Consumer News: Taco Bell removes fresh toppings as parasite outbreak spreads across U.S.

GLP-1 weight-loss drugs had the highest denial rate

By Mark Huffman of ConsumerAffairs

• Insurance denials for first-time prescriptions of brand-name drugs with no generic alternative jumped 67% between 2018 and 2024, according to a new study published in JAMA.

• Nearly half of patients whose prescriptions were initially denied never filled either the prescribed medication or a similar drug within 90 days, raising concerns about delayed or foregone treatment.

• Researchers say growing use of prior authorization, step therapy and formulary exclusions is the primary driver of the increase, reflecting insurers' efforts to control soaring prescription drug costs.

Americans prescribed brand-name medications without generic alternatives are increasingly running into insurance roadblocks at the pharmacy counter. A newly published study found that denial rates rose dramatically between 2018 and 2024.

The study, led by researchers at the Johns Hopkins Bloomberg School of Public Health and the American Enterprise Institute and published in the Journal of the American Medical Association (JAMA), analyzed more than 2 million first-time prescription fill attempts across commercial insurance, Medicare, Medicaid and Affordable Care Act marketplace plans.

Researchers found that insurers rejected 40.7% of initial attempts to fill brand-name prescriptions in 2024, up from 24.3% in 2018a 67% increase.

The consequences often extended beyond a temporary inconvenience. Among patients whose prescriptions were initially denied, 48.4% did not fill either the prescribed medication or another drug in the same therapeutic class within 90 days. Those who ultimately obtained treatment waited an average of 12 days after the initial rejection.

"We found that insurance restrictions are increasingly shaping whether and when patients receive medications their clinicians prescribe," lead author Joseph Levy, an assistant professor in the Bloomberg School's Department of Health Policy and Management, said in a statement.

"While these policies may help control drug spending, they can also create meaningful barriers to timely treatment and place growing administrative burdens on patients, pharmacists, and clinicians."

Prior authorization a growing hurdle

About one-third of all initial prescription attempts were rejected because of formulary exclusions or utilization management policies, such as prior authorization requirements or step therapy, which require patients to try less expensive medications before insurers will cover the prescribed drug.

The researchers concluded that the growing use of these utilization management tools accounted for most of the increase in denials during the study period. Commercial insurance plans and Medicaid managed care plans experienced some of the largest increases in these restrictions.

Denial rates also varied significantly by drug category. Medications in the incretin classincluding GLP-1 weight-loss drugshad the highest rejection rate at 85%, while oral anticoagulants had one of the lowest rates at 6.7%.

Marketplace plans and Medicaid managed care plans posted the highest overall denial rates, with nearly half of all first-time prescription attempts rejected. Medicare plans generally had lower rejection rates.

Balancing access and costs

The study comes as insurers face mounting pressure to manage spending on expensive brand-name drugs, particularly specialty medications and newer therapies that can cost thousands of dollars per month.

According to the Association for Accessible Medicines, cited by the researchers, brand-name drugs accounted for only about 10% of prescriptions filled in 2024 but represented 88% of total prescription drug spendingabout $700 billion. By contrast, generic drugs and biosimilars made up roughly 90% of prescriptions while accounting for only 12% of spending.

The researchers acknowledged that utilization management can help insurers negotiate lower prices and encourage cost-effective prescribing. However, they suggested that simplifying and standardizing prior authorization requirements, along with providing clinicians with real-time information about insurance coverage, could reduce unnecessary delays in treatment while preserving insurers' ability to manage costs.

Chevy and Toyota are part of this week's recall roundup

Environmental group warns new approvals could expand exposure concerns nationwide

• The EPA has approved three new PFAS-based pesticides for use on food crops, according to the Environmental Working Group (EWG).

• One of the newly approved pesticides was previously flagged by EPA scientists as having "suggestive evidence of carcinogenic potential."

• EWG is urging regulators to pause additional PFAS pesticide approvals while more research is conducted on their long-term and cumulative health effects.

The Environmental Protection Agency (EPA) has approved three pesticides containing PFAS often called "forever chemicals" because they can persist in the environment for long periods according to a recent report from the Environmental Working Group (EWG).

The nonprofit says the approvals bring the total number of PFAS pesticides authorized by the agency to five all in less than two years.

The newly approved pesticides are trifludimoxazin, diflufenican, and epyrifenacil. The EWG says they can now be used on a variety of food crops, including wheat, citrus, and other agricultural products.

The EPAs hands-off approach to pesticide mixtures is leaving families exposed to a cocktail of forever chemicals on their food, Varun Subramaniam, a science analyst at the Environmental Working Group, said in a news release.

We know ultra-short-chain PFAS like TFA [trifluoroacetic acid] are accumulating in the environment and pose potential reproductive risks, yet regulators assess these hazards one by one and without considering the full range of potential health harms. The science shows combined chemical exposure can amplify health harms, but the EPA is consistently failing to enforce the extra safety protections legally required to safeguard children during pregnancy and early life.

Why is the EWG concerned?

According to the EWG, one of the newly approved herbicides trifludimoxazin was cleared for use despite EPA documents describing it as having "suggestive evidence of carcinogenic potential." The group also says the chemical can degrade into multiple persistent PFAS compounds after it is applied.

Beyond the three new approvals, the EWG notes that the EPA also expanded approved uses for bifenthrin, a PFAS pesticide the agency has previously classified as a possible human carcinogen.

The organization's broader concern is that regulators evaluate pesticides individually rather than considering how multiple PFAS chemicals might interact or contribute to overall exposure.

The EWG also says many PFAS pesticides have not undergone updated developmental, reproductive ,or immune-system toxicity testing, and argues that waiving certain studies leaves important questions unanswered. As a result, the group is calling on the EPA to halt additional PFAS pesticide approvals until more comprehensive testing and cumulative risk assessments are completed.

By the time these PFAS residues reach our plates, they have become part of a toxic cocktail that may suppress the immune system and harm reproductive health, said Subramaniam. That raises serious concerns about the long-term health risks of using these chemicals on food crops.

Were spraying millions of pounds of chemicals on food without understanding their full health impacts or considering what little we do already know. Its unconscionable.

What this means for consumers

For shoppers, the EWG says the findings shouldn't discourage people from eating fruits and vegetables.

A diet rich in fruits and vegetables is essential, said Subramaniam. Families should enjoy the significant health benefits of consuming produce while making informed choices to reduce pesticide exposure, particularly for children, without sacrificing nutrition."

Instead, the EWG says consumers should stay informed about PFAS research while regulators continue to study the chemicals' long-term health effects. The group is urging the EPA to require additional testing for PFAS pesticides, evaluate the combined effects of exposure to multiple PFAS compounds, expand environmental monitoring, and require fuller disclosure of pesticide ingredients.

According to the EWG, stronger oversight would help address unanswered questions about how these persistent chemicals behave in the environment and what their long-term impact could be on people and ecosystems.

Allowing an avalanche of new PFAS pesticides onto our fields will never make America healthy again, Jared Hayes, senior policy analyst at the EWG, said in the release.

Contaminating our agricultural fields with persistent forever chemicals does nothing to help the farmers who work tirelessly to feed us. By prioritizing corporate chemical approvals over public health, the EPA is actively undermining both our long-term food security and the very farming communities we rely on, said Hayes.

New study examines retired players in midlife

• Researchers found structural brain differences in some retired professional soccer players compared with people who had no history of repetitive head impacts.

• Former players also reported higher levels of anxiety, depression, and difficulties with thinking and decision-making in daily life.

• The findings do not show cognitive decline, but they highlight the need for more long-term research and monitoring.

Years of playing professional soccer may leave measurable changes in the brain, even before signs of neurodegenerative disease typically appear.

That's according to new research presented at the Alzheimer's Association International Conference (AAIC) 2026, where scientists shared findings from the largest study to date examining brain health in retired elite professional soccer players.

The researchers were interested in understanding how repeated head impacts over the course of a professional career might affect brain health later in life. While previous research has explored this topic, this study focused specifically on retired players in midlife, offering a snapshot of their brain health before diseases such as Alzheimer's would usually be expected to develop.

Importantly, the researchers did not find meaningful differences in objective thinking and memory tests between former players and people who had not experienced repetitive head impacts. However, they did identify other differences that suggest the topic deserves continued study.

These findings suggest there may be measurable effects on brain health in former elite soccer players even in mid-life, before clinically apparent neurodegenerative disease would typically emerge, researcher Caleigh Grace Lynch, M.Sc., said in a news release.

While we did not find significant differences in objective cognitive testing between the groups, we did observe important differences in symptoms and brain structure.

How the study was conducted

The study included 142 retired professional soccer players between the ages of 30 and 60. Most were men who had played professionally for at least three years, while 16 were women who competed in the top levels of professional soccer in the United Kingdom. Their results were compared with 56 healthy adults of similar ages who had not played contact sports, served in the military, or experienced repetitive head impacts or neurological conditions.

Participants completed questionnaires about their mental health and daily thinking abilities, along with standardized cognitive testing. Researchers also performed MRI scans on 124 of the former players to examine brain structure and compare those images with scans from members of the control group.

What the findings could mean

Former soccer players reported higher levels of depression and anxiety than the comparison group, along with more self-reported difficulties planning, focusing, solving problems, and managing everyday tasks.

Brain scans also showed lower gray matter volume in several regions involved in memory, attention, decision-making, and emotional regulation. A neuroradiologist reviewing the scans found that about 2% of former players showed brain shrinkage suggestive of neurodegeneration, although researchers said additional investigation is needed to better understand that finding.

At the same time, the players performed similarly to the control group on objective cognitive tests, meaning the study did not find evidence of measurable cognitive decline.

Researchers say these results underscore the importance of following participants over time to learn whether repeated head impacts influence long-term brain health and to help guide future efforts to make sports safer.

Research like this helps us better understand brain health factors across the lifespan and reinforces the importance of injury prevention and monitoring, researhcer Maria C. Carrillo, Ph.D., said in the release.

These findings can help players, physicians and sports organizations better understand the risks of contact sports and how to participate safely.