Health Care Cost

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).

By better understanding the nature of atopic dermatitis and its varying comorbidities, providers might be able to better predict patient outcomes, said Raj Chovatiya, MD, PhD, assistant professor of dermatology, Northwestern University Feinberg School of Medicine.

The Biden administration and drug manufacturers are looking at different ways to keep free access to COVID-19 vaccines; mifepristone remains available without new restrictions while a court battle continues; the goal to reduce HIV in the US by 2030 may fall short, some warn.

While employers fall on a spectrum when it comes to knowledge and understanding of biosimilars, there does remain a need to educate them, as well as for them to educate their employees, said Margaret Rehayem, vice president, National Alliance of Healthcare Purchaser Coalitions.

For all the success the hematology/oncology space has seen over the past 20-plus years, difficult discussions now focus on paying for that care, explained David A. Eagle, MD, New York Cancer & Blood Specialists.

President Joe Biden signs order to boost care worker compensation and support caregivers; social media adds are fueling weight loss medication demands; an investigational metabolic modulator has been shown to mitigate fatigue in patients with long COVID.

The Employer Playbook on Biosimilars highlights strategies employers can use to navigate challenges around ensuring employee access to biosimilars at the pharmacy, as well as how to respond to pharmacy benefit managers who aren’t making biosimilars available on the formulary, said Margaret Rehayem, vice president, National Alliance of Healthcare Purchaser Coalitions.

Autism is being diagnosed more often in girls; cancer medication shortages mean some patients may die before receiving treatment; new CMS policies aim to reach underserved populations.

Many gene therapies promise life-changing effects, but without long-term data it remains to be seen how long the benefits last.

A new report from AHIP indicates that biosimilars have the potential to garner savings of $180 billion over 5 years, but there needs to be a review of the approval process for interchangeability to encourage more approvals.

A federal ruling could undermine the framework of FDA drug approvals; Florida’s warning on COVID-19 vaccines omits key data; uninsured patients with cancer struggle to find care.

Sashi Naidu, MD, is director of research at Carolina Blood and Cancer Care Associates, where the No One Left Alone (NOLA) initiative is working to break down cancer health disparities among its patients and prevent care fragmentation.

With the global market for biologics estimated at $382 billion just last year, and a projected global drug spend of close to $1.5 trillion by 2027, the landscape is ripe for biosimilars to help decrease the health care system’s cost burden.

CMS finalizes plans to decrease overpayments to Medicare Advantage insurers; an experimental respiratory syncytial virus (RSV) vaccine is highly effective in infants when given to pregnant women; obesity may be influenced by different brain factors between men and women.

The National Cancer Plan is being implemented as part of the Cancer Moonshot aims; inflation and higher spending are driving up monthly plan premiums under the Affordable Care Act; millions of people may lose Medicaid coverage after pandemic protections end.

Under preferred pharmacy networks, unsubsidized Part D beneficiaries faced substantial incentives and moderately switched toward preferred pharmacies, whereas subsidized beneficiaries were insulated and demonstrated little switching.

Rates for reimbursement cuts will be lower than expected within Medicare Advantage plans; financial safety nets, in the form of Social Security and Medicare, are likely to be unable pay full benefits; CDC teams experience symptoms similar to East Palestine, Ohio, residents following train derailment

The Protocol AC study analyzed visual acuity gains and cost if patients with diabetic macular edema started on bevacizumab, which costs less, and switched to aflibercept later, explained Jennifer K. Sun, MD, MPH, associate professor of ophthalmology and chief of the Center for Clinical Eye Research and Trials, Harvard Medical School; and chair, DRCR Retina Network.

The province of Newfoundland and Labrador and the territory of Yukon both announced biosimilar switching policies, bringing Canada to a total of 10 out of 13 jurisdictions have a policy in place.

For employers, keeping members engaged with their health care is one of the key factors that leads to better outcomes, said Jeremy Wigginton, MD, vice president of health quality and innovation at Blue Cross and Blue Shield of Louisiana.

Panelists at the Value-Based Insurance Design Summit discussed research and reforms to address the high cost of medications and the impact it has on equitable access to treatment.

Implementing a strategy that focuses on dose rounding for chemotherapies can have a 3-fold impact of decreasing drug costs, minimizing drug waste, and improving treatment efficiency. This strategy and its benefits were explored in a session on day 2 of AMCP 2023.

Some challenges linking medication adherence to medical cost offsets include the potential of reverse causality, omitted variable bias, how adherence is measured between studies, and the outdated nature of some of the most-cited literature, said Ben Urick, PharmD, PhD, principal health outcomes researcher at Prime Therapeutics.