Health Care Cost

A vaccine is showing promising results in treating melanoma; the Biden administration will implement inflation penalties on dozens of drugmakers to reduce out-of-pocket costs for Medicare recipients; the CDC issued an alert urging health care providers to increase immunization coverage for influenza, COVID-19, and respiratory syncytial virus (RSV).

A new report from AHIP shows that Medicare Advantage outperformed traditional Medicare on several clinical quality measures, including preventive screenings. However, debate continues over these plans’ cost efficiency and impact on the financial sustainability of rural hospitals.

The commercial market got slightly less competitive while the Medicare Advantage market got a little more competitive, but both markets remain highly concentrated.

This year’s top content from the fall meeting of the Association of Community Cancer Centers (ACCC) highlights both treatment gains made through innovative referral, screening, and assistance initiatives and the ongoing need to improve health equity and research inclusivity.

Authors highlight key aspects of the California Cancer Care Equity Act, including its focus on Medi-Cal beneficiaries, the requirement for managed care plans to contract with specialized cancer centers, and the definition of complex cancers.

Treatment with blinatumomab or inotuzumab ozogamicin particularly confers higher total costs for patients with relapsed/refractory B-cell acute lymphoblastic leukemia.

The Biden administration recently met with manufacturers of respiratory syncytial virus (RSV) immunizations to encourage them to increase access to the vaccine; since the Dobbs v Jackson decision, many patients have been seeking more permanent reproductive health care solutions; a Mathematica analysis showed that Medicare prescription drug price negotiations could have cut seniors’ out-of-pocket costs by nearly a quarter had the program been in effect in 2021.

Data analysis showed that 40% of patients who filled a prescription for Wegovy in 2021 or 2022 were still taking it a year later; both Democrats and reproductive rights organizations are pressuring the Biden administration to ensure health insurers fully cover contraception; CMS implemented Medicare changes in March that limited access to blood tests that help transplant recipients ensure their organs remain healthy.

The company is changing the way it prices prescription drugs and providing more transparency, which has been one focus of pharmacy benefit manager regulation efforts.

Low vaccination rates raise fears of COVID-19 resurgence; a survey highlights racial discrimination in health care; Eli Lilly’s tirzepatide (Zepbound) has entered US pharmacies.

This article estimates the comprehensive value of direct-acting antivirals for the treatment of hepatitis C virus using a generalized cost-effectiveness analysis.

The initiative emphasizes equal partnerships between research institutions and community organizations.

Families struggle to find affordable, reliable home health aides; reports of increased pediatric pneumonia cases; legal battle ensues over Purdue Pharma’s bankruptcy settlement.

The Center on Health Equity and Access highlights the most recent updates in the realm of health equity, including news, research findings, and initiatives focused on mitigating health care disparities and enhancing overall access to quality care.

A mandatory nationwide transition from reference adalimumab to a biosimilar was implemented in New Zealand.

A new analysis evaluated the economic implications of alopecia on women and their families, with significant out-of-pocket expenses attributed to treatments and measures to conceal the condition.

At present, it is difficult for clinicians to identify patients at greatest risk for developing preeclampsia with severe features and tailor treatment plans for them; this difficulty increases costs significantly.

After recent policy changes removing most medical debts from credit reports, Americans are seeing their credit scores increase, but experts warn of the need to monitor billing and collection practices for unintended consequences.

Safety-net programs need to not only be budgeted for but also aimed at the right people to ensure receipt of proper health care.

Jeffrey Sippel, MD, MPH, addresses the increasing denial of insurance claims for non-invasive ventilators (NIV) in Medicare Advantage plans, particularly impacting ALS patients, emphasizing the time crunch on patients, and criticizing the financial focus over patients' well-being.

Allegations call out restrictions on medically necessary care; CDC data highlight surge in COVID-19 deaths and hospitalizations; failure to include additional Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) aid raises concerns over food access.

Additional COVID-19 tests can be ordered amid rising cases and insurance challenges; therapies targeting toxic proteins in Alzheimer disease spark renewed interest; new poll indicates 55% approval for legal abortion on any grounds.

The recent availability of 3 FDA-approved treatments for patients with spinal muscular atrophy (SMA) has dramatically altered patient outcomes and provided a wealth of new avenues for SMA research.

A simulation study estimated the impact of biosimilar substitution on total cost of care (TCOC) and provider financial performance in the final performance period of the Oncology Care Model.

Jeffrey Sippel, MD, MPH, discusses the trend of insurance claim denials related to non-invasive ventilators for patients with ALS.

Christian John Lillis, cofounder and executive director of the Peggy Lillis Foundation for C difficile Education & Advocacy, explained how FDA-approved microbiome-based therapeutics help to treat and prevent C difficile infection.

A Biologics License Application has been submitted to the FDA review for sotatercept in the treatment of pulmonary arterial hypertension.

The FDA approved delandistrogene moxeparvovec-rokl (Elevidys, Sarepta Therapeutics) in June to treat Duchenne muscular dystrophy in ambulatory pediatric patients aged 4 through 5 who have a confirmed DMD gene mutation.

Sophia Humphreys, PharmD, MHA, BCBBS, discussed how biosimilars can play a role in formulary management as well as the main takeaways of her presentations at the Newport Beach Institute for Value-Based Care conference.

A class action lawsuit was filed against UnitedHealth Group and a subsidiary for allegedly using an algorithm to deny rehabilitation coverage for seriously ill patients; US and China officials are finalizing an agreement to crack down on fentanyl; a study published Tuesday projected global heat deaths to increase by 370% if no action is taken against global warming.