The Insider's Guide to Health & Drug Benefits® - March 2024

A comprehensive analysis by the Patient Access Network (PAN) Foundation explores the state of patient access for adults living with chronic conditions in the US.

For more than a decade, certain high-value preventive care services have been covered at no cost to patients under the Affordable Care Act, but a current legal challenge has the coverage at risk.

Since 2016, 5 targeted treatments have received accelerated approval from the FDA for use in Duchenne muscular dystrophy (DMD), and the total spend for just 3 of them is $3.1 billion.

After years of efforts to reduce low-value care, panelists at the 2024 Value-Based Insurance Design Summit proposed a new strategy: drawing a line in the sand that payers will not be on the hook for these services.

During a session of the 2024 V-BID Summit, panelists Stacie Dusetzina, PhD, and Inma Hernandez, PharmD, PhD, discussed how access to essential medications is curtailed not just by the longstanding complexities of insurance design but also by emerging threats such as supply chain weaknesses and cyberattacks.

The Affordable Care Act (ACA) Medicaid expansions increased health care coverage for American Indian/Alaska Native (AI/AN) women of childbearing age but had limited effects on prenatal care, birth outcomes, and health care supply.

When compared with patients on traditional Medicare, patients on Medicare Advantage had less intensive home health care, even if they had similar needs.