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A review of thousands of FDA inspection records, recalls, warning letters, and lawsuits showed how drugs that are poorly manufactured or contaminated can reach patients; biosimilars have the potential to deliver substantial savings to the healthcare system, but only insofar as they are adopted and used in clinical practice; Maine’s new Democratic Governor, Janet Mills, ordered the state to implement Medicaid expansion with an executive order, calling for state health officials to make the necessary changes and work with the Trump administration.

January 4 marks the anniversary of the Orphan Drug Act, which was enacted in 1983. Since the law was passed, it has successfully encouraged more orphan drug development, but some now say drug makers are manipulating the system and the incentives need to be revisited.

The federal judge who ruled last month that the Affordable Care Act (ACA) was invalid issued an order over the weekend that the law will remain in effect pending appeal; pharmacies and businesses with pharmacies in New York City will no longer be allowed to sell cigarettes and other tobacco products; a federal judge has blocked the administration's cut to the 340B program.

This year, The American Journal of Managed Care® asked readers for the first time who they thought was the most influential person in healthcare. We provided some options in the poll, but we also gave readers the opportunity to write in answers, which resulted in answers like Steve Jobs of Apple, who passed away in 2011.

The Sickle Cell Disease and Other Heritable Blood Disorders Research, Surveillance, Prevention, and Treatment Act of 2018, which reauthorizes a sickle cell disease prevention and treatment program and provides grants for research, surveillance, prevention, and treatment of heritable blood disorders, has passed Congress and been signed into law.

As the US healthcare system continues to go through major shifts in policy and care delivery, 2018 saw several trends that remained prevalent throughout the year and will likely have significant implications for 2019.

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