The Ledger

Eli Lilly will sell Zepbound and its obesity pill Foundayo directly on the Hims & Hers telehealth platform, starting at $299 and $149 a month, and Hims & Hers committed not to offer compounded copies of Lilly’s drugs. In a Lilly press release dated November 6, the companies said patients with a prescription from a licensed provider on the platform pay the same self-pay prices open to any patient, without leaving the site. According to Fierce Healthcare, those patients previously had to go to LillyDirect, Lilly’s own direct-to-patient pharmacy channel, to buy the drugs. Who it hits: compounding pharmacies and telehealth competitors that sell copies of GLP-1 (glucagon-like peptide 1) drugs, and health system weight-management programs now competing with a posted cash price. So what: a manufacturer-priced cash channel is becoming the benchmark for obesity drugs outside insurance, and Hims & Hers has agreed to stay out of copies of Lilly’s drugs. Confidence: Med. The terms come from the Lilly release and consistent trade coverage; we found no financial terms between the companies.

Medline’s third quarter sales rose 10.4% to $7.9 billion, but its gross margin fell to 24.5% from 26.4%, and its distribution unit earned just 4.4%. Medline, the largest private-label medical supply maker and hospital supply distributor, said in its Form 8-K earnings release dated November 4 that net income slipped 1.2% to $318 million while adjusted EBITDA (earnings before interest, taxes, depreciation and amortization) rose 11.8% to $960 million. Supply Chain Solutions, the distribution segment that sells to hospitals, grew sales 13.9% to $4.2 billion while its adjusted EBITDA fell 10.2% to $184 million. Inventory inflation adjustments hit $122 million in the quarter against $2 million a year earlier. Through nine months Medline booked $402 million of gross refunds on import tariffs that the Supreme Court ruled unauthorized in February, partly offset by $78 million of accrued repayments to customers. It raised 2026 organic sales growth guidance to 10.0% to 10.5% and kept adjusted EBITDA at $3.3 billion to $3.4 billion. So what: hospital supply chain leaders should ask whether tariff refund pass-throughs reach their contracts. Separately, per a KFF Health News summary of Chicago Tribune and Modern Healthcare reporting, Medline filed notice of 304 layoffs and plans higher prices to customers in January 2027; we have not read either original report, so treat both as Low confidence. Confidence: High on the filing figures.

UPDATE: S&P Global Ratings raised Norman Regional Hospital Authority in Oklahoma to CCC from D on November 5, with a negative outlook, after bondholders funded the payment it missed in September. This updates our September 11 coverage. According to Bond Buyer, the missed September 1 payment was nearly $12 million, and it was paid October 16 from proceeds of $40 million in new Series 2026 senior bonds sold to majority bondholders at a 7.5% coupon, due September 1, 2031. Those bonds take priority over the authority’s roughly $247 million of older 2016, 2017 and 2019 bonds outstanding as of June 30, 2025, and a $35 million line of credit became a five-year note. S&P cites improving debt service coverage and reserves, and says the negative outlook means at least a one-in-three chance of a downgrade within a year. Moody’s, per the same report, cut the revenue bonds one notch to Caa3 in October. So what: the cure came by giving new lenders first claim, which pushes existing bondholders down the line. Confidence: Med. We read Bond Buyer’s account of the S&P action, not S&P’s own release.

UPDATE: Roseland Community Hospital, a Chicago safety-net hospital, filed Chapter 11 on November 4, a month after saying it would close its labor and delivery unit. This updates our October 10 coverage. According to Becker’s Hospital Review and CBS Chicago, the petition in the U.S. Bankruptcy Court for the Northern District of Illinois lists estimated assets and liabilities of $10 million to $50 million each. The hospital tied the filing to debt from a malpractice settlement, threatened lawsuits over service agreements, and possible Medicaid cuts, and about 51% of its 2025 inpatient revenue came from Medicaid. Tax records show 2024 expenses exceeded income by about $14 million. The hospital says it keeps operating and expects to file a reorganization plan within 120 days. So what: a plan deadline in early March puts creditors and the state on a short clock. Confidence: Med. Both reports are secondary; we have not read the petition.

Altru Health System signed a definitive agreement with CommonSpirit Health for CHI St. Alexius Health’s hospitals in Bismarck, Turtle Lake and Garrison, North Dakota, to join Altru. Altru’s own November 4 press release says the deal follows a letter of intent announced earlier this year, is expected to close in early 2027 pending regulatory review, and does not change current patient care or day-to-day operations. Price, bed counts and employee numbers for the St. Alexius sites were not disclosed. Who it hits: North Dakota’s regional referral market, where Grand Forks-based Altru, with more than 3,100 staff and providers, gains a western footprint, and CommonSpirit continues shedding rural sites. Confidence: High on the agreement and timing, Low on economics.

THE DEAL SHEET

Target	Acquirer/Investor	Vertical	Value	Source
CHI St. Alexius Health hospitals (Bismarck, Turtle Lake, Garrison, N.D.)	Altru Health System	Hospital / regional health system	Not disclosed; close expected early 2027	Altru press center
Lilly obesity medicines distribution on Hims & Hers platform (commercial agreement, not an equity deal)	Eli Lilly and Hims & Hers Health	Telehealth / pharma	No financial terms found; self-pay prices from $149 and $299 a month	Lilly press release
Roseland Community Hospital (Chapter 11, filed November 4)	Not applicable, reorganization plan due within about 120 days	Safety-net hospital	Estimated assets and liabilities $10 million to $50 million each	Becker’s Hospital Review

No other new acquisitions, take-privates or antitrust actions surfaced in a scan of the last 24 hours. Previously reported pending deals such as Option Care Health and Definitive Healthcare have no new terms in today’s filings.