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This Week in Managed Care: November 19, 2016


This week, the top managed care news included president-elect Donald Trump outlining parts of Obamacare he would be willing to keep, lawmakers confirming they still want to pass the 21st Century Cures Act, and the FDA held a 2-day hearing on off-label use.

Hello, I’m Justin Gallagher. Welcome to This Week in Managed Care from the Managed Markets News Network.

Keeping Parts of the ACA

President-elect Donald Trump said this week he wants to keep some parts of the Affordable Care Act. In an interview with 60 Minutes, Trump said he favors “guaranteed issue,” which bars insurers from denying coverage based on pre-existing conditions.

Trump also wants to keep the part of the law that allows adult children to stay on their parents’ plan until they are 26 years old.

The day before Trump’s interview, health economist Glenn Melnick, PhD, told AJMC that he expected Trump to keep these parts of the law because they are popular. However, Melnick said he expects the provisions to be financed through tax credits, and the exchanges will go away. Said Melnick, “Insurance companies don’t exclude people because they’re sick—they exclude them because they can’t charge an actuarially fair price.”

For 5 things to look for in healthcare in the Trump administration, read our article.

21st Century Cures

Lawmakers from both parties still hope to pass the 21st Century Cures Act before the current session of Congress ends. The act would ensure funding for the Cancer Moonshot and the Precision Medicine Initiative after President Obama leaves office.

But the act balances new funding at the National Institutes of Health and the FDA with smoother paths for getting drugs and medical devices to market. Given the incoming president’s disdain for regulation, it’s not clear that Democrats will ease the rules before he arrives.

For more, click here.

Anticoaglant Prescriptions

Too many patients at risk of a stroke don’t get a prescription for an anticoagulant or stop taking them within a few months, according to a new study. The findings were presented this week at the American Heart Association Scientific Sessions. The study is the result of a data-sharing collaboration between Boehringer Ingelheim, the maker of Pradaxa, and health insurer Anthem.

The study found that 23% of the patients who started taking anticoagulants stopped taking them within 3 months, and nearly three-fourths stopped taking them after about 2 years.

Boehringer Ingelheim funded the study, which will look next at the reasons why patients stop taking these medications.

Off-Label Use

The FDA recently held a 2-day hearing to take input on whether pharmaceutical companies should be allowed to promote drugs for off-label uses. The decision to take public comment came after court rulings found the FDA had violated drug companies’ First Amendment rights. The agency wants to develop standards for off-label promotions to avoid those that would cause harm.

Companies are very concerned about Twitter, because they feel current recommendations don’t offer enough direction for how to follow FDA rules within 140 characters.

Patient-Centered Oncology Care

This week AJMC was in Baltimore as we hosted the 5th annual meeting of Patient-Centered Oncology Care. You read exclusive coverage of the Live Meeting at ajmc.com.

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

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