This Week in Managed Care: June 1, 2018

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This week, the top managed care stories include Senator Bill Cassidy's new plan to lower healthcare costs; policy recommendations from the American Diabetes Association on how to lower insulin prices; and coverage from the American Society of Clinical Oncology annual meeting.


A Senator presents a new plan to lower healthcare costs, the American Diabetes Association offers recommendations to lower insulin prices, and AJMC® gets ready to cover ASCO.

Welcome to This Week in Managed Care, I’m Laura Joszt.

Cassidy's New Health Proposal

Price transparency would help lower healthcare costs, says Republican Senator Bill Cassidy of Louisiana. Cassidy offered a set of proposals this week that he said would bring down health insurance premiums. They include:

  • Giving patients more information on price and quality for elective medical procedures
  • Ending the pharmacy gag rule, which bars pharmacists from telling consumers the cash price for their drug is less than their co-pay
  • Pegging the cost of new drugs to an index based on what other countries pay
  • Calling on Congress to promote low-cost care settings, such as freestanding emergency rooms and rural health centers

Cassidy also called for HHS to launch a study on the social determinants of health and disparities that currently affect the health system.

Read more.

Recommendations for Insulin Access, Affordability

The American Diabetes Association has released a set of recommendations to make insulin more affordable, based on findings of a working group that were presented at a Senate hearing last month.

Insulin costs people with diabetes 15 billion dollars per year, and price increases are one reason the annual price tag for diabetes is now 327 billion dollars in the United States.

The policy statement makes four core recommendations:

  • Streamline the biosimilar process
  • Increase price transparency across the insulin supply chain
  • Reduce or remove patient cost-sharing
  • Increase access to healthcare coverage

ADA supports having HHS directly negotiate with drug companies for Medicare Part D—something that was not included in President Trump’s new prescription drug pricing plan.

Learn more.

ASCO Annual Meeting Coverage

This weekend the world of cancer care descends on Chicago, Illinois, for the annual meeting of the American Society of Clinical Oncology (ASCO). The American Journal of Managed Care® (AJMC®) will be there to bring you updates from the meeting, and you can already find previews of studies to be presented at ASCO, including:

  • Cutting trastuzumab from 1 year to 6 months for women with HER2-positive breast cancer did not harm rates of disease-free survival and reduced the chance of cardiac problems.
  • Head and neck cancer patients who received radiation had fewer symptoms when they were monitored with a mobile and sensor technology called CYCORE.

Check out all of our coverage from ASCO.

Pembrolizumab Results

Merck announced that new data to be presented at ASCO will bring more good news about pembrolizumab, the anti-PD-1 therapy sold as Keytruda.

The company said a new phase 3 study from the KEYNOTE trial has shown that the immunotherapy pembrolizumab and chemotherapy helped patients with advanced, squamous non-small cell lung cancer survive significantly longer than with chemotherapy alone.

Read more.

Virginia to Pass Medicaid Expansion

Virginia appears poised to be the 33rd state to expand Medicaid, following votes from the Republican-controlled legislature. Governor Ralph Northam supports expansion, which will feature a work requirement that was not included in earlier attempts to expand the program.

The expansion plan is part of a broader budget agreement.

Emerging Leader Award

Do you know a young leader in managed care?

Early career investigators in healthcare and pharmacy are encouraged to apply for the Seema S. Sonnad Emerging Leader in Managed Care Research Award, which honors the late associate editor of The American Journal of Managed Care®.

See the eligibility requirements.

For all of us at the Managed Markets News Network, I’m Laura Joszt. Thanks for joining us.