Health Care Cost

Debt limit deal will not effect Medicaid; a national safety board may make health care safer; experimental hemophilia therapy reduces bleeding.

On this episode of Managed Care Cast, we speak with the lead researcher from a study published in the May 2023 issue of The American Journal of Managed Care® about the impact of low-income subsidies on the uptake and equitable use of expensive orally administered antimyeloma therapy.

AHIP president and CEO Matthew Eyles will step down later this year; the House Energy and Commerce Committee moved a series of health care measures concerning pharmacy benefit managers (PBMs); US debt default could stop FDA drug and device reviews, said FDA chief.

The FDA approved Celltrion Healthcare’s Yuflyma (adalimumab-aaty), which is a high-concentration, citrate-free formulation.

Although lack of routine testing and limitations to current diagnostic testing likely lead to underreporting of respiratory syncytial virus, RSV still poses a substantial economic burden.

Blue Cross Blue Shield in Massachusetts sets agreement with Tufts Medicine using equity benchmarks; drug prices covered by Medicaid to undergo yearly audit; South Carolina abortion ban headed to governor as Planned Parenthood announces national staff cutbacks to shift resources to the states.

On this episode of Managed Care Cast, we feature several leaders in diversity, equity, and inclusion advancing health equity in their respective organization’s policy and practice initiatives.

The World Health Organization (WHO) prepares for the next pandemic; new restrictions on reproductive health services in the South; Thermo Fisher Scientific receives FDA approval for a first-of-its-kind preeclampsia test.

Researchers took both the learning curve of the new process and the COVID-19 pandemic into consideration.

Compared with first-line immunotherapy or chemotherapy alone, combination chemoimmunotherapy for advanced/metastatic non–small cell lung cancer has significantly higher antineoplastic drug and associated medical costs.

WHO urges caution regarding artificial intelligence (AI) bias; South Carolina ban would restrict abortion at 6 weeks; appeals court pauses ruling barring free preventative health services.

Medicare Part D low-income subsidies alone are insufficient to improve the uptake and equitable use of high-cost, orally administered antimyeloma therapy.

Aflibercept was a less cost-effective treatment for retinal vein occlusion (RVO) compared with bevacizumab, although visual acuity outcomes were similar.

The researchers of a new study highlighted the unique financial burden facing these patients, eligible for hematopoietic stem cell transplantation (HSCT), who often require lengthy hospitalizations and have associated risks of acute and chronic morbidity.

Although commercial accountable care organization populations are healthy on average, some individuals might benefit from programs for high-risk patients to mitigate high levels of health care utilization.

Knowledge is limited on the potential exclusion from pay-for-performance (P4P) programs of patients living with diabetes who have with individual or neighborhood social risks.

The possible consequences for health care if the United States breaches the debt ceiling; skepticism follows proposal for over-the-counter birth control pill; North Carolina governor calls potential abortion ban harmful.

Jeffrey E. Lancet, MD, chair of the Department of Malignant Hematology at Moffitt Cancer Center, discussed the issue of cost and optimizing patient outcomes acute myeloid leukemia (AML).

Long-term tele-messaging was more effective than no messaging and short-term messaging for positive airway pressure use, and it was highly likely to be cost-effective with an acceptable willingness-to-pay threshold.

Naveen Mansukhani, director of operations and account management of Retail Pharmacy Services at Cardinal Health, talks about how the responsibility for saving costs does not just fall on one department or person, but is collaborative and requires strategy.

Oncology has been an easy area for employers to adopt biosimilars because of the rising costs in the space, said Margaret Rehayem, vice president, National Alliance of Healthcare Purchaser Coalitions. Now that multiple adalimumab (Humira) biosimilars are hitting the US market, employers should take a step back to review their current strategy around the drug.

This study examines the availability of cost-effectiveness analyses for medical devices, both in terms of the number of studies and when studies are published.

Financial toxicity is defined as financial hardship related to cancer and can have major effects on patients’ quality of life

Todd A. Zigrang, MBA, MHA, FACHE, CVA, ASA, ABV, president of Health Capital Consultants, discusses accountable care organizations (ACOs) and the move toward value-based care models.

Rebates remain very attractive for many employers, but they should push back on the reliance on rebates that may be preventing biosimilars from being added to formularies, said Margaret Rehayem, vice president, National Alliance of Healthcare Purchaser Coalitions.

Some of the health care transformations that were forced by the COVID-19 pandemic could continue to benefit patients and the health care system, Jacques Sokolov, MD, said during his keynote address at the National Association of Managed Care Physicians (NAMCP) Spring Managed Care Forum 2023.

Researchers set out to collect empirical evidence on how a capitated risk-based county plan performs as a viable public option in the Affordable Care Act (ACA) marketplace in California

FDA accelerates approval of drug for amyotrophic lateral sclerosis (ALS); hundreds of thousands could lose Medicaid coverage under Republican debt bill including work requirements; the Department of Veterans Affairs (VA) reports that half a million veterans have filed claims for health benefits related to toxic exposures.

The projected cost reductions held both for patients switching from a different extended-half-life product and for patients switching from a standard-half-life product.

Ten-year mean costs associated with psoriasis-related health care visits were 10 times higher for patients with generalized pustular psoriasis (GPP).