The FDA approved Pfizer’s respiratory syncytial virus (RSV) vaccine Wednesday; Medicare announced plans to largely cover a new class of expensive Alzheimer drugs; more states are extending postpartum coverage under Medicaid.
The FDA approved Pfizer’s respiratory syncytial virus (RSV) vaccine (Abrysvo) for adults age 60 and older on Wednesday, the second approval granted for a shot offering protection from the virus, reported The New York Times. GSK was the first manufacturer to get the FDA’s go-ahead to market an RSV vaccine (Arexvy) on May 3, and both vaccines are expected to be available in the fall prior to the winter RSV season. The FDA estimated that about 6000 to 10,000 adults 65 years and older die from RSV each year, and it is also considered a global killer of infants.
Medicare officials announced plans Thursday to largely cover a new class of Alzheimer drugs after patient advocates and drugmakers called for access to these medications, which are the first shown to slow cognitive decline from the illness, according to The Washington Post. CMS said it would cover the expensive drugs for anyone enrolled in the outpatient portion of Medicare who meets coverage criteria. The medications target amyloid plaque in the brain, but come with controversy around their safety and effectiveness. An earlier version of the policy would require patients to be enrolled in clinical trials for these drugs to be covered, but the new plan will cover those whose prescribing doctors report information to real-world data registries.
At least 8 states in 2023 have decided to pursue federal approval to extend postpartum Medicaid coverage, leaving just a few that have decided not to guarantee at least a year of health care for women during the important period after pregnancy, reported KFF Health News. Over 4 in 10 births in the US are covered under Medicaid, but the default postpartum coverage period is 60 days. One new state is Montana, where lawmakers in the just-ended legislative session approved a state budget to lengthen continuous postpartum eligibility from 60 days to 12 months after pregnancy.
Managed Care Reflections: A Q&A With A. Mark Fendrick, MD, and Michael E. Chernew, PhD
December 2nd 2025To mark the 30th anniversary of The American Journal of Managed Care (AJMC), each issue in 2025 includes a special feature: reflections from a thought leader on what has changed—and what has not—over the past 3 decades and what’s next for managed care. The December issue features a conversation with AJMC Co–Editors in Chief A. Mark Fendrick, MD, director of the Center for Value-Based Insurance Design and a professor at the University of Michigan in Ann Arbor; and Michael E. Chernew, PhD, the Leonard D. Schaeffer Professor of Health Care Policy and the director of the Healthcare Markets and Regulation Lab at Harvard Medical School in Boston, Massachusetts.
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