Medicare may cover full cost of preexposure prophylaxis drugs; rules aim to prevent excessive compensation in Medicare Advantage (MA) market; health officials advocate for widespread syphilis testing and intervention.
The Biden administration has introduced a proposed federal policy to enhance the prevention of HIV in older Americans by offering free preventive medication, specifically preexposure prophylaxis drugs (PrEP), according to ABC News. Under this plan, Medicare would fully cover the cost of PrEP, including long-acting injectables, for those 65 years and older. With older Americans making up a significant portion of those already living with HIV, this policy shift aims to reduce infections among this age group. However, it also underscores the need for more equitable access to PrEP for those under 65, especially women and people of color, to further combat the HIV epidemic in the United States.
The Biden administration is introducing stricter regulations to address anticompetitive practices within the Medicare Advantage (MA) market, with a focus on limiting excessive compensation to agents and brokers, according to The Hill. CMS aims to enhance the selection and enrollment of Medicare beneficiaries in plans that align with their health care needs, rather than financial incentives for agents and brokers. The proposed rule would eliminate current frameworks allowing separate payments, redefine compensation definitions, and establish a fixed compensation amount of $632 per MA enrollment, promoting better alignment with statutory requirements. If finalized, these rules would come into effect by 2025.
US health officials are deeply concerned about the significant increase in congenital syphilis cases, with more than 3700 babies born with the disease in 2022, marking a 10-fold increase from a decade ago and a 32% rise from 2021, according to the Associated Press. The CDC is urging intensified prevention measures, emphasizing the importance of encouraging women of childbearing age and their partners to undergo syphilis testing. This surge in congenital syphilis is linked to a simultaneous rise in primary and secondary syphilis cases in adults and has been exacerbated by difficulties in accessing the main treatment, benzathine penicillin injections, due to supply shortages. The CDC's data indicate that more than half of the congenital syphilis cases involve mothers who tested positive during pregnancy but did not receive proper treatment, underscoring the need for proactive intervention.
Examining Low-Value Cancer Care Trends Amidst the COVID-19 Pandemic
April 25th 2024On this episode of Managed Care Cast, we're talking with the authors of a study published in the April 2024 issue of The American Journal of Managed Care® about their findings on the rates of low-value cancer care services throughout the COVID-19 pandemic.
Listen
Industry Experts Tackle Specialty Drug Access Challenges for Employer Benefit Plans
May 2nd 2024Representatives from ICON plc and Symphony Health joined forces at AXS24 to discuss the challenges of managing high-cost specialty drugs and how they influence self-funded employer benefit plan design and employee access to specialty medications.
Read More
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.
Listen
Diving Deep Into Specialty Pharmacy: Insights and Forecasts From IQVIA’s Doug Long
May 1st 2024Doug Long, MBA, vice president of industry relations at IQVIA, covered a bevy of stakeholder investment–related topics in his presentation at AXS24 on trends in specialty pharmacy, chief among them challenges facing the industry, obesity medications, generics and biosimilars, new product launches, and the outlook for the US market.
Read More