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What We're Reading: Anthem Will Not Cover First Drug Approved for Duchenne
What we're reading, October 10, 2016: Anthem will not cover Exondys 51, the first drug approved for treatment of Duchenne muscular dystrophy; big soda has sponsored 96 health and medical groups; and new Illinois program seeks to fill care gaps for working poor.
Citing concerns over the clinical trial data used to approve Sarepta’s treatment for Duchenne muscular dystrophy, Anthem has announced it will not cover Exondys 51. According to STAT, the health insurer concluded that the drug has not demonstrated clinical benefit. The approval of Exondys 51 was controversial because it came after medical staffers in the FDA questioned the effectiveness of the drug. However, the FDA chose to acknowledge the unmet need of patients with this rare disease, and approved the drug.
Coca-Cola Co and PepsiCo have provided sponsorships for nearly 100 health and medical groups combined. A study found that between 2011 and 2015, the 2 soda companies provided 96 sponsorships for groups including the American Heart Association, the American Diabetes Association, and the CDC, reported The Washington Post. During those 4 years, the 2 companies lobbied against 29 proposed bills or regulations that aimed to reduce soda consumption.
In Illinois, a new program aims to fill care gaps for the working poor. Uninsured residents who earn up to 200% of the Federal Poverty Level are eligible for the new coordinated health program, which will provide an assigned medical home, as well as a primary care physician, according to the Cook County Record. The program will be centered on the primary care medical home model and members will have to reapply every year.
NCCN Guidelines Update Adds Momelotinib Below Ruxolitinib for High-, Low-Risk Myelofibrosis
January 23rd 2024Momelotinib was given category 2A and 2B status for patients with high- and low-risk myelofibrosis (MF) and MF with anemia. However, ruxolitinib retains a higher category of recommendation as a treatment for patients with MF.
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Oncology Onward: A Conversation With Dr Shereef Elnahal, Under Secretary for Health
April 20th 2023Shereef Elnahal, MD, MBA, under secretary for health at the Veterans Health Administration (VHA), sat for a conversation with our hosts Emeline Aviki, MD, MBA, Memorial Sloan Kettering Cancer Center, and Stephen Schleicher, MD, MBA, Tennessee Oncology, that covered the cancer footprint of the VHA.
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Interventions Needed to Increase DMT Uptake in Sickle Cell Disease
December 26th 2023A recent study found that uptake of disease-modifying therapies (DMTs) has been low among patients with sickle cell disease, suggesting that more interventions that consider individual patient characteristics are needed to improve adoption.
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Exploring Payer Coverage Decisions Following FDA Novel Drug Approvals
May 3rd 2022On this episode of Managed Care Cast, Ari D. Panzer, BS, lead author and researcher, then at Tufts Medical Center—now at Duke University—discusses the findings from his team’s investigation into coverage decisions by health plan insurers of the 66 drugs approved by the FDA in 2018.
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Exagamglogene Autotemcel Meets End Points in Severe Sickle Cell Disease, β-Thalassemia
December 7th 2023Two posters set to be presented at the 65th American Society of Hematology Annual Meeting & Exposition met their primary and secondary end points regarding exagamglogene autotemcel therapy for sickle cell disease and β-thalassemia.
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