January 28th 2025
The high cost of incretin mimetics for weight management limits insurance coverage and potentiates variation in utilization management strategies to control near-term spending.
The FDA ordered 4 companies to stop selling 44 of their flavored e-liquid and hookah tobacco products that lack the required approval for sale; CMS has yet to implement a 2014 law preventing unnecessary, expensive screening tests (magnetic resonance imaging, computed tomagraphy scans and other tests) that could harm patients and waste resources; Amarin, which is seeking FDA approval for an expansion of Vascepa labeling to include data that showed a 25% reduction in the risk of heart attacks and strokes, said the FDA has scheduled an advisory committee meeting for November 14.
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Physician Satisfaction With Health Plans: Results From a National Survey
Several physician and payer characteristics are associated with physician satisfaction with health plans. There is opportunity to improve physician satisfaction with payers, specifically in pharmacy.
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Understanding Price Growth in the Market for Targeted Oncology Therapies
The prices of targeted oncology therapies have grown substantially, but revenues have not. This is due in part to large declines in per-drug patient counts.
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New Therapies Offer Possible Cures but Pose Affordability Challenges
May 23rd 2019The upfront prices of potentially curative therapies are terrifying to commercial payers and government payers alike. A panel on the last day of ISPOR 2019 discussed these issues in a session called, “Is Affordability Driving a Need to Revolutionize Drug Pricing?”
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Effect of Changing COPD Triple-Therapy Inhaler Combinations on COPD Symptoms
April 10th 2019Changing patients from an inhaled corticosteroid (ICS)/long-acting β agonist (LABA) inhaler and long-acting muscarinic agonist (LAMA) inhaler to a LAMA/LABA inhaler and a separate ICS inhaler did not appear to affect patient-reported chronic obstructive pulmonary disease (COPD) symptom scores.
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Value-Based Arrangements May Be More Prevalent Than Assumed
We surveyed biopharmaceutical manufacturers and payers to understand the prevalence and characteristics of value-based payment arrangements, as well as their implementation obstacles and success factors.
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HHS Releases Proposals Seeking End to Information Blocking, Promoting EHR Interoperability
February 11th 2019HHS released 2 long-awaited rules meant to transform how health records and medical claims are delivered and communicated, with one aimed at aggregating electronic health records and claims information into an interoperable mobile format that patients could call up on their devices and another that would require that access to electronic health information come at no cost to the patient and end information blocking.
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Rise of Marijuana Cries Out for Research, Regulation, Physicians Say
January 8th 2019Research and regulatory gaps in the use of marijuana will only grow unless the scientific community and policy leaders fill the void, according to a commentary series in Annals of Internal Medicine on marijuana’s rising availability.
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With the Midterm Election Over, Reports Assessing Healthcare Impact Turn to States
November 8th 2018Despite impending changes in Washington, DC, as the Democrats are set to take over the House of Representatives in 2019, the divided federal government could lead to a spell of predictability for some healthcare sectors as most action shifts to the state level.
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Payers, Unions Protest Additional Cost Shift of ESRD Services in Opioid Bill
August 20th 2018A coalition of diverse interest groups—payers, unions, and business groups—wrote Senate leaders Monday to express their opposition to the inclusion of “pay for” legislation regarding end-stage renal disease (ESRD) in an opioid bill passed in June by the House of Representatives.
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5 Things About Chronic Pain and Pain Management in the Age of Opioids
July 6th 2018Payers and providers are looking to keep vulnerable patients in pain from becoming addicted to painkillers, but those who live with pain on a daily basis are understandably upset at the thought of losing access to medications they say keep them functional. Here are 5 takeaways from recent coverage about this important issue.
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Payers Have Room for Improvement in Delivering Pain Care, Study Says
June 22nd 2018Using the example of low back pain, a study in JAMA Open suggests insurers could help to reduce opioid overuse by expanding access to nonopioid alternatives through improved coverage and reimbursement policies.
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Adults Surviving Nonfatal Opioid Overdose Have Higher Risk of Death Later
June 20th 2018Compared with the general population, adults who survive an opioid overdose are 24 times more likely to die during the year after the incident from a variety of mental health and medical conditions, including from substance use–associated diseases and suicide, according to a study published in JAMA Psychiatry.
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How Can Public Health, Traditional Healthcare Transform Community Wellness?
June 18th 2018For true comprehensive community wellness to take place, barriers must end between the old silos of what is considered “healthcare” and what is considered public health, in order to improve health outcomes and curb rising costs, according to a new report from The Health Care Transformation Task Force and The Public Health Leadership Forum.
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Can We Fight Opioid Use Disorder by Filling Data and Policy Gaps?
June 1st 2018Which data, policy, and information gaps exist throughout the healthcare system and need filling in order to combat opioid use disorder (OUD) through better prevention and treatment strategies? Two recent reports discuss how these gaps are worsening efforts to fight OUD.
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Navigating the Rocky Waters to Value-Based Healthcare
April 26th 2018Problems in healthcare seem overwhelming, with at least 17 different factors cited as driving unsustainable spending, according to a presentation at the Academy of Managed Care Pharmacy’s Managed Care & Specialty Pharmacy Annual Meeting held April 23-26, in Boston, Massachusetts. Two executives from Precision for Value LLC spoke about “Charting the Shifting Value-Based Healthcare Landscape: Emerging Developments for 2018 and Beyond” and offered their view on what healthcare companies can do to succeed.
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Delivering on the Value Proposition of Precision Medicine: The View From Healthcare Payers
Genomics-based precision medicine has the potential to transform healthcare delivery. However, effective collaborations among scientists, clinicians, and payers are needed to accelerate the translation of precision medicine to clinical practice and ensure its sustainability.
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