Health Care Delivery

About 40% of new specialty drugs in 2017 are expected to be for orphan drug indications, which is keeping with the trend; however, an upcoming investigation into potential abuses of the Orphan Drug Act could have an unknown impact on development and prices, said Aimee Tharaldson, PharmD, senior clinical consultant for emerging therapeutics at Express Scripts.

With the high cost of new drugs to cure hepatitis C, ensuring that real-world outcomes are consistent with those seen in clinical trials is important, explained Gail Bridges, PharmD, of Accredo Health. She explained that Accredo ensured patients adhered to hepatitis C drugs in order to get the best outcomes through a disease- and drug-specific education program.

In a wide-ranging discussion, panelists at the 12th annual meeting of the Pharmacy Quality Alliance discuss the role of pharmacy benefit managers, the prospects of changes to Medicaid, and how the cloud of uncertainty affects planning decisions.

The former House healthcare expert said that changes are sure to come to the AHCA when the Senate takes up the bill, especially in the Medicaid provisions.

The provision in the Affordable Care Act to remove cost sharing for preventive care visits created a shift in how Medicare pays with a greater emphasis on prevention and managing chronic diseases, and less on treatment of acute illness, said Mariétou Ouayogodé, PhD, post-doctoral fellow at The Dartmouth Institute for Health Policy and Clinical Practice at the Geisel School of Medicine at Dartmouth.

Medical financial burden has been highest for families in the nongroup market. After the implementation of the Affordable Care Act, the share of families experiencing financial burden declined 6.7 percentage points, Health Affairs study finds.

Every week, The American Journal of Managed Care® recaps the top managed care news of the week, and you can now listen to it on our podcast, Managed Care Cast.

This week, the top managed care stories included the Senate began working on its own Obamacare replacement bill; Scott Gottlieb, MD, was confirmed as FDA commissioner; and coverage from Digestive Disease Week.

According to Daniel J. Klein, president and CEO of the Patient Access Network Foundation, patients now have an easier time accessing the high-cost treatments they need, thanks to certain policies and programs. Klein also anticipates that a recently-passed law will bring down the prices of some prescription drugs.

A new report from the Urban Institute seeks to characterize the rating regions across the United States by the number of insurers offering plans in the healthcare marketplaces and found stark disparities in demographics, coverage, and price.