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Jared is a freelance writer for The American Journal of Managed Care® (AJMC®), and previously worked as a senior editor for HCPLive® at MJH Life Sciences®.

He has an MA from University of Sioux Falls. You can connect with Jared on 

Articles

Chimeric antigen receptor T-cell therapies, along with bispecific antibodies, have changed the treatment paradigm for patients with relapsed or refractory mantle cell lymphoma.

CAR T-Cell Therapies, Bispecific Antibodies Usher in New Era in R/R MCL

A new analysis based on two prospective trials helps clarify the roles of chemotherapy and radiotherapy.

Trial Data Yield Risk-Based NRSTS Treatment Strategies

Chronic kidney disease now affects more than 788 million adults globally, with rising prevalence, increasing mortality, and substantial contributions to cardiovascular deaths

Global CKD Burden Nearly Doubles Since 1990, Reaching 788 Million Adults Worldwide

A study identified 32 dysregulated cytokines and 5 key signaling hubs in idiopathic pulmonary fibrosis (IPF), mapping a complex network of profibrotic pathways that may serve as future therapeutic targets.

New Proteomic Analysis Maps Cytokine Signatures Driving IPF

The American Journal of Managed Care provides insights into the latest news and research in managed care across multimedia platforms.

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Compendium

On this episode of Managed Care Cast, we engage in a discussion with John M. Ostrominski, MD, fellow in cardiovascular medicine and 

 medicine, Brigham and Women’s Hospital and Harvard Medical School, and first author of a new study published in 

, “Trends in Utilization of Glucose- and Weight-Lowering Medications After Tirzepatide Approval in the United States.”

First approved on May 13, 2022, to treat adult patients with 

, the dual glucose-dependent insulinotropic polypeptide and glucagon-like peptide-1 receptor agonist has since been approved for chronic weight management and obstructive sleep apnea. Using commercial insurance claims data and the US launch of tirzepatide as their dividing point, Ostrominski and his team studied trends in the use of both glucose-lowering and weight-lowering medications, comparing outcomes between adults with and without type 2 diabetes. Overall, their findings show a significant uptick in tirzepatide dispensations, alongside other glucose- and weight-lowering medications, including semaglutide.

Speaking to the impact of their findings on health care providers who treat patients for type 2 diabetes and/or obesity, Ostrominski explains that these findings “underscore the need and importance of personalized and shared decisions around treatment.”

Listen above or through one of these podcast services:

Using commercial insurance claims data and the US launch of tirzepatide as their dividing point, John Ostrominski, MD, Harvard Medical School, and his team studied trends in the use of both glucose-lowering and weight-lowering medications, comparing outcomes between adults with and without type 2 diabetes.

Personalized Care Key as Tirzepatide Use Expands Rapidly

Welcome to the latest episode of Managed Care Cast and our conversation with Jeff Giullian, MD, MBA, chief medical officer with DaVita Kidney Care. In this interview, we dive into 4 important aspects of kidney care: prevention, social support, integrated care, and patient support.

Throughout this conversation, highlights include how to best manage 

 among high-risk populations, community education initiatives from DaVita that focus on kidney health resources, and comorbidity management. Dr Giullian underscores the value of integrated care teams in managing comorbidities and improving patient outcomes, emphasizes the role of technology in enhancing care without replacing the essential human touch, and addresses the need to reduce health disparities.

Listen above or on one of these podcast services:

In our conversation with Jeff Giullian, MD, MBA, chief medical officer with DaVita Kidney Care, we dive into 4 important aspects of kidney care: prevention, social support, integrated care, and patient support.

Engage, Educate, Empower: Transforming Kidney Care

Research shows a sharp rise in bisphenol-attributable metabolic disease since 2000, with annual costs exceeding $250 billion in North America.

BPA Exposure Linked to 127 Million Global Metabolic Disease Cases

Updated guidelines set lower systolic blood pressure goals, expanded risk-based treatment, and call for stronger implementation to close care gaps.

2025 Hypertension Guideline Updates Presented at AHA Scientific Sessions

Papillary muscle scarring has a substantial association with both cardiovascular mortality and arrhythmia.

Papillary Muscle Scarring May Predict Cardiac Death in Dilated Cardiomyopathy

Researchers urged caution in interpreting DECAF Trial results that suggest daily coffee intake is linked to a lower risk of atrial fibrillation recurrence.

Can a Coffee a Day Keep AFib Away?

The trial did not meet its primary end point for reducing plaque progression.

CAVIAR: Alirocumab Safely Lowers Cholesterol After Heart Transplant

Tirzepatide's dual mechanism targets GIP and GLP-1 so it provides strong cardiovascular benefits, said Stephen Nicholls, MBBS, PhD, MBA.

Tirzepatide’s Dual Approach Better for MACE, HF: Stephen Nicholls, MBBS

The dual glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) mechanism of tirzepatide makes it a powerful tool in the toolbox, said Stephen Nicholls, MBBS, PhD, MBA, professor of cardiology at Monash University, program director of the Victorian Heart Hospital at Monash Health, and director of the Monash Victorian Heart Institute in Melbourne, Australia.

Transcript was edited; captions were auto-generated.

Tirzepatide is a dual GIP and GLP-1 receptor agonist. What can we take away from the results about the impact of the dual mechanism?

I think the added impact of the dual approach to targeting GIP and GLP-1 is clearly the favorable effects on a range of metabolic parameters: better weight loss, better reductions in [hemoglobin] A

, blood pressure, atherogenic lipids, [and] less of a reduction in eGFR [estimated glomerular filtration rate]. We've seen at least comparable effects on cardiovascular end points. In fact, at the AHA [American Heart Association Scientific Sessions], we're reporting more favorable effects in the heart failure setting, [and] more favorable effects on an expanded MACE [major adverse cardiovascular events] end point, including coronary vascularization. Then we've also presented more favorable effects when we look at a composite of kidney end points.

There are a whole range of other benefits, some of them are biochemical, and then we're starting to see that roll out into more clinical events. Particularly fatal outcomes, which is particularly important, are consistently looking like they're more favorable in the patients treated with tirzepatide compared with dulaglutide.

How do these head-to-head results specifically influence current treatment algorithms for this high-risk population?

I think that if tirzepatide is available in the clinic, it's a tool in the toolbox, and it's a great opportunity for us to sit down with patients and say, “Well, here's the plan. Here are the risk factors we need to target. Here are the therapies we can use. Here's a therapy that at least seems to be more favorable in terms of a number of those risk factors, and it's important to keep in mind that those risk factors don't just drive the cardiovascular complications, but we're going to see a range of other complications of obesity, overweight, whether it's joint disease, dementia, liver disease, you name it.” There's a range of other reasons why one might consider the use of a dual receptor agonist as opposed to a standalone GLP-1.

Videos

Tirzepatide's dual mechanism targets GIP and GLP-1, so it provides strong cardiovascular benefits, said Stephen Nicholls, MBBS, PhD, MBA.

Providers

Conference

New findings reveal sotagliflozin's benefits for patients with heart failure with preserved ejection fraction without diabetes, said Juan Badimon, PhD.

Sotagliflozin Efficacy in Non-Diabetic HFpEF: Juan Badimon, PhD

Sodium-glucose cotransporter (SGLT) inhibitors have established themselves as foundational therapy for heart failure, but confirming their mechanism-agnostic efficacy across all patient groups is important, explained Juan Badimon, PhD, FACC, FAHA, professor of medicine and director of the Atherothrombosis Research Unit at The Mount Sinai School of Medicine’s Cardiovascular Institute.

American Heart Association Scientific Sessions

, Badimon presented results from the SOTA-P-CARDIA trial, a dedicated, randomized, double-blind, placebo-controlled study, which was designed to test the dual SGLT1/2 inhibitor sotagliflozin (Inpefa; Lexicon Pharmaceuticals) in patients with heart failure with preserved ejection fraction (HFpEF) who do not have type 2 diabetes. The central rationale for this focused, randomized design was to ensure similarities between the study groups and standardize concomitant therapy.

Sotagliflozin was approved by the FDA more than 2 years ago for patients with heart failure regardless of their diabetic status,

 but these new results demonstrate the clinical benefits for patients with preserved ejection fraction without diabetes, Badimon said in a press release.

SOTA-P-CARDIA enrolled 50 patients (25 per arm) and set its primary end point as the change in plasma N-terminal pro-B-type natriuretic peptide (NT-proBNP) at 12 weeks, a key biomarker of cardiac stress. Secondary end points included changes in left ventricular function, quality of life, and exercise capacity based on the 6-minute walking test.

These data significantly broaden the potential treatment landscape, reinforcing the view that HFpEF is not solely a complication of diabetes. Badimon concluded that the data needs “to be corroborated in a larger clinical setting” to solidify its position as a standard of care regardless of a patient's diabetic status.

1. Inserro A. FDA approves sotagliflozin, a dual SGLT1/2 inhibitor, for full range of heart failure. 

®. May 27, 2023. Accessed November 10, 2025. 

https://www.ajmc.com/view/fda-sotagliflozin-a-dual-sglt1-2-inhibitor-for-full-range-of-heart-failure

2. Clinical data demonstrating efficacy of sotagliflozin in preserved ejection fraction heart failure (HFpEF) without diabetes presented at American Heart Association (AHA) Annual Scientific Sessions 2025. News release. Lexicon Pharmaceuticals. November 8, 2025. Accessed November 10, 2025. 

https://investors.lexpharma.com/news-releases/news-release-details/clinical-data-demonstrating-efficacy-sotagliflozin-preserved

Sotagliflozin Efficacy in Nondiabetic HFpEF: Juan Badimon, PhD

Integrating nephrology and cardiology care for patients with kidney and cardiovascular (CV) risks can be challenging but is possible, said Roy Mathew, MD.

Integrated Care for Patients With Kidney and CV Risks: Roy Mathew, MD

Captions were auto-generated and lightly edited.

Establishing best practices for the seamless integration of care from nephrologists, cardiologists, and primary care for patients with coexisting 

 risks is challenging, said Roy Mathew, MD, associate professor of medicine at the Loma Linda VA Health Care System. He presented on kidney health as a determinant of cardiovascular risk during the 2025 

American Heart Association (AHA) Scientific Sessions

, held in New Orleans, Louisiana, November 7-10, 2025.

Right now, there is no definitive answer on what the best practices are to integrate care between different specialties for these patients, but there are some models that have been able to do it. He pointed to the Cardiometabolic Center Alliance, which has found a way to incorporate cardiology and endocrinology into the care of patients with high-risk heart failure and diabetes in the chronic kidney disease space.

“We'd bring in pharmacists, nutritionists, [and] social workers, along with the nephrologist,” he said. “But I think that care has to now expand.”

However, he acknowledged that every health system is different, and they don’t all have the same capabilities. In rural areas with limited specialist availability, integration relies on leveraging nonphysician providers, including primary care, nurse practitioners, physician assistants, and community members. For larger health systems, the solution involves structural changes, particularly adjusting payment systems to incentivize collaboration and enable truly patient-centered care.

At University Hospitals in Cleveland, Ohio, the Center for Integrated and Novel Approaches in Vascular-Metabolic Disease, known as 

, is a very patient-centric model that brings all the providers to the patient, Mathew explained. The 

 is designed to not only address cardiovascular-kidney-metabolic (CKM) health risks in patients with 

 or prediabetes, but it also aims to streamline care through multidisciplinary collaboration.

AHA’s CKM Health initiative is focusing on what models, like CINEMA, work throughout the country. “That will be a good registry of information for people who want to try to implement that [model] into their systems,” Mathew said.

Health System

Hormonal shifts drive fat redistribution, muscle loss, and bone decline—all risk factors for cardiovascular disease in women, says Brooke Aggarwal, EdD.

How Menopause Alters Body Composition and Heart Risk: Brooke Aggarwal, EdD

Menopause comes with more symptoms than just hot flashes—many women experience major shifts in body composition that can influence long-term health. These changes are different from those seen with typical aging and include fat redistributing to the abdomen, muscle mass loss, and bone tissue decline.

The Menopause Society 2025 Annual Meeting

, Brooke Aggarwal, EdD, MS, FAHA, associate professor of medical sciences at Columbia University Irving Medical Center, discussed how these changes contribute to rising cardiovascular risk among 

This transcript has been lightly edited; captions were auto-generated.

What are the most significant shifts in body composition during the menopausal transition, and how do these differ from changes that occur with aging alone?

The most significant shifts that we see in body composition during the menopausal transition are really 3 things. One is a redistribution of fat, so fat from subcutaneous areas—especially in the legs, the thigh region, for example—moves more into the central region. That’s when we hear women are accumulating belly fat. That is usually referring to visceral fat, which is a little bit different than subcutaneous fat because visceral fat surrounds the organs, is biologically active, and is related to increased risk for 

The second major change that we see during the menopausal transition in terms of body composition is related to loss of lean muscle mass. As we age, we naturally lose lean muscle, but there is more of a rapid decline in muscle tissue during the menopausal transition.

Also, potentially the third thing is a loss of bone tissue during this menopausal transition. That’s why it’s really important to keep up with strength training, for example, to preserve both muscle and bone.

Now, when we’re talking about shifts in weight, that’s a little bit distinct from shifts in body composition. Shifts in weight, meaning gaining weight, are normal with chronological aging—that happens to both women and men. But for women, what’s unique is that they actually have a shift in body composition—meaning fat, muscle tissue, and bone tissue—and that is beyond what we would expect from normal chronological aging. It’s related to the hormone changes that they experience during the menopausal transition.

Remote monitoring and algorithm-based tools help pharmacists balance complex workloads in value-based care, says Lindsey Valenzuela, PharmD.

Tools for Managing Multiple Disease States Without Burning Out: Lindsey Valenzuela, PharmD

“perfect opportunity” for pharmacists

 to manage several layers of disease in 1 setting, according to Lindsey Valenzuela, PharmD, APh, BCACP, vice president of population health integration at Desert Oasis Healthcare, . For example, 

, and having a single pharmacist involved in the patient’s care can help expedite communication and reduce care gaps.

But how do pharmacists take on this responsibility without getting overwhelmed?

) that smart infrastructure and remote monitoring can make this workload manageable. Tools such as algorithm-driven dashboards and cellularly enabled glucometers help pharmacists 

 at the right time, boosting both efficiency and outcomes.

“[Patients] with the highest priority rise to the top based on the algorithms from the input of their remote patient monitoring data,” she explained. “We can address really the right patient at the right time, which makes us more effective.”

Does having 1 pharmacist manage multiple disease states increase their workload?

Putting all of those disease states on 1 pharmacist can seem like a burden. But when you are in a position to make changes and improvements to the medication profile for 

Cardiorenalmetabolic

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