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Chronic pain affects many patients worldwide and often leads to opioid prescribing, thereby increasing the risk of opioid misuse. A position statement by the Association of Academic Physicians, published by the American Journal of Physical Medicine & Rehabilitation, reflects experts’ call for a new, comprehensive national strategy to include a functional approach to the diagnosis and treatment of pain.

Patients with a rare neuromuscular disease called Lambert-Eaton myasthenic syndrome are now terrified the cost for their treatment could soar to $100,000 without insurance because of a quirk in pharmaceutical approvals and pricing; Bloomberg Philanthropies will donate $50 million to 10 states fighting the opioid epidemic; Republican lawmakers in the GOP Doctors Caucus expressed their concerns about President Trump's controversial proposal to lower drug prices in a meeting this week with HHS Secretary Alex Azar.

This week, the top managed care news included a CMS plan for changes in drug coverage that brought a wave of criticism; a government task force recommended more people at risk for HIV take pre-exposure prophylaxis, known as PrEP; the American College of Cardiology issued an Expert Consensus Pathway on treatment of patients with type 2 diabetes and atherosclerotic cardiovascular disease.

With health policy increasingly transferring to the state level, what’s the most effective way for states to cover the majority of their population through affordable health insurance leveraging public funds? On a day when the Trump administration unveiled 4 ways states can request Section 1332 waivers, some of which are aimed at avoiding key parts of the Affordable Care Act (ACA), an advocacy organization released its own proposal to cover more of the uninsured and lower health insurance costs.

This week, the FDA approved larotrectinib, to be sold as Vitrakvi, for the treatment of adult and pediatric patients with solid tumors that have a neurotrophic receptor tyrosine kinase (NTRK) gene infusion without a known acquired resistance mutation, are metastatic or where surgical resection is likely to result in severe morbidity, and have no satisfactory alternative treatments or that have progressed following treatment.

CMS Administrator Seema Verma announced consumers buying health insurance through the exchanges set up by the Affordable Care Act (ACA) would be allowed to have heath savings accounts, and the agency will allow states to set their own subsidies and decide what type of health plan is eligible for subsidies. In addition, waivers would be evaluated against the Hyde amendment.

For the first time in a decade, the number of children without health insurance rose; CVS Health has officially acquired Aetna after New York and New Jersey provided the last 2 state approvals necessary for the merger to occur; although the Federal Bureau of Prisons has imposed a policy to provide better care and oversight for inmates with mental health issues, a new report has found that treatment has not been expanded.

Chronic obstructive pulmonary disease (COPD) is the fourth leading cause of death in the United States, and for COPD Awareness Month this November, The American Journal of Managed Care® conducted a Q&A with Jamie Sullivan, MPH, vice president of public policy and outcomes for The COPD Foundation, as well as Chief Medical Officer Byron M. Thomashow, MD. The COPD Foundation is a not-for-profit organization that works to improve the lives of patients with COPD.

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