Diabetes

Jeffrey D. Dunn, PharmD, MBA, has served as vice president of clinical strategy and programs and industry relations at MagellanRx, a national pharmacy benefit manager (PBM); cofounder, senior vice president, chief clinical officer, and board member of VRx, a regional PBM; and pharmacy director of SelectHealth, part of Intermountain Healthcare. Dunn was instrumental in opening and running the VRx retail pharmacy in downtown Salt Lake City, Utah. He is a board member of Care Pharmacies Cooperative, a chain of 100 retail pharmacies. An editor from The American Journal of Managed Care® recently conducted a question-and-answer session with Dunn regarding the recent Institute for Clinical and Economic Review report on the cost-effectiveness of oral semaglutide.

Results from an analysis conducted by the Pharmacy Benefit Management Institute (PBMI) show that the use of Jardiance (empagliflozin) among employees with type 2 diabetes and cardiovascular disease can save employers around $737,000 per 10,000 covered lives each year.

Novo Nordisk announced Thursday the FDA has approved injectable semaglutide (Ozempic) for adult patients with type 2 diabetes (T2D) and known heart disease.

The implementation of the Smart Snacks in School standards in 310 public schools resulted in healthier dietary intakes among students compared with those without the standards, according to a JAMA study published January 15.

The FDA expanded the use of Fiasp, a fast-acting insulin aspart injection, in children as young as 2 years to treat diabetes. First approved for adults in 2017, Novo Nordisk said it is the only "mealtime insulin injection that does not have a pre-meal dosing recommendation.”

Heart disease and kidney disease are widely known comorbidities of diabetes, but a lesser-known complication that dramatically effects between 10 million and 20 million American adults is peripheral arterial disease (PAD). In its most extreme form, PAD can lead to limb loss.

The workshops were aimed at ensuring that primary care centers were following clinical care guidelines developed after 2011 meeting requirements of a national certification program.

This week, the top managed care stories included the FDA announcing a ban on flavored e-cigarettes; Google’s artificial intelligence system can find breast cancer as well as experts; new diabetes guidelines including 2 new drug classes to treat comorbidities.

The significant findings of the DAPA-HF data have been well received in both the scientific and payer communities, but we also need to ensure that patients with diabetes are educated on the signs, symptoms, and risk factors linked with heart failure, said Kiersten Combs, BS, US vice president of Cardiovascular Metabolism at AstraZeneca.

Advances in continuous glucose monitoring, reimbursement for genetic testing, and payment models in oncology care were popular with readers of the Evidence-Based series.

Although there were many updates in various facets of diabetes care, one change stood out. New recommendations call for 2 drug classes to be used to treat patients with type 2 diabetes (T2D) and comorbidities: sodium glucose co-transporter 2 (SGLT2) inhibitors and glucagon-like peptide-1 (GLP-1) receptor agonists.

We are in the regulatory process to get an indication for the treatment of heart failure in both type 2 and non-type 2 diabetic patients, and this serves as just the start of the scientific investment that we have made with dapagliflozin, said Kiersten Combs, BS, US vice president of Cardiovascular Metabolism at AstraZeneca.

Researchers constructed a risk prediction model of hospitalizations due to heart failure (HHF) for patients with type 2 diabetes mellitus (T2DM), according to a Clinical Cardiology study.

The company said that with the clearance, the FDA outlined standards for a new device category, the interoperable automated glycemic controller designation.

The agency said this was the first such approval, as the purified omega-3 fatty acid is now approved to be used alongside statins to treat elevated cholesterol levels and cut the risk of events such as heart attacks or strokes. The drug was first approved in 2012 for patients with elevated triglycerides.

This week, the top managed care stories included the White House seeking a truce between CMS Administrator Seema Verma and HHS Secretary Alex Azar; Sanofi will shift its focus from diabetes to cancer drugs; results highlight real-world evidence of chimeric antigen receptor T-cell therapies.

Sanofi is ending research efforts in diabetes and cardiovascular diseases; the White House endorsed an emerging bipartisan agreement on legislation aimed at curbing rising healthcare costs by targeting surprise medical billing; the Supreme Court will hear oral arguments in a case involving whether the federal government owes insurers $12 billion in a dispute about risk corridor payments.

Limiting eating to a 10-hour window benefitted patients with metablic syndrome, according to a study published Thursday.

The findings from researchers at The Centers for Disease Control and Prevention (CDC) highlight the public health risks of obesity and type 2 diabetes, which have been tied to recent studies that find rising deaths from heart failure and even an overall drop in US life expectancy, with the long-term rise in obesity playing a role in the decline.

A high-tech drug testing machine is being utilized to detect fentanyl in illicit drugs; the Massachusetts governor enacts a stingent vaping flavor ban; data on blood-sugar levels for patients with diabetes using Dexcom's continuous glucose monitor (CGM) has been unavailable since Saturday.

The findings have important implications, the authors wrote, as the study confirms “the potential clinical utility of empagliflozin for the treatment of obesity and related metabolic disorders, such as insulin resistance, type 2 diabetes, and [nonalcoholic steatohepatitis."

Three straight years of declining life expectancy—from 2014 to 2017—have roots that go back to the 1980s, when the authors say US life expectancy began to lose pace with other countries.

Humana outlined its progress in its third annual Value-Based Care Report, which details growth and evolution in this area since 2016, both in the number of agreements and in its spread across more parts of the country.

EMPRISE (Empagliflozin Comparative Effectiveness and Safety) will examine 5 years of real-world data on empagliflozin, which is sold as Jardiance by Eli Lilly and Boehringer Ingelheim. The study is comparing data on empagliflozin with that for dipeptidyl peptidase 4 (DPP-4) inhibitors. This latest interim analysis also features a cohort comparison with glucagon-like peptide 1 (GLP-1) receptor agonists.

The pioglitazone safety warning issued in South Korea, which recommended prescribing with careful attention among those with high risk of bladder cancer, led to a moderate decrease in pioglitazone users.

This week, the top managed care news included Medicaid tightening the reins on supplemental payments; employers needing more data to control benefit costs; experts saying prior authorization mostly burdens patients.

Solera announced this week that the company has expanded its relationship with Blue Mesa Health to offer a Spanish-language Diabetes Prevention Program (DPP) Transformemos as a covered California Medicaid (Medi-Cal) member benefit.

Every week, The American Journal of Managed Care® recaps the top managed care news of the week, and you can now listen to it on our podcast, Managed Care Cast.