Health Care Cost

This new economic valuation of the societal and health care benefits of gene therapy to treat sickle cell disease (SCD) concludes the highly personalized treatment has potential to be cost effective if priced below $2 million.

Although ibrutinib adds to the cost of treatment, its benefits over the long term justify the cost, investigators found.

Most patients in the cohort received rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone for first-line therapy; hospitalization was prevalent; and average medical and pharmacy costs were more than $140,000 per patient per year.

The findings demonstrate the critical need for immediate policy reforms to tackle structural racism and promote equitable pediatric care in the US for children regardless of race or ethnicity.

Mike Brown, vice president of managed services at Cardinal Health, shares how drug cost control software has improved monitoring efficiency and reduced drug spending.

Families with workplace health insurance may have missed out on $125,000 in earnings over the past 3 decades due to rising premiums; so far, there have been about 600 drug price hikes in January; experts worry that minority and low-income people will not have easy access to zuranolone, the first FDA-approved postpartum depression pill.

New program seeks to revitalize struggling rural health care facilities; NIH director advocates for actions to address unaffordable medications; WHO reveals significant drop global tobacco use

This new study examined postoperative survival among discharged patients following treatment of non–small cell lung cancer (NSCLC) via surgical resection using the National Cancer Database.

Biosimilars offer substantial promise for a new era of accessibility and affordability for patients and the broader health care industry, but better understanding of these products from payers and providers is necessary for biosimilars to reach their full potential in the US.

Patients with multiple myeloma are living longer; therefore, their lifelong treatment expenses can become burdensome.

The Center on Health Equity and Access provides up-to-date news, showcases research advancements, and ongoing initiatives dedicated to tackling healthcare disparities and enhancing overall accessibility to outstanding care.

Popular weight loss drugs are not linked to suicidal actions, says the FDA; the White House is calling for urgent support amid economic challenges; rising hospitalizations and deaths prompt calls to increase vaccination coverage.

A social-impact startup, Pittsburgh-based Fabric Health is adept at using community engagement to help members and their families navigate the complex world of health care—meeting customers where they are at, knowing time is often their most valuable resource.

Malpractice insurance costs and coverage denials skyrocket for clinics that provide gender-affirming care to minors; American Red Cross declares emergency as low blood supply puts strain on hospitals; Walgreens agrees to pay $360 million to Humana.

Based on a comparison of prices for drugs up for Medicare price negotiations, there is a long way to go to reach the prices of 7 comparable countries.

“These autosomal diseases, from an inheritance standpoint, affect men and women equally, but because of their impact on the gynecological system and menses, women are often affected much more than men," hematologist Donna DiMichele, MD, explains.

Margaret Liang, MD, MSHPM, gynecologic oncologist and health services researcher and director, Gynecologic Oncology Fellowship Program, Cedars-Sinai Cancer Center, discusses financial toxicity in cancer care and how institutions can help alleviate the financial burden for patients.

The Center on Health Equity and Access delivers current news, highlights research advancements, and continuous initiatives focused on addressing health care disparities and improving overall accessibility to exceptional care.

"It’s time for our industry to recognize the consequences of the lack of investment in maternal health and come together to bring forward innovations," Charlotte Owens, MD, stated.

The average direct cost for hospital treatment for patients with COVID-19 in the United States rose by 26% from 2020 to 2022; scientists have developed a new type of antibiotic to treat a deadly bacteria resistant to most current antibiotics; a survey conducted for Utah state officials gave some clues as to why millions of Americans lost Medicaid coverage last year.

Amy Laughlin, MD, MSHP, of Orlando Health commented on at-home cancer care costs and shared her predictions on how at-home cancer care will evolve.

Drugmakers are expected to increase prices on more than 500 drugs early this month; the FDA approved nearly 50% more novel drugs in 2023 than in 2022; the number of Americans who were not pregnant and wanted abortion pills increased by nearly 10 times after the Supreme Court’s 2022 Roe v Wade decision leaked.

Lawmakers contemplate the return of mental health institutions in response to the drug crisis; new measures to rein in insulin prices take effect; FDA intensifies efforts to curb the teen vaping epidemic.

While the first ustekinumab biosimilar, Wezlana, was approved in October 2023, a settlement with Johnson & Johnson (J&J) will keep it off the market until 2025, preventing competition, and causing purchasers to pay substantially more for the agent.

The most popular content from our Asembia coverage largely covered biosimilars.

The most popular reimbursement content of 2023 included coverage of the shift from the Oncology Care Model to the Enhancing Oncology Model, reactions to the 2024 Medicare Physician Fee Schedule, and concerns around denial of services in Medicare Advantage plans.

Patients with spinal muscular atrophy (SMA) treated with a more expensive medication were found to have higher pharmacy costs but lower SMA-related health care resource utilization and medical costs compared with patients receiving standard-of-care nusinersen monotherapy.

The top articles of 2023 addressed key issues such as representation gaps in aRCC research, concerns about the 340B program's impact on asthma disparities, slow adoption of equity innovations, potential biases in type 2 diabetes risk models, and addressing disparities in psoriasis treatment based on race and culture.

Employers, recognized as pivotal contributors to health equity, are urged to prioritize equitable benefits, address the complexity of health plans, and engage in education, data-driven interventions, and systematic measurements to comprehensively improve outcomes for diverse employee populations.

In September, The American Journal of Managed Care® joined 4 individuals whose involvement with UPMC Health Plan, a Strategic Alliance Partner of AJMC®, has proved to be instrumental in furthering health equity and providing high-quality care in Pennsylvania, Ohio, West Virginia, and Maryland.