Policy

School nurses play an overworked and understaffed role; Merck's immunotherapy Keytruda (pembroilzumab) has been granted approval for pre- and postsurgical treatment in lung cancer; the FDA is helping to curb tobacco-related health disparities.

The level of biosimilar market sustainability differs between countries, largely due to variances in biosimilar policies and years of experience managing a biosimilar market.

Medicare Advantage star ratings reveal shifts in plan quality and performance; Rite Aid seeks debt reduction and restructures amid financial challenges; workers secure improved wages and staffing

According to the National Cancer Institute, in the year following a cancer diagnosis, the average cost of medical care plus medication exceeds $42,000, with some treatments having a price tag of more than $1 million.

Medicare Part A and B premiums are set to increase by $9.80 next year; 20 experts from various specialties and institutions have developed updated brain death guidelines; many Black patients are strongly affected by multiple COVID-19 infections due to a lack of health insurance and health care access.

Fabric Health is transforming laundry time into an opportunity for community well-being, engaging families in laundromats to address health needs and connecting them with health care experts and needed social services. Adaptable and problem-solving oriented, the social-impact startup helps to bridge pandemic-exacerbated disparities by meeting people where they are, fostering health equity.

For patients who had 12 months of continuous health care coverage before and after receiving a diagnosis of vitiligo, treatment rates were at suboptimal levels.

Clinical studies have transformed how breast cancer is prevented, identified, and treated. Successful clinical trials improve patient outcomes, so trial administrators must ensure participants receive appropriate support at trial enrollment.

Updated vaccines are on their way to US pharmacies; importance of early diagnosis and treatment for individuals at risk of cardiovascular disease; Walgreens pharmacists stage their own protest.

Based on the comprehensive findings of a review, investigators outline several crucial policy implications, each designed to address the complex issue of bias mitigation in clinical algorithms effectively.

Mike Koroscik, MBA, MHA, vice president of oncology, Allina Health and the Allina Health Cancer Institute, discusses the successes and challenges of a population health reimbursement model and gives advice for other health organizations considering a similar partnership within their practices.

Patients with Medicare were 5.08 times more likely than patients with private insurance, and 2.81 times more likely than patients with Medicaid, to face a financial barrier to obtaining varenicline and combination nicotine replacement therapy.

Margaret Liang, MD, MSHPM, gynecologic oncologist and program director for the gynecologic oncology fellowship program at Cedars-Sinai Cancer Center, discusses the Association of Community Cancer Centers' Financial Advocacy Services guidelines, which focus on providing financial support to patients with cancer.

Kathy Oubre, MS, CEO of Pontchartrain Cancer Center, speaks on the unique perspectives and challenges smaller health care practices may face when entering into alternative payment models and shares key insights for addressing these issues.

A poster presented at the 40th National Oncology Conference addressed several hot topics in the oncology treatment and research space: addressing medical mistrust in underresourced communities, partnering with trusted organizations to improve health equity, and increasing inclusivity in research.

Among Latino men who have sex with men (MSM), access to and use of pre-exposure prophylaxis (PrEP) remain at suboptimal levels, despite this population of individuals having disproportionately high rates of diagnosed HIV in the United States.

Jennifer Sturgill, DO, Central Ohio Primary Care, discusses how shortages of antibiotics and medications for attention-deficit/hyperactivity disorder have affected primary care, as well as addresses the impact on heart failure care of CMS’ recent announcement of the first 10 drugs up for price negotiation in 2026 under the Inflation Reduction Act (IRA).

Fee-for-service care is not really in line with how primary care physicians think or how primary care should be delivered; the crux of value-based care is wanting patients to have the care they want and need, noted Kristin Oaks, DO, Agilon regional medical director at Central Ohio Primary Care.

Major companies committed to joining Medicare drug price negotiations; Boehringer Ingelheim introduced a low-cost version of its adalimumab biosimilar; schools begin to stock naloxone amid rising opioid deaths among young people.

The October issue of Health Affairs examines the multifaceted aspects of structural racism in health care, exploring historical roots, policy implications, public biases, innovative solutions, and institutional challenges, urging action to confront and dismantle disparities.

Robin Shah, CEO of Thyme Care, which he founded in 2020 with Bobby Green, MD, president and chief medical officer, joins hosts Emeline Aviki, MD, MBA, and Stephen Schleicher, MD, MBA, to discuss his evolution as an entrepreneur in oncology care innovation and his goal of positively changing how patients experience the cancer system.

A new grant aims to address maternal mortality in predominantly Black rural areas; Eli Lilly's drug to treat atopic dermatitis has not received FDA approval; a preliminary injunction is granted to Planned Parenthood South Atlantic.

FDA action is no longer expected in Q3 of 2023.

ViiV Healthcare is developing a self-injectable HIV drug similar to Cabenuva; HHS met with insurance companies to resolve COVID-19 vaccine coverage issues; the FDA has greenlit drugmaker Novo Nordisk to add reports of ileus, or intestinal blockage, to its Ozempic label.

A government shutdown could impact Medicaid and Medicare in important ways; new Medicare Advantage plans personalize offerings to special populations; nursing homes are still waiting for COVID-19 shots since the US government has stepped back.

Medicare Advantage and Medicare Part D prescription drug plans will maintain stability in 2024; a report found that women encounter disadvantages in cancer prevention and care; prescriptions for semaglutide, similar drugs surpass 9 million.

Chemotherapy drug shortages put young patients at risk; restrictions and challenges cause concerns of a rise in teen births; at least 28 companies failed to prove sufficient product testing for cough syrups.

The CDC recommends pregnant women receive RSV vaccinations; 6 states expand their Medicaid programs to offer dental coverage; a new bill aims to address issues in the US organ transplant system

On this episode of Managed Care Cast, we speak with the senior author of a study published in the September 2023 issue of The American Journal of Managed Care® on the importance of adequate and effective lung cancer risk factor documentation to determine a patient's eligibility for screening.

Drugmakers turn to artificial intelligence (AI); new reports of vaccine appointment cancellations or insurance issues; Biden plans to clear Americans’ credit scores of medical debt.