This study compares the impact of the 3 different out-of-pocket maximums proposed in Congress and by the Medicare Payment Advisory Commission.
Immune checkpoint inhibitors (ICIs) represent a significant benefit for the initial treatment of patients with advanced or metastatic non−small cell lung cancer (NSCLC). Beyond clinical benefit of increased overall survival, it represents a class of medications with a favorable adverse effect profile compared with chemotherapy. Drugs that target programmed cell death protein 1 (PD-1) receptor and its ligand PD-L1 are ICIs that work by taking the brakes off the immune system and promote T-cell−mediated cancer cell destruction. Current NCCN guidelines recommend that all patients with advanced or metastatic NSCLC have their PD-L1 status (amount of PD-L1 on cancer cells) assessed to guide treatment section. However, this recommendation is not always followed and may lead to inappropriate treatment selection and potential increased cost. Through appropriate biomarker testing, subsequent appropriate utilization of ICIs may help to drive down other costs and improve health-related quality of life. Managed care pharmacists should continue to focus on promotion of guideline concordant care that includes appropriate biomarker testing and selection of an evidence-based preferred treatment option.
This study aimed to evaluate the impact of a smoking cessation service in a group of patients admitted to a short-stay unit in the emergency department.
Physician groups under 2-sided risk–based Medicare Advantage provide care associated with higher quality and efficiency compared with care by these same groups under fee-for-service Medicare.
For pharmacists wondering whether bismuth quadruple therapy still reigns as the gold standard, the wait is over—the latest recommendations are here.
Panelists discuss how the relapsed/refractory chronic lymphocytic leukemia treatment landscape evolved significantly in 2024 with expanded Bruton tyrosine kinase inhibitor options, growing real-world evidence for newer agents, and emerging combination strategies, while expressing optimism for future advances in personalized therapy approaches and novel drug development.
Raj Chovatiya, MD, PhD, MSCI, highlights the long-term effectiveness of lebrikizumab across diverse patients, including those with prior biologic use, positioning it as a potential first-line treatment for moderate to severe atopic dermatitis.
This study evaluated whether limited English proficiency modifies the association between cardiovascular risk factors or cardiovascular disease and outcomes in patients hospitalized with COVID-19.
Real-world cross-validation of insurer and hospital price transparency data finds low overlap but high concordance between data sources.
Drs Steven Levine, Patricia Ares-Romero, Samuel Nordberg, Martin Rosenzweig, and Carrie Jardine share insight on the future treatment landscape for TRD.
Marius Hoeper, MD, describes the role clinicians can play in advocating for health care system reforms that could address the economic implications of PAH and discusses the key unmet needs in the PAH treatment landscape.
This analysis evaluates the relationship between hospital care delivery network fragmentation and in-hospital and 90-day outcomes. These networks may be novel targets for improving outcomes.
The COVID-19 pandemic disrupted access to routine medical care in community populations in Taiwan. The unmet needs should be emphasized as normal life resumes.
Learn about how Allegheny Health Network's "Food as Medicine" initiative tackles food insecurity and enhances health through personalized nutrition support.
In this study, 52% of adult patients achieved the treat-to-target goal of 1% BSA or less within 3 months of incorporating tapinarof cream into their biologic regimen.
Care coordination engagement increases over time in long-term high-cost, high-need patients, with no identifiable data-driven times for when to initiate patient care de-escalation.
This study provides insight on the experiences of patients of a national health plan with 2 structural determinants of health—health care discrimination and health literacy—and how those interact with social determinants of health and patient demographics.
This study evaluates the cost-effectiveness and budget impact to US payers of point-of-care nucleic acid amplification tests (NAAT) for group A streptococcus.
A methodology to monitor patient-in-the-loop modes and faults was examined using a hybrid automata model that was able to replicate patient’s real-life operation modes.
This retrospective study evaluated real-world implementation of the updated CDC HIV algorithm in a large US laboratory.
This study evaluates the growth in electronic consultation use over the first 7 years after its implementation across the entire Veterans Health Administration system.
Federally qualified health centers (FQHCs) must focus on enhancing the nonemergency medical transportation Medicaid benefit to improve patient access during the coronavirus disease 2019 (COVID-19) emergency as states reopen.
Authors from the Community Oncology Alliance and Avalere Health present data that show breast cancer screening rates recovered more slowly among some racial/ethnic groups following on the onset of the COVID-19 pandemic.
Advanced care at home (otherwise known as hospital at home) can be scaled and provide care for a sizable portion of a hospital’s inpatient census, creating hospital capacity in an integrated delivery system.
An investigation of management patterns after initial radiographic diagnosis of small renal masses showed that early urologist referral was associated with guideline-concordant care.
Results from the AZALEA-TIMI 71 phase 2 trial showed great promise for abelacimab to transform care for high-risk patients with atrial fibrillation.