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This Week in Managed Care: August 1, 2015


The announced price for alirocumab, the first PCSK9 inhibitor approved for use in the US, was the top story in managed care this week. Also, HHS announced $100 million available to combat substance abuse, and Medicare and Medicaid turn 50 years old.

The first PCSK9 inhibitor to combat bad cholesterol was approved for use in the US, and this week Sanofi and Regeneron set the wholesale price at $40 a day, which is well above what analysts had predicted. It is expected that payers, despite discounts, will strictly limit who gets the drug. A competitor, Amgen's evolocumab, may be joining the market by the end of the month.

Researchers determined that patients who receive a high number of prescriptions upon being discharged from the hospital are more likely to be readmitted within 30 days. Those who are readmitted are more like to be younger, African American, and have health problems such as heart disease, chronic obstructive pulmonary disease, diabetes, or metastatic cancer.

The government made a large number of funding available this week. HHS made $100 million in new funds available to combat substance abuse with a special focus on fighting opioid addiction. Plus, the Office of the National Coordinator announced it will award $38 million to 20 organizations to promote national efforts for better care, smarter spending, and healthier people.

And this week marked the 50th birthday of Medicare and Medicaid, the 2 largest healthcare payers in the country. The first Medicare recipient was former President Harry S. Truman, who received his card from President Lyndon B. Johnson at the signing ceremony in 1965. Currently, more than 55 million Americans are covered by Medicare.

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