Laura Joszt, MA

At an Institute for Value-Based Medicine® event cohosted by The American Journal of Managed Care® and Optum, speakers emphasized that innovation is urgently needed in primary care delivery to address the broken US health care system.

The Democratic Women’s Caucus is urging insurers to comply with the Affordable Care Act (ACA) contraception requirement to cover birth control without cost sharing.

Results of a phase 1/2 trial show encouraging outcomes for patients with higher-risk myelodysplastic syndromes (MDS) and chronic myelomonocytic leukemia (CMML) treated with the fully oral regimen of venetoclax and decitabine plus cedazuridine.

The application is based on results of the phase 3 TROPION-Lung01 trial of datopotamab deruxtecan in nonsquamous non–small cell lung cancer (NSCLC), first presented at the 2023 European Society for Medical Oncology Congress.

Despite socioeconomic and biological differences that contribute to disparities between Black men and White men with prostate cancer, improved access has been shown to reduce the gaps, explained Jun Gong, MD, of Cedars Sinai.

Coverage from the Institute for Value-Based Medicine event with the University of Kansas Cancer Center in Kansas City, Kansas.

Experts explain how diabetes is diagnosed during pregnancy, how treatment differs from that of nonpregnant individuals, the importance of diabetes technology education, and how things change postpartum.

Aducanumab’s accelerated approval was controversial and insurance coverage of the expensive therapy was limited.

The expanded indication makes dupilumab the only approved treatment for eosinophilic esophagitis (EoE) in this age group.

Once treated with a one-size-fits-all approach, changes in the landscape for myasthenia gravis are allowing for more precise treatment of the disease.

Based on a comparison of prices for drugs up for Medicare price negotiations, there is a long way to go to reach the prices of 7 comparable countries.

While the first ustekinumab biosimilar, Wezlana, was approved in October 2023, a settlement with Johnson & Johnson (J&J) will keep it off the market until 2025, preventing competition, and causing purchasers to pay substantially more for the agent.

The most popular reimbursement content of 2023 included coverage of the shift from the Oncology Care Model to the Enhancing Oncology Model, reactions to the 2024 Medicare Physician Fee Schedule, and concerns around denial of services in Medicare Advantage plans.

Through interviews and contributed content, Strategic Alliance Partnerships provide insights into changes in health care delivery and medicine.

While the Enhancing Oncology Model is the successor of the Oncology Care Model, it includes some very real challenges for participating practices, explained Lalan Wilfong, MD, senior vice president of payer and care transformation at The US Oncology Network.

In 2023, there were 18 oncology and 7 population health Institute for Value-Based Medicine® events cohosted with organizations such as Optum, OneOncology, Vanderbilt Ingram Cancer Center, Duke Health, Cleveland Clinic, and Memorial Sloan Kettering Cancer Center.

Jun Gong, MD, of Cedars-Sinai Medical Center, discusses the latest data on adagrasib in colorectal cancer, the importance of conducting genomic testing, and more.

A one-size-fits-all approach to alternative payment models (APMs) often isn’t very fair to community practices, said Miriam Atkins, MD, FACP, president of the Community Oncology Alliance.

In 2023, adalimumab biosimilars took center stage in the biosimilar space due to 8 long-anticipated products finally launching.

The government of Australia’s pricing policy links the price of new medications with similar safety and efficacy, resulting in significant savings over the first 3 years after the etanercept biosimilar Brenzys was introduced.

Top coverage from the National Association of Managed Care Physicians (NAMCP) Spring Managed Care Forum 2023 included sessions on value-based care implementation and best treatment practices.

The commercial market got slightly less competitive while the Medicare Advantage market got a little more competitive, but both markets remain highly concentrated.

Activity to regulate pharmacy benefit managers (PBMs) has started in the states and is trickling up to the federal level, said Ted Okon, MBA, executive director of the Community Oncology Alliance.

ABP 959, an eculizumab biosimilar in development, has demonstrated similar efficacy and pharmacokinetics to the reference product for patients with paroxysmal nocturnal hemoglobinuria (PNH), according to research at the 2023 American Society of Hematology Annual Meeting.

The company is changing the way it prices prescription drugs and providing more transparency, which has been one focus of pharmacy benefit manager regulation efforts.

For patients with advanced non–small cell lung cancer (NSCLC), regardless of PD-L1 status, cemiplimab plus chemotherapy had favorable survival benefits and patient-reported outcomes over chemotherapy alone.

A mandatory nationwide transition from reference adalimumab to a biosimilar was implemented in New Zealand.