Health Care Cost

Theresa Juday, RPh, director, Specialty Product Development, CVS Health, discusses the indirect and direct cost burden associated with chronic insomnia.

Key quality and savings metrics as measured within the most recent performance period from The Centers for Medicare & Medicaid Innovation (CMMI) for the Oncology Care Model (OCM) demonstrated Florida Cancer Specialists & Research Institute as a top performing oncology practice nationwide.

Pfizer predicts that a fourth dose of a COVID-19 vaccine may be needed to quell the Omicron variant; CMS officials share figures on enrollment for health coverage under the Affordable Care Act (ACA); City of Hope announces acquisition of Cancer Treatment Centers of America.

The Alliance of Community Health Plans (ACHP) recently released its 2021 Report on Affordability. In this episode of Managed Care Cast, we speak with the organization about the steps that its payer members are taking to lower costs through offerings such as virtual-first care, remote patient monitoring, and other new products, some of which were created because of the pandemic.

As the cost of oncology drugs increases, there has been a growing pressure to manage oncology drug spend, which some payers have done by establishing preferred therapies, including biosimilars.

The announcement of a "strategic refresh" for payment models under the Center for Medicare and Medicaid Innovation offered no details on what practices should expect when the Oncology Care Model (OCM) expires in 2022.

Findings presented at the 2021 American College of Rheumatology Annual Meeting showed that patients with concomitant psoriasis and psoriatic arthritis (PsA) reported greater incidence of obesity, hypertension, and diabetes, as well as a higher likelihood of work inability than those with only psoriasis.

A report from the Centers for Medicare and Medicaid Innovation confirmed that practices within the US Oncology Network and Tennessee Oncology participating in the Oncology Care Model (OCM) program have contributed significant savings to the agency.

Investigators drew insights about consumers’ health care shopping behavior by analyzing use of an online price transparency tool.

For trastuzumab and bevacizumab, biosimilars now represent a high share of administrations, but payer policies still hinder uptake of these products, the Community Oncology Alliance (COA) reports.

Uveitic macular edema is common in patients with noninfectious uveitis, and its significant burden on patients and payers warrants more specific treatment guidelines to minimize quality-of-life and economic effects.

States are turning to alternative payment models to improve outcomes and reduce health care expenditures, representing a critical step forward specifically for the US maternal health crisis.

The share of patients meeting the definition of polypharmacy for the condition of overactive bladder declined from 2006 to 2017, but the phenomenon was still prevalent in women and patients in nursing homes, according to a recent study.

An overview of activities at the FDA to promote the use of biosimilars was presented by Jacqueline Corrigan-Curay, JD, MD, principal deputy center director for the Center for Drug Evaluation and Research (CDER) at the FDA.

On this episode of Managed Care Cast, we speak with Abi Sundaramoorthy, MD, MBA, executive vice president of clinical enterprise at Somatus, on fragmented care in chronic kidney disease, its disproportionate impact on minority communities, and the potential of value-based arrangements to address disparities and promote preventive, effective care.

Consumers strategically used a price transparency tool by searching more often in procedure markets with provider-specific information, higher charges, and more out-of-network claims and provider competition.

Patients with lupus nephritis (LN) were found to have as much as twice the inpatient hospitalizations of patients with systemic lupus erythematosus without LN.

To avoid bankrupting health care, providers must carefully consider how they use biologics in patients with severe asthma, according to a presenter at the American College of Allergy, Asthma & Immunology Annual Scientific Meeting.

Conference abstracts explored the relationship between serum phosphate levels on mortality in patients with chronic kidney disease (CKD) and cost burdens for employers as patients transition to end-stage renal disease.

With new and expected future options for treating atopic dermatitis (AD), including an injectable biologic and an oral small molecule inhibitor, which is preferred and which makes the most sense for patients?

Coverage of our peer-reviewed research and news reporting in the health care and mainstream press.

Cost increases were particularly pronounced among patients with severe systemic lupus erythematosus (SLE), the study found.

Two posters presented at AMCP Nexus 2021 analyzed the costs of treating cytokine release syndrome and neurological events, 2 common adverse events (AEs) of chimeric antigen receptor (CAR) T-cell therapy.

A panel at Asembia 2021 Specialty Pharmacy Summit in Las Vegas addressed challenges in the treatment journey of patients with rare diseases, efforts to improve access to gene therapies, and cost and value considerations for stakeholders.

Oncology drugs are a huge driver of cost, but there’s a lot of innovation happening in the space to improve care and outcomes for patients, said Michelle Booth, PharmD, director of specialty clinical solutions at Magellan Rx Management.

The state of value-based contracting in specialty pharmacy was addressed in a panel discussion at Asembia 2021 Specialty Pharmacy Summit in Las Vegas, with speakers touching on the essentials of such agreements, how to optimally integrate them, and future considerations for the pharmaceutical marketplace.

In the years since its inception, debates around the 340B program have centered on whether savings actually benefit the underserved as intended. A new paper in The American Journal of Managed Care® analyzed secondary data on 340B participation and uncompensated care provision from general acute care and critical access hospitals between 2003 and 2015.

Panelists of the opening session at Asembia 2021 Specialty Pharmacy Summit in Las Vegas address emerging shifts in specialty pharmacy, its impact on the health care system, and future implications post pandemic.

In studies presented at the American College of Gastroenterology 2021 meeting, success was reported for RBX2660, a treatment for clostridioides difficile infection (CDI).

Posters presented at AMCP Nexus 2021 evaluated the health care resource utilization (HRU) and costs associated with the chimeric antigen receptor T-cell therapies tisagenlecleucel and axicabtagene ciloleucel.