Health Care Cost

An unprecedented level of detail and robustness around interoperability standards is on its way, and on this episode of Managed Care Cast, we speak with Donald Rucker, MD, the former National Coordinator for Health Information Technology in HHS, about what the opportunities and responsibilities for payers are.

President Biden releases the budget for fiscal year 2023; health care spending is projected to hit $6.8 trillion in 2030; rates of prediabetes on the rise in children.

The FDA approved a drug to treat a rare form of childhood epilepsy; uninsured Americans will no longer have access to free COVID-19 tests; a conservation group is suing the Environmental Protection Agency (EPA) over failure to protect rivers from pollution.

The annual spring meeting of AMCP 2022 will include keynote sessions on health care and marketplace trends and the specialty pharmaceutical pipeline, with a featured preconference session on bias in health care.

Patients switched from the originator product maintained their clinical outcomes and remissions status while biologic-naïve patients recorded positive responses and remission outcomes after initiating infliximab-dyyb.

Coverage of COVID-19 tests and treatment bills halted for uninsured; Moderna low-dose vaccine in children under 6 years of age shows promise in early clinical trial findings; Pfizer recalls blood pressure medications due to potential carcinogen.

The special enrollment period for Affordable Care Act (ACA) coverage has opened to low-income Americans; the FDA approves the first drug for a rare genetic epilepsy disorder; the National Institutes of Health to launch biomarker testing program for pediatric tumors.

On this episode of Managed Care Cast, Teresa Tyson, DNP, MSN, FNP-BC, FAANP, and Paula Hill-Collins, DNP, MSN, FAANP, discuss how The Health Wagon, a free mobile-based and nurse-managed clinic, provides accessible health care to rural residents in Virginia's Appalachian region.

Recent research presented at the 2022 American Academy of Allergy, Asthma & Immunology Annual Meeting examined different aspects of the use of biologics for severe asthma.

Eosinophilic esophagitis (EoE) is triggered by food and in this interview, Colette Romero, whose son has the disease, discusses the financial implications for families, including equity considerations.

While filgrastim biosimilars had substantial uptake, there was low uptake of infliximab biosimilars. In addition, there was a lack of price competition.

Medicare advantage beneficiaries who received care from providers in 2-sided risk payment models had lower rates of acute care use, according to new study findings.

The phase 3 trial of valoctocogene roxaparvovec for severe hemophilia A showed it reduced bleeding events as well as the use of factor VIII concentrates.

For most patients who survive COVID-19 hospitalization, out-of-pocket spending within 180 days of discharge is modest. However, 1 in 10 have out-of-pocket spending exceeding $2000.

Full approval by the FDA follows tentative approval for the complex drug delivery advice for asthma and chronic obstructive pulmonary disease (COPD) granted by the FDA last week amid a patent dispute.

On this episode of Managed Care Cast, Anna Forsythe, PharmD, MSc, MBA, vice president of value and access at Cytel, explains the monetary and humanistic costs of conversion therapy among LGBTQ+ populations in the United States.

After years, the biosimilars horizon may be here with valuable opportunities to improve patient outcomes and reduce costs, said Eric Palmer, president and CEO of Evernorth.

Polypharmacy was associated with a nearly doubled increase in health care expenditures and a tripled increase in pharmacy expenditures among older patients with cardiovascular diseases (CVD).

A lack of transparency and misaligned incentives had curtailed the adoption of biosimilars in the United States.

From one-stop testing and treatment sites to boosting research and surveillance, Biden administration health officials expanded on the COVID-19 plan the president announced in his State of the Union address Tuesday night, but the plan will require additional funding from Congress.

The economic burden of rare diseases based on direct, indirect, and mortality-related costs is 10 times greater than the burden for mass market diseases, such as diabetes and cardiovascular disease, and this burden increases when no treatment is available.

The prior authorization process is a hurdle to getting care for individuals with rare diseases and limited options, according to a rheumatologist and a patient interviewed just before Rare Disease Day.

The redesigned accountable care organization (ACO) model is called the Realizing Equity, Access, and Community Health model and is scheduled to begin in 2023.

A new white paper from FAIR Health highlights the increase in costs for advanced life support and basic life support emergency ground ambulance transport between 2017 and 2020.

On this episode of Managed Care Cast, we discuss how already wide health care inequities in cancer are becoming much worse because of the COVID-19 pandemic, with guest Monica Soni, MD, associate chief medical officer at New Century Health.

Researchers compared drug costs among hospitals, specialty pharmacies, and physician offices.

Speaking during a webinar presented by the National Alliance of Healthcare Purchaser Coalitions, experts weighed the pros and cons of employer high-deductible health plans (HDHPs) and outlined steps to address challenges raised.

The researchers investigated the role that economic evaluation and budget impact analysis plays in reimbursement decisions for nusinersen, collecting data from countries across the globe.

AHIP released a report looking at the price markups for 10 drugs that can be delivered more affordably through specialty pharmacies, including 3 drugs with multiple biosimilars available.

The Senate voted 50-46 to confirm Robert Califf, MD, as commissioner of the FDA, which has been without a permanent leader for more than a year.