Policy

The planned separation would keep Aetna, CVS Caremark, and Oak Street Health together and move roughly 9000 drugstores into a new CVS Pharmacy.

Medicare Advantage exits, rising ACA premiums, a Medicare for America bill, and a Medicaid work rule ruling frame health policy on Election Day.

As National Family Caregivers Month begins, AJMC presents coverage from PCOC's first-ever panel on caregiving, where participants discuss demands on family members who are the “eyes and ears” when patients receive CAR T, bispecific, or transplant treatments.

PBM reform, Medicare Advantage exits, and the 340B rebate pilot are reshaping drug access. Here is what payers need to know heading into 2027.

HHS enforcement discretion lets state pharmacies compound BPC-157 and other peptides amid rulemaking and legal challenges.

HHS does not intend to take enforcement action against pharmacies compounding BPC-157 and 5 other unapproved peptides if they meet 10 conditions.

Early modeling put sickle cell gene therapy coverage near 11 cents per member per month.

At an AJMC® Stakeholder Interchange in Los Angeles, leukemia specialists described a region where hospital formularies push menin inhibitor starts into the clinic, emergency department (ED) physicians may not recognize differentiation syndrome, and capitated insurance contracts steer some patients with acute myeloid leukemia away from academic centers.

Cost and access, not side effects, drive GLP-1 discontinuation, and obesity should be covered like diabetes, says Fatima Cody Stanford, MD.

At AMCP Nexus 2026, payers said evidence, differentiation, and delivery now matter as much as FDA approval.

Experts at AMCP Nexus say biosimilar launches should prompt payers to revisit step therapy and measure value beyond market share.

Single-discipline autism guidelines that fail Institute of Medicine standards risk omitting critical developmental domains, potentially distorting care coverage and clinical decisions for children with autism.

Three experts apply policy, pharmacy operations, and member-level lenses to the same prescriptions to show why cost at the counter decides adherence.

Most Medicaid unwinding losses were procedural. mPulse's SriVani Ganti explains how plans can keep eligible members.

KFF finds 4.3 million Medicare beneficiaries will lose their MA or stand-alone Part D plans at the end of 2026 as PDP options keep shrinking.

The new NCCN Guidelines for Patients: Caregiving for People With Cancer address finances, legal concerns, and household tasks alongside medical management, areas that an expert involved in their development says “often leave people reeling.”

Unclear ownership often leaves survivors without support, and coverage of social and psychological services could close the gap, says Bhatnagar.

CEO Susan Cantrell previews AMCP Nexus 2026, discussing AI, drug pricing, emerging therapies, and a decade of change in managed care pharmacy.

At IDWeek 2026, IDSA and HIVMA leaders and clinician advocates outline how stories, relationships, and bipartisan outreach shape ID and HIV policy.

As CKCC nears its sunset, kidney care leaders urge CMS to preserve a dedicated, nephrologist-led accountable care model for advanced kidney disease.

Legal and clinical experts examined the US medical aid in dying framework, its limits, and ethical debates.

Nearly half of working-age adults were inadequately insured in 2026, and half went without needed care due to cost, a Commonwealth Fund survey found.

AMCP Nexus 2026 brings managed care leaders to San Diego October 26-29 to tackle Medicare negotiation, drug pricing policy, AI, and patient access.

Medicare’s GLP-1 Bridge program aims to expand obesity treatment, but eligibility hurdles and drug costs leave many seniors paying hundreds monthly.

Birth centers are unavailable in 10 states, and 39% of birth center births are self-pay, as licensing and Medicaid pay limit access, a report finds.

At CHEST 2026, 3 speakers explained why respiratory medications stay expensive, assessed what recent federal, state, and industry fixes have achieved, and urged clinicians to use their voices on behalf of patients.

The editor in chief of Evidence-Based Oncology, who was recently named medical director of Precision Medicine for The US Oncology Network, discussed milestones met and those still to be achieved.

COA's Nicolas Ferreyros discusses next steps for PBM reform, funding for supportive cancer services, and a hopeful outlook for community oncology.