design, cash pay pathways, TrumpRx, and public policy. The question is no longer only whether these drugs work. It is how...

How did a gut hormone that disappeared in seconds become one of the biggest drug classes in the world? In this episode, I walk through the story of GLP-1, from early scientific discovery and the Gila monster breakthrough to Novo Nordisk’s drug design strategy, Eli Lilly’s competitive push, and the shift that turned GLP-1 from a diabetes treatment into something much bigger. This is a story about h...

What does it actually take to turn a scientific breakthrough into a drug patients can access? In this episode, I look at the manufacturer side of the healthcare system, the part that absorbs scientific failure, funds long-shot bets, and then enters a second battle after the science succeeds. Because FDA approval is not the finish line. It is the point where a therapy enters the real commercial sys...

If your doctor writes a prescription, who actually decides whether you get it, where you fill it, and what you pay? In this episode, I unpack the hidden role of pharmacy benefit managers, or PBMs, the intermediaries that sit between drugmakers, insurers, employers, pharmacies, and patients. PBMs do not invent drugs or prescribe them, but they often control formularies, prior authorization, special...

What happens when an insurance company stops acting like a payer and starts acting like infrastructure? In this episode, I explore how private insurers became some of the most powerful actors in American healthcare. Using UnitedHealth Group as a central case study, I trace the shift from passive bill payer to managed care gatekeeper to vertically integrated healthcare empire. From Medicare Advanta...

Why does getting care in America so often feel like navigating a maze? In this episode, I unpack the hidden architecture behind that confusion. U.S. healthcare is not one coherent system. It is a patchwork of rulebooks built over time through employer-sponsored insurance, Medicare, Medicaid, the ACA Marketplace, ERISA, and decades of political compromise. The result is a system where your job, age...

Why does the United States spend more on healthcare than any other country in the world, and still underperform on many basic health outcomes? In this episode, I unpack the machinery behind the high cost of American healthcare. From employer-sponsored insurance and tax policy to hospital consolidation, administrative complexity, and market power, this is a story about how the U.S. built a system t...