This Week in Managed Care: May 25, 2018

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This week, the top managed care stories include the finding that new guidelines will mean the number of people with hypertension will soar; research finds that most diabetes apps don’t lower glycated hemoglobin; and a health plan announced its plan to fight housing instability.


New guidelines mean the number of people with hypertension will soar, most diabetes apps don’t lower your A1C, and a health plan vows to fight housing instability

Welcome to This Week in Managed Care, I’m Samantha DiGrande

Impact of New Hypertension Guidelines

When the definition of hypertension changes, millions more will have it. More precisely, 31 million more Americans will have hypertension if the 2017 changes to the guideline from the American Heart Association and American College of Cardiology are fully implemented.

An analysis published in JAMA Cardiology projects that 105 million people will have high blood pressure based on the new guideline and 11 million more will need medication to treat it. The authors found that based on data collected for clinical trials and by the government, 45 percent of all American adults have high blood pressure.

Read the full article.

Evidence on Diabetes Apps

There are dozens of diabetes management apps on the market, but how many of them actually work? According to the Agency for Healthcare Research and Quality (AHRQ), only a handful.

The federal entity looked for evidence on the diabetes management apps on the market and found studies for only 11 of them. Only fi5e actually lower A1C. In addition, the authors of the report warned that some apps that are free may not protect patient data.

Said AHRQ Director Gopal Kanna, MBA: “Although consumers have access to dozens of apps for diabetes management, only a handful of these technologies have been evaluated. AHRQ’s report helps identify an important area where more research will help us understand how these apps can improve the health of people with diabetes.”

Addressing Housing Instability

Kaiser Permanente will spend $200 million on community housing programs, the first of what will be many investments to address social determinants of health. Kaiser’s investment to fight homelessness is the largest ever by a health plan. CMS approved the use of Medicaid dollars by health plans to fight housing insecurity in 2015.

Multiple studies and professional organizations have found that people with chronic conditions cannot manage their disease if basic needs like food and shelter are not met. Kaiser’s goal, according to Chairman and CEO Bernard J. Tyson, is to improve health outcomes for the people it helps. He said: "We hope our commitment creates a broader national conversation on homelessness and encourages other companies to join us to advance economic, social and environmental conditions for health."

HIV Treatment for Teens

FDA will now allow teens at risk of HIV infection to use Truvada, the pre-exposure prophylaxis or PrEP that was first approved for adults in 2012. The expanded indication is based on a study of 67 HIV negative teens aged 15 to 17 who received the treatment once a day. The safety profile was comparable to that seen in adult users.

PARP Inhibitor Expanded Indication

Rucaparib, the PARP inhibitor sold by Clovis Oncology as Rubraca, may have potential use for patients with advanced pancreatic cancer. The drug is currently approved for women with ovarian cancer, but could be used for pancreatic cancer patients with BRCA mutations.

A phase 2 study involving 19 patients with locally advanced or metastatic disease and a known BRCA mutation showed an overall response rate of 15.8%, and 4 patients achieved a response. The disease control rate was 31.6%.

Said Susan Domcheck, MD, of the Ambramson Cancer Center, “These results not only point us in a new treatment direction to further investigate for patients with pancreatic cancers, but it also reinforces the clinical significance of the BRCA genes beyond ovarian and breast cancer and the utility of PARP inhibitors in other cancers.”

Analyzing the Trump Drug Pricing Plan

Finally, AJMC® spoke this week with our co-editor-in-chief Michael E. Chernew, PhD, about the features of President Donald Trump’s plan to rein in the cost of prescription drugs. Chernew said the plan shows the difficult of balancing innovation and affordability.

“What I think we are hearing politically in this country is that people want more emphasis on affordability and less emphasis on innovation—or at least people believe they can have more affordability with the same amount of innovation.”

Hear the Managed Care Cast interview with Chernew.

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