
Who should receive genetic counseling and screening for colorectal cancer (CRC)? And how early should annual colonoscopies happen once those at risk are identified? These are important questions with equally important and complex answers.

Who should receive genetic counseling and screening for colorectal cancer (CRC)? And how early should annual colonoscopies happen once those at risk are identified? These are important questions with equally important and complex answers.

Life-saving therapies that halt cancer can take a toll on the skeletal system, leaving survivors with bone loss or more serious injuries such as broken wrists, ribs, or hips. Watchful attention, screening, and therapy are needed to prevent these outcomes.

Did you think biology only involved studying people, animals, and plants? How about tumors, or maybe cells? Keep going. Smaller. A lot smaller.

A sunrise session on climate change, followed by Tuesday's poster session on allergen immunotherapy at the 2014 Annual Meeting of the American Academy of Allergy, Asthma & Immunology (AAAAI) in San Diego, California, highlighted the irony: Thanks in no small part to the cost of navigating the approval process of the US Food and Drug Administration (FDA), Europe has more options to treat seasonal allergies, even though America has far more ragweed.

The American Academy of Allergy, Asthma & Immunology (AAAAI) on Monday released its second list of overused tests and procedures that allergists, primary care physicians, and patients should question before they occur. The list represents the fruits of the Academy's second year of participation in the Choosing Wisely initiative, and was presented at a press conference during the Academy's meeting in San Diego, California.

Taking care of asthma patients costs the nation $56 billion a year, and included in that total are the costs of the many sufferers who do not properly follow their prescriptions.

Researchers seeking to reduce the dangers of peanut allergies have seen encouraging results in recent years from oral immunotherapy. But many questions remain: How large of a dose? For how long? And, once treatment ends, does its effectiveness last, or does it eventually wear off?

Two oral immunotherapy treatments for allergic rhinitis being developed by Merck and ALK-Abello, which received separate approvals in recent months from the Allergenic Products Advisory Panel (APAC) of the US Food and Drug Administration (FDA),1,2 are the subject of results presented Monday at the 2014 Annual Meeting of the American Academy of Allergy, Asthma & Immunology in San Diego, California.

Some of the same themes being raised across medicine-how to balance the quality of care with soaring therapy costs, and how to unleash the power of genomics to tailor treatment-were part of Saturday's workshop Hot Topics in Pediatric Allergy and Immunology. The session of the American Academy of Pediatrics took place during the 2014 Annual Meeting of the American Academy of Allergy, Asthma & Immunology in San Diego, California.

Asthma is among the diseases for which adherence presents challenges, both to physicians and to manufacturers of therapies. Two studies presented Saturday at the 2014 Annual Meeting of the American Academy of Allergy, Asthma & Immunology in San Diego, California, discuss an attempt by one manufacturer, Merck, to overcome the problem through the development of an adherence estimator called AE.

The introduction for Eric J. Topol, MD, who gave the keynote address Saturday at the 2014 Annual Meeting of the American Academy of Allergy, Asthma & Immunology (AAAAI) in San Diego, California, ended with the usual instruction: Please silence your cell phone.

Laura Beerman, director, customer segment analysis, Decision Resources Group, presented a discussion that highlighted the early results of accountable care organizations (ACOs). She said that while the Pioneer ACOs created a large initial buzz, their cost savings has varied widely.

In a panel discussion moderated by Neil Minkoff, MD, CEO of FountainHead HealthCare, panelists examined the current state of healthcare exchanges, both public and private. Panelists included Dennis Falci, MBA, director, US managed markets training, sales training and leadership development, Sanofi-Aventis SA; Thomas Kaye, director of consulting pharmacy, Prescription Formulary Exchange, LLC; and Sheri Sellmeyer, vice president, market analysis, HealthLeaders-InterStudy, a Decision Resources Group Company. They analyzed the current benefit models required by public exchanges, and the rising popularity of the private counterparts, offering a glimpse into the new healthcare marketplace now unfolding.

Health information technology (HIT) was the focus of a discussion led by Farzad Mostashari, MD, visiting fellow, Brookings Institution, former national coordinator for HIT, US Department of Health and Human Services. In his Managed Markets Summit 2014 keynote address, Health IT and Reform: The Road to Right Care, Dr Mostashari touched upon the obstacles and shortcomings in our nation's healthcare landscape, and asserted that more prominent usage of HIT would help to alleviate fiscal concerns and affect better outcomes in patient care.

Raulo S. Frear, PharmD, general manager, OmedaRx, says pharmacy benefit managers are aligning benefit designs for delivery system reform in a few ways. With respect to the delivery system reform, if you look at ACOs as a specific example, our experience has been that the ACOs are not really ready to talk about different benefit designs, Dr Frear says. They're still learning what it means to accept risk and that means risk across a lot more areas than just pharmaceuticals.

Ed Pezalla, MD, MPH, national medical director for pharmacy policy and strategy, office of the CMO, Aetna, says payers and health plans are preparing for patient-centered care by utilizing digital tools. Everything from virtual people to cost search tools are used to assist employed and general patient populations. Dr Pezalla says many of these tools will also be used in the public and private health insurance exchanges to help people make decisions as they purchase health plans.

Neil Minkoff, MD, CEO, FountainHead HealthCare, discusses the impact that formulary has on both employer and consumer choice in the health insurance exchanges.

Dennis Falci, MBA, director, US managed markets training, sales training and leadership development, Sanofi-Aventis SA, says it's no secret-Health Insurance Exchanges are a hot topic in health news.

Laurie Wesolowicz, PharmD, director, pharmacy services clinical, Blue Cross Blue Shield of Michigan (BCBSM), says that clinical evidence and other factors can drive formulary decision-making. Evidence can influence the value and coverage recommendations for drugs covered under the pharmacy (formulary) and medical benefits.

Farzad Mostashari, MD, visiting fellow, Brookings Institution, former national coordinator for health information technology (HIT), US Department of Health and Human Services, says we need to have payment reform to support the success of HIT.

Pat Gleason, PharmD, FCCP, BCPS, director of health outcomes, Prime Therapeutics, and Shelley Sanchez, senior director of specialty product development, Prime Therapeutics, presented on 1 approach to managing the specialty drug benefit, which includes optimizing the use of PhARMA manufacturer coupons and patient assistance programs (PAPs).

Presenters in this talk focused on how the creation of health insurance exchanges (HIEs) and other federal and state regulations will impact the provision and administration of pharmacy benefits.

With nearly half of specialty spending occurring on the medical benefit in 2012, and seeing that specialty spending is predicted to account for 50% of total pharmacy spending by 2019, Mike Waterbury, president, ICORE Healthcare, specialty division of Magellan Pharmacy Solutions, reports that specialty drug costs will surpass traditional spending in the next few years.

According to Howard K. Crowley, head of pharmacy strategic initiatives, Aetna Pharmacy Management, a Towers Watson/ National Business Group on Health survey found that 29% of employers rank the rising costs of specialty drugs as a top challenge to keeping health benefit coverage affordable.

James Gartner of CareSource and Jessica Frank of OutcomesMTM shared the first-year results of a cooperative comprehensive medication therapy management (MTM) program that they implemented for nearly 1 million Ohio Medicaid members.

In medication use and improving patient outcomes, Susan Cooper, MPH, RPh, senior director, pharmacy services, HealthPartners, says her organization envisions prescription drug optimization going beyond addressing adherence. It seeks to improve the patient experience.

In a presentation entitled The PBM Has No Clothes: A (Public Sector) Proposal Is More Transparent Than You Think, Steffanie Mathewson, Esq, principal, Mathewson Research, described how the Freedom of Information Act (FOIA) and state sunshine laws make it easier for stakeholders to view and understand the strategic direction of major PBMs.

When it comes to managing chronic conditions and rare disease, the cost of treatment can be astronomical.

According to John Miller, executive director, MidAtlantic Business Group on Health, The National Business Coalition on Health (NBCH) is an organization that seeks to drive conversations about prescription drug benefit management (PBM) to value.

To build on the success and ideas generated at last year's inaugural event, Joslin Diabetes Center once again brought together numerous key stakeholders in the collective battle to conquer diabetes and to provoke thought, innovation, and action. Highlights from Diabetes Innovation, which took place on October 3-5, 2013, in Washington, DC, are available in a special report published by The American Journal of Managed Care.