Biotech Drugs Still Won't Copy

A pediatric shot for respiratory syncytial virus (RSV) may not be covered as a free routine vaccine; hospitals fail to comply with payment transparency rules; the fate of abortion pills is in the hands of conservative judges

The editors of The American Journal of Managed Care® reflect on the past year and discuss what they’re looking forward to in 2023.

The government is allowing Medicare Advantage (MA) plans to delay returning hundreds of millions of dollars or more in government overpayments; a proposed new extension of the Affordable Care Act (ACA) might make birth control coverage more accessible for certain private insurance plans; a study found that students lost around 33% of their school year because of the pandemic’s educational barriers and are struggling to regain that lost time.

On this episode of Managed Care Cast, we speak with Matthew D. Eisenberg, PhD, lead author of a study published in the October issue of The American Journal of Managed Care® that investigated the use of high-deductible health plans and their impact on substance use disorder care and spending.

An HHS report said that if the Inflation Reduction Act (IRA) had been implemented in 2020, Medicare Part D beneficiaries could have saved a total of $734 million, averaging out to about $500 per member.

A new study estimated Medicare drug price negotiation savings; food benefits provided under the Supplemental Nutrition Assistance Program (SNAP) will return to prepandemic amounts; pharmacies reduce hours to cope with staffing shortages, improve work-life balance.