Clinical

What we're reading, November 30, 2015: the Spanish language HealthCare.gov is lagging in sign-ups; the overall federal insurance exchange has fewer preferred provider organizations; and many Americans don't understand why they need the flu vaccine.

Initial adoption of clinical pathways grew from payers mandating their use with individual providers, but there is now greater interest from accountable care organizations and others to use pathways to reduce variation and cost while improving outcomes, explained Robert Dubois, MD, PhD, chief science officer and executive vice president of the National Pharmaceutical Council.

A new study finds that the use of proton pump inhibitors, used for many patients admitted to the hospital, may actually cause more harm to hospitalized patients than good.

This week in managed care, CMS proposed changes to the health insurance marketplaces for 2017, AJMC highlights 5 takeaways from the HHS Pharmaceutical Forum, CVS chose to cover just 1 PCSK9, and industry reacts to FDA regulating diagnostic tests.

The Nationwide Inpatient Sample has been critically underreporting certain health information for its database, according to a recent study by Johns Hopkins researchers.

Diabetes is a growing epidemic in the United States and new research has indicated that half of healthy 45-year-olds will develop pre-diabetes and one-third will develop diabetes at some point.

The American College of Physicians has published a paper in the Annals of Internal Medicine that advices clinicians to prescribe generic drugs whenever possible.

Here are the top 5 papers published by The American Journal of Managed Care and its sister publications about hepatitis C, treatment, and costs of care.

The Patient-Centered Outcomes Research Institute (PCORI) will approach biosimilar research the way it does research on anything else, but there is the added element of finding the right timing, said Joe V. Selby, MD, MPH, executive director of PCORI.

This Thanksgiving, as families gather around the table, health and wellness should be a topic of discussion.

Glen D. Stettin, MD, senior vice president of clinical, research, and new solutions at Express Scripts, discusses what strategies for managing high-cost treatments aren't working and how they could be improved.

What we're reading, November 25, 2015: hospitals can save money in the long run by preventing hospital-acquired infections with private rooms; Arizona's co-op plans to close December 31; and study finds testing prison inmates for hepatitis C is extremely cost-effective.

What we're reading, November 26, 2015: CMS blog on step-wise transition to value-based care, payer-drug industry alliance on drug pricing, and a new model to override the proposed ACA tax credits.

Patients considering using a genetic test should meet with a genetic counselor first to get a better understanding of the patient's goal for getting the test done and determine the likelihood that a test might be useful, explained Joy Larsen Haidle, MS, CGC, president of the National Society of Genetic Counselors.

What we're reading, November 24, 2015: expensive hepatitis C drugs are more cost effective when used earlier; clinicians aren't prescribing generics enough; and half of health 45-year-olds will develop prediabetes.

The approval follows 5 months after Bristol-Myers Squibb submitted phase 3 results of the Checkmate-066 trial for FDA review.

Two months after being granted a Breakthrough Therapy designation by the FDA for metastatic renal cell carcinoma (mRCC), nivolumab was today approved by regulators for treating mRCC patients who have failed a certain type of prior therapy.

A state-led program, initiated in 2003, has nearly doubled screening colonoscopy rates in New York City and also eliminated racial and ethnic disparities in the process.

What we're reading, November 23, 2015: Oregon and California both pass laws that authorize pharmacists to prescribe birth control; the US and Europe are approving more drugs; and Turing discounts Daraprim just 50% and only for hospitals.

A recent study published by JAMA Surgery intended to pinpoint risk factors for hospital readmission in patients who underwent an emergency general surgery procedure, in hopes of finding out what decreases readmissions in the long run.

A pharmacist who engages in formulary decisions, a medical director for population management for a private health exchange, and an innovations leader at a pharmacy benefit manager, took to the podium at the Patient-Centered Oncology Care meeting on November 20, 2015, to discuss cost-saving strategies in oncology and whether benefit managers can play a role in reining-in some of these costs.

While the FDA could regulate diagnostic tests the way they are in Europe-through simple verification that the test is accurate-the FDA has not chosen to do that and comes closer to requiring clinical utility, explained Bruce Quinn, MD, PhD, senior director at FaegreBD Consulting.

At the Patient-Centered Oncology Care 2015 meeting, held November 19-20, 2015, in Baltimore, Maryland, keynote speaker Julie M. Vose, MD, MBA, FASCO, president of the American Society of Clinical Oncology provided perspectives on the challenges faced by oncologists as the healthcare system transitions to define and incorporate value in the care delivered.

Eligibility for prescription coverage and family income significantly influenced women's decisions to continue hormonal therapy and prevent recurrence of breast cancer, the authors found.

A majority of life sciences companies are planning on acquisitions and are targeting companies with a personalized medicine focus.