Payers

As health care costs continue to rise and the burden of chronic disease grows, data-driven insights will be essential in shaping the future of patient care, according to experts from Komodo Health and SmarterDx.

The study found that just 20% of trials submitted to both the FDA and European Medicines Agency had matching evidence.

An oncologist from Atrium Health outlines how saving time administering immunotherapy could have far-reaching benefits.

Artificial intelligence (AI) helps a Sarasota, Florida, health system catch lung nodules that appear on CT scans for patients treated for scores of conditions, allowing them to be referred for a possible lung cancer diagnosis.

Revakinagene taroretcel-lwey (Encelto; Neurotech), an allogeneic encapsulated cell-based gene therapy, is the first therapy to be approved for macular telangiectasia type 2.

In this qualitative investigation, leaders of Medicaid managed care plans were interviewed to identify facilitators of and barriers to electronic consultation for specialty care delivery.

More than 5 years after the American Society of Clinical Oncology warned of emerging disparities in precision medicine, efforts by community practices to embrace technology, form partnerships, and use data show how patients can gain access to personalized approaches. But challenges remain, especially for those covered by Medicaid.

Tislelizumab plus chemotherapy received FDA approval as a frontline therapy for individuals with unresectable or metastatic esophageal squamous cell carcinoma (ESCC) whose tumors express PD-L1.

The Health Insurance Disparities Index allows stakeholders to assess progress in addressing health care disparities using publicly available, validated, reported health plan quality metrics results.

Health care institutions with large numbers of Medicare and Medicaid patients may be constrained from offering cancer therapies made available under the accelerated approval pathway.

Comparing plans with similar characteristics, such as size, geographic location, or demographics served, allows for more meaningful insights and improvement opportunities.

Cell and gene therapies can be life-changing for patients with certain conditions, but the process of receiving them poses barriers for patients and caregivers that require multistakeholder solutions, according to a white paper from the National Pharmaceutical Council.

In an interview, Debra Patt, MD, PhD, MBA, FASCO, discusses the priorities of the Community Oncology Alliance as she starts her term as president.

Two new measures tied to outcomes drawn from data in the CLEAR phase 3 trial will be presented during the ASCO Genitourinary Cancers Symposium later this week in San Francisco, California.

This analysis demonstrated significant variability in medical policy determinations and evidence cited for clinically relevant pharmacogenetic tests among major US health insurers and laboratory benefit managers.

Relying on veteran survey responses and novel actuarial data, the authors examine the relationship between benefit value and reliance on the Veterans Health Administration.

World Cancer Day also marks the start of the ‘United by Unique’ campaign, which seeks to highlight how each person’s journey with cancer is unique, even though the patients, caregivers, and health care teams who are touched by cancer are united by shared goals.

Amid the uproar over the firing of 18 inspectors general, a report offering a coda to the aducanumab approval episode has been overlooked. It shows the need for reforms of the FDA's accelerated approval process.

The high cost of incretin mimetics for weight management limits insurance coverage and potentiates variation in utilization management strategies to control near-term spending.

Semaglutide (Ozempic) is 1 of 15 medications that will be included in yearly price negotiations between Medicare and manufacturers.

Altruism values for treatments of rare, severe pediatric diseases have not been estimated. This study found the altruism value for a hypothetical new Duchenne muscular dystrophy treatment to be $80 per year.

If the subcutaneous delivery method gains approval, an advantage daratumumab holds over isatuximab would be removed.

The authors used medical loss ratio forms to assess trends in premiums, medical claims, administrative costs, quality improvement, and margins in the large group insurer market.

Data from a systematic review of 30 real-world studies show comparable discontinuation rates of ocrelizumab to those in pivotal clinical trials among patients with different types of multiple sclerosis (MS).

The most-read obesity articles of 2024 mostly focused on insurance coverage of weight loss medications and costs.

Coverage from the IVBM Regional event in Denver, Colorado.

Payers and employers have tightened access to the glucagon-like peptide 1 receptor agonist class once these therapies became more commonly prescribed for obesity.

Lindsay Bealor Greenleaf, JD, MBA, of ADVI Health, weighs in on what to expect in key health care policy areas in the wake of the election.