Policy observers and industry stakeholders debate the possible spillover effects of Medicare drug pricing reform in the employer-based insurance market; a California federal judge rules Walgreens could be held liable for not investigating suspicious orders of opioids in San Francisco; a blood test performed the day of a traumatic brain injury (TBI) can predict which patients may die and who may survive with a disability.
What Effect Will Medicare Drug Pricing Reform Have on the Private Market?
Experts disagree on what effect Medicare drug pricing reform will have on the private employer market. According to Roll Call, some payers and employer groups are concerned that the insulin cap for Medicare beneficiaries and HHS' price negotiating power in the Inflation Reduction Act, which passed the Senate earlier this week and is expected to pass the House of Representatives, will cause drugmakers to make up lost revenue in the job-based insurance market. Others disagree, saying that would mean pharmaceutical companies are choosing to bypass profits now.
Federal Judge Rules for San Francisco in Opioid Case Against Walgreens
A US District Court judge in California ruled that Walgreens could be held liable for the opioid crisis in San Francisco by distributing hundreds of thousands of “suspicious orders” of the prescription pain killers, The Los Angeles Times reported. Walgreens did not probe orders deemed “suspicious,” according to Judge Charles Breyer. The ruling in the public nuisance lawsuit, filed by the city in 2018, means the company could face a nonjury trial on the extent of its financial liability. More than 100 million prescription opioid pills were dispensed by Walgreens in the city between 2006 and 2020.
Blood Test on Day of TBI Provides Prognosis on Severity, Study Finds
A blood test perfromed the day of a traumatic brain injury (TBI) can predict which patients may die and who may survive, albeit with severe disability, according to research published in Lancet Neurology and reported by STAT. The rapid assay looks for 2 protein biomarkers—GFAP and UCH-L1. Diagnostic tests to detect the biomarkers are already approved by the FDA to evaluate whether patients with mild TBI should have CT scans. The latest research shows that the tests are also prognostic. While the study had some limitations and cannot predict a partial recovery, the results could help guide conversations with families or help providers make resource decisions.
Real-World Study Reveals Key Insights into DLBCL Treatment Patterns, Outcomes
April 18th 2024A recent study offers valuable insights into the characteristics, treatment patterns, and outcomes of diffuse large B-cell lymphoma (DLBCL) in patients across different lines of therapy, providing a look into the landscape of DLBCL management.
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Navigating Health Policy in an Election Year: Insights From Dr Dennis Scanlon
April 2nd 2024On this episode of Managed Care Cast, we're talking with Dennis Scanlon, PhD, the editor in chief of The American Journal of Accountable Care®, about prior authorization, price transparency, the impact of health policy on the upcoming election, and more.
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Gene, Light Therapy Combo Shows Promise Against Prostate Cancer Cells in Proof-of-Concept Study
April 18th 2024In their preclinical model, the researchers found efficacy both in vitro and in vivo by using CRISPR-Cas9 to mimic porphyria and combining the technology with light therapy.
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Navigating Health Literacy, Social Determinants, and Discrimination in National Health Plans
February 13th 2024On this episode of Managed Care Cast, we're talking with the authors of a study published in the February 2024 issue of The American Journal of Managed Care® about their findings on how health plans can screen for health literacy, social determinants of health, and perceived health care discrimination.
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Collecting SDOH Data Can Assess Risk of Medical Nonadherence, Improve HEI and Star Ratings
April 18th 2024At the Academy of Managed Care Pharmacy (AMCP) 2024 annual meeting, a panel of presenters explored changes coming to Medicare that incorporate social determinants of health (SDOH) data to improve patient and health system outcomes.
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