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This Week in Managed Care: March 17, 2017


This week, the top managed care stories included the Congressional Budget Office releasing its rating of the GOP's health plan, the Senate voted to confirm Seema Verma for CMS administrator, and Scott Gottlieb, MD, was nominated to lead the FDA.

An estimate from the Congressional Budget Office on insurance coverage loss under the GOP health plan comes in higher than expected; CMS has a new administrator; and President Donald Trump forwards his nominee for FDA

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

CBO Rates GOP Health Plan

Up to 24 million people would lose health coverage by 2026 under the GOP health plan that has already cleared two committees in the House of Representatives, the CBO found this week.

The estimate for the American Health Care Act was higher than expected and has many wondering if the plan to replace the Affordable Care Act will need changes before it can go further.

House Speaker Paul Ryan focused on the CBO’s projections about deficit reduction and said the finding that fewer people would be covered is no surprise since the bill scraps the individual mandate. He said: “Our plan is not about forcing people to buy expensive, one-size fits-all coverage. When people have more choices, costs go down.”

However, opposition from healthcare groups is increasing, with the American Diabetes Association and the American College of Preventive Medicine coming out against the plan.

Seema Verma Confirmed for CMS

The Senate voted 55-43 this week to confirm healthcare consultant Seema Verma to be the new CMS administrator.

Verma is best-known for her work on Indiana’s Medicaid program, where she developed a waiver that required premiums and included a “lock out” rule if clients missed payments. Vice President Mike Pence worked with Verma when he was Indiana’s governor.

Nominee for FDA Commissioner

As expected, President Trump has nominated Scott Gottlieb, MD, to be the next FDA Commissioner.

Gottlieb previously served as the agency’s deputy commissioner for medical and scientific affairs and will face opposition from consumer groups. But 2 Obama appointees, former FDA Commissioner Robert Califf, MD, and former CMS Acting Administrator Andy Slavitt, praised the choice.

Gottlieb has called for streamlining regulations but has also sought to speed up approval of generics and has written about the need for fairer drug prices. He has a history of working with The American Journal of Managed Care®, including a 2015 interview where he discussed how FDA regulation of diagnostic testing might limit innovation.

Watch the interview.

BRCA1/2 Treatment

A study in Nature Medicine shows that many more women with breast cancer might respond to PARP inhibitors than previously believed.

The study found that up to 22% of those with breast cancer who have the BRCA1 and BRCA2 deficiency may have a therapeutic sensitivity to PARP inhibitors, compared with the 1% to 5% who were thought to be treatable. Lead author Serena Nik-Zainal, PhD, reported: “Our study shows that there are many more people who have cancers that look like they have the same signatures and same weaknesses as patients with faulty BRCA1 and BRCA2 genes.”

Coverage of ACC17

This week, AJMC® heads to the 66th Scientific Session of the American College of Cardiology, taking place in Washington, DC. Major results are expected in the FOURIER trial, which studies long-term cardiovascular safety in the cholesterol drug evolocumab, and the EINSTEIN-CHOICE trial, which compares long-term safety and efficacy of rivaroxaban and aspirin for patients with venous thromboembolism.

For full coverage of ACC, visit our dedicated conference page.

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

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