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What We're Reading: Anthem Will Not Cover First Drug Approved for Duchenne

AJMC Staff
What we're reading, October 10, 2016: Anthem will not cover Exondys 51, the first drug approved for treatment of Duchenne muscular dystrophy; big soda has sponsored 96 health and medical groups; and new Illinois program seeks to fill care gaps for working poor.
Citing concerns over the clinical trial data used to approve Sarepta’s treatment for Duchenne muscular dystrophy, Anthem has announced it will not cover Exondys 51. According to STAT, the health insurer concluded that the drug has not demonstrated clinical benefit. The approval of Exondys 51 was controversial because it came after medical staffers in the FDA questioned the effectiveness of the drug. However, the FDA chose to acknowledge the unmet need of patients with this rare disease, and approved the drug.

Coca-Cola Co and PepsiCo have provided sponsorships for nearly 100 health and medical groups combined. A study found that between 2011 and 2015, the 2 soda companies provided 96 sponsorships for groups including the American Heart Association, the American Diabetes Association, and the CDC, reported The Washington Post. During those 4 years, the 2 companies lobbied against 29 proposed bills or regulations that aimed to reduce soda consumption.

In Illinois, a new program aims to fill care gaps for the working poor. Uninsured residents who earn up to 200% of the Federal Poverty Level are eligible for the new coordinated health program, which will provide an assigned medical home, as well as a primary care physician, according to the Cook County Record. The program will be centered on the primary care medical home model and members will have to reapply every year.

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