- Center on Health Equity and Access
- Clinical
- Health Care Cost
- Health Care Delivery
- Insurance
- Policy
- Technology
- Value-Based Care
What We're Reading: CMS Nixes Medicare Drug Pricing Rule; 5 More States Sue Purdue; Bariatric Surgery Benefits
The Trump administration is backing off a proposal that would have allowed private Medicare plans to refuse to pay for certain drugs for chronic conditions that experience steep price hikes; 5 more states have sued Purdue Pharma, alleging the company llegally marketed and sold opioids; bariatric surgery may offer more benefits for adolescents than adults.
CMS Backs Off Proposal to Ease Protections on Protected Classes of Drugs
The Trump administration is backing off a proposal to ease protections on 6 protected classes of drugs, reported STAT. The proposal would have allowed private Medicare plans to refuse to pay for certain drugs for chronic conditions that experience steep price hikes. The administration argued the move would help lower drug prices by giving these plans more leverage over high-cost drugs. The 6 classes include antidepressants, antipsychotics, anticonvulsants, immunosuppressants for treatment of transplant rejection, antiretrovirals, and antineoplastics.
More States Sue Purdue Pharma Over Opioid Epidemic
Five states are suing Purdue Pharma, claiming the company illegally marketed and sold opioids. The 5 states—Iowa, Kansas, Maryland, West Virginia, and Wisconsin—join 39 other states in filing lawsuits against Purdue Pharma and its executives, including the former president, Richard Sackler, and his family, according to Reuters. Last week, a North Dakota judge threw out the state’s lawsuit that accused the company of overstating the benefits and trivializing the risks of long-term opioid use. Purdue Pharma called the new lawsuits “misleading attacks.”
Bariatric Surgery May Be More Effective for Adolescents
While bariatric surgery results in comparable weight loss among adolescents and adults, adolescents may reap more benefits from the surgery. According to a study published in the New England Journal of Medicine, after 5 years of surgery, adolescents had remission of diabetes (86% vs 53%) and hypertension (68% vs 41%) more often than adults. However, more adolescents than adults had abdominal reoperations (19 vs 10 reoperations per 500 person-years) The researchers compared the effects of the surgery among 161 adolescents between 2006 and 2012 and 396 adults between 2006 and 2009.
Prices for care at hospital trauma centers vary across hospitals; drug shortages reached a record high during the first quarter of 2024; although 3 of the biggest makers of asthma inhalers pledged to cap out-of-pocket costs for some US patients at $35, these do not apply to daily inhalers used by the youngest kids with asthma.
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
The Biden administration recently launched the Global Health Security Strategy, a new effort to combat the spread of infectious diseases; lawmakers zeroed in on the risks of massive consolidation in health care during the first congressional hearing on the Change Healthcare hack; the FDA recently announced the recall of a pair of heart devices linked to numerous deaths and injuries.
Read More
Exploring Medicare Advantage Prior Authorization Variations
March 26th 2024On this episode of Managed Care Cast, we're talking with the authors of a study published in the March 2024 issue of The American Journal of Managed Care® about their findings on variations in prior authorization use across Medicare Advantage plans.
Listen
