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This study evaluates the long-term cost-effectiveness of treatment involving combination therapy with dipeptidyl peptidase 4 (DPP-4) inhibitors and sodium-glucose cotransporter 2 (SGLT2) inhibitors compared with an alternative with sulfonyureas prior to insulin initiation on a background of metformin.

This week, the top managed care news included HHS announcing a finalized rule requiring the disclosure of drug prices in television ads; a report finding high satisfaction with employer health coverage despite the cost; a study finding heart failure is surging among young adults.

This week, the top managed care news included CMS Administrator Seema Verma calling for more disruption to the healthcare system; former FDA Commissioner Scott Gottlieb, MD, reflecting on the agency’s record of innovation; liraglutide demonstrating promise for youth with type 2 diabetes.

Some large employers and policy makers advocate for retail competition that relies on providers competing on healthcare performance. Using diabetes care in Minnesota as an example, researchers examined whether the public reporting of care measures encouraged health systems to improve their clinics’ diabetes care performance in the latest issue of The American Journal of Managed Care®.

This week, the top managed care news included CDC clarifying its opioid guidelines for chronic pain; pharmacy benefit managers testifying before a Senate committee; Sanofi expanding its insulin savings program starting in June.

The program comes as Congress has singled out the cost of insulin in its scrutiny of drug prices. Patients with type 1 diabetes cannot survive without the hormone, and press reports have highlighted the plight of young adults who ration insulin after they reach age 26 and cannot stay on family insurance plans.

Today we’re speaking with Tom Milam, founder and president of TrueLifeCare. As a former chief operating officer for a national diabetes supply, education, and support company, Milam created programs for people with diabetes that served more than 100,000 members nationwide. His experience also includes a federal appointment providing advisory service to Medicare. His extensive experience and knowledge within the diabetes space allows Tom to offer us an expert view of CMS’ Competitive Bidding Program.

This week, the top managed care news included courts rejecting multiple health initiatives from the Trump administration; Congress heard more about rising insulin prices; a new agreement seeks standards for reporting social determinants of health.

The potential value of continuous monitoring of blood glucose and the enzyme-based electrode that underlies continuous glucose monitoring (CGM) in the subcutaneous tissue were described in the 1960s. In 1999, the FDA approved the first “professional” CGM system, which stored data over 3 days for later retrieval and analysis. However, many patients (even volunteers in CGM-based clinical trials) found early-generation systems uncomfortable and difficult to wear. By contrast, current systems are more accurate, provide customizable alerts and alarms, are easier to use and less likely to cause skin irritation, resist interference from acetaminophen, allow for real-time data to be shared and remotely monitored, and are stable enough so as not to require periodic calibrations with SMBG values.