Payers

According to Eli Lilly's statement, the investigational drug worked quickly, so too few patients in the phase 2 study took it for a full year.

Ken Cohen, MD, director of translational research for Optum Care, talks about the value of prior authorizations in different contexts, and how simplicity can benefit the process in some situations.

Initiatives to address social determinants of health are likely to positively change the health care landscape, and better patient education can contribute to more favorable care choices says Ken Cohen, MD, director of translational research for Optum Care.

Creating new incentive models and transparently sharing data in a way that changes behaviors are 2 ways to reduce low-value care in the health care system, explains Ken Cohen, MD, director of translational research for Optum Care.

Patients with epilepsy on Medicaid insurance of Black, Latino, and Native Hawaiian and Other Pacific Island ethnicity were associated with lower odds of being on newer, second- and third-generation, antiseizure medications compared with White individuals.

Black Americans with multiple myeloma face disparities in incidence of disease, survival outcomes, and use of evidence-based treatment, which may be exacerbated by socioeconomic factors.

The FDA’s approval of lecanemab for Alzheimer disease is very important, but there will remain significant challenges around pricing and access that will need to be addressed to deliver on the promise the therapy actually represents, said Alvaro Pascual-Leone, MD, PhD, of Harvard Medical School.

The lecanemab decision follows the controversial 2021 approval of aducanumab, which led to tight coverage restrictions for monoclonal antibodies directed against amyloid for the treatment of Alzheimer disease.

In the last 2 years, half of women reported needing mental health services compared with only 35% of men. Women who needed mental health care cited provider availability and cost, especially for those who are uninsured, to be 2 major barriers to receiving care.

Michael Thompson, president and CEO of the National Alliance of Healthcare Purchaser Coalitions (National Alliance), addressed the current state of health equity strategies in the workplace and how employers can better address inequities in their benefit designs, programs, and policies in the near future.

The addition of adalimumab biosimilars to formularies can help accelerate realized savings as the blockbuster drug Humira faces competition from multiple biosimilars, including 1 approved interchangeable biosimilar.

The top 5 pieces of content published on AJMC.com relating to reimbursement issues included 2 on the significance of a California law giving Medicare beneficiaries access to expert oncology care; other articles looked at the work involved in value-based care models and CMS news.

The top content published in The American Journal of Accountable Care® (AJAC) covered redesigning health care, value-based care, and novel payment models, like the ACO REACH model.

In 2022, the most-read articles published in Evidence-Based Oncology™ included the latest updates in cancer treatments, the promises and challenges of technology, and a look at the shifting landscape of care delivery.

Biosimilars are a wonderful option for patients, but the growing number available can be challenging to manage when different payers prefer different agents, said Susan Sabo-Wagner, MSN, RN, OCN, executive director of clinical strategy for Oncology Consultants of Houston, Texas.

Among the conference highlights from the annual meeting of the Academy of Managed Care Pharmacy (AMCP) were an interview on chimeric antigen receptor T-cell therapies and a session on best practices for value-based contracting.

Impending cuts to Medicare physician services could have an overwhelmingly negative impact on millions of older patients and individuals with disabilities across the country.

The novel coalition was announced at the Institute for Healthcare Improvement (IHI) Forum, which took place December 4-7 in Orlando, Florida.

The 64th American Society of Hematology (ASH) Meeting & Exposition will run Saturday through Tuesday in New Orleans, Louisiana, at the Ernest N. Morial Convention Center.

A session at the 2022 American Society of Health-System Pharmacists Midyear Clinical Meeting & Exhibition reviewed some trends in the 340B drug pricing programs and Medicaid.

Patient-reported outcome (PRO) measures were included in approximately one-half of acne vulgaris and rosacea randomized controlled trials, despite their utility in capturing the patient perspective.

The groups who told researchers they would be more likely to skip additional testing had lower levels of income or education and were more likely to be on Medicaid or be uninsured, among other factors.

Key social determinants affecting MDD are evaluated by Michael Rothrock, MBA, MHA, and H. Eric Cannon, PharmD, FAMCP.

Expert panelists explore prevalence and disparities of MDD across patient populations.