Health Care Cost

A new study has found that prior authorizations for anti–vascular endothelial growth factor treatment led to a delay in patient care for most patients.

Researchers estimate the financial impact of respiratory syncytial virus (RSV) in cardiorespiratory hospitalizations using MarketScan data and CDC viral positivity rates.

Those in minority groups face barriers even after they’ve made the hard decision to seek mental health care. The Department of Labor aims to address systemic issues on a personal level.

Smokers with diabetes on Ozempic are less likely to receive smoking cessation interventions; initiative incentivizes hospitals to eliminate medical debt for low- and middle-income patients; high costs prevent mental health treatment.

Crystal S. Denlinger, MD, FACP, CEO of the National Comprehensive Cancer Network, discusses possible federal policies to help mitigate ongoing and future cancer drug shortages.

The hospitalization rate for patients with pulmonary hypertension (PH) and interstitial lung disease (ILD) doubled over a 2-year period, and total health care costs more than doubled over the same period.

Patients with alopecia areata (AA) face significant out-of-pocket costs for treatments, despite many having limited efficacy.

This week, the Center on Health Equity & Access delved into the state of equity as it relates to national spending, ovarian cancer care, health technology, insurance coverage, and postpartum depression.

Patients with fibrosing interstitial lung disease (ILD) who began supplemental oxygen therapy had triple the per patient per month ILD-related health care costs compared with those who did not.

Efforts to regulate social media for youth face resistance; MK-1654 meets key goals in mid-to-late stage trial; active drug shortages remain above 300 for sixth consecutive quarter.

A new report provided updated figures estimated the birth prevalence of spinal muscular atrophy (SMA) in the US.

This study examined employers’ understanding of rebate guarantees, dependency upon rebate dollars, and the role that pharmaceutical rebates or employer benefits consultants play in their pharmacy benefits manager selection.

Almost half of all Americans struggle to afford quality health care and prescription medications; the cyberattack on UnitedHealth Group's Change Healthcare unit will cost the company between $2.3 billion and $2.45 billion in 2024; CMS releases the final part 2 guidance for plan outreach and education for the Medicare Prescription Payment Plan.

A retrospective database analysis demonstrated the high clinical burden experienced by patients with severe deficiencies of ADAMTS13 and thrombotic thrombocytopenic purpura (TTP)–related diagnoses.

Patients with both diabetes and atherosclerotic cardiovascular disease (ASCVD) have about 1.5 times higher total direct health care expenditures than those without diabetes.

The Federal Trade Commission (FTC) is preparing a lawsuit against the 3 largest drug middlemen over their use of rebates for insulin and other drugs; Sen Bernie Sanders (I, Vermont) feels confident that Novo Nordisk will cut Ozempic and Wegovy costs after hearing; CMS proposed a payment rule that would increase Medicare reimbursement for hospital outpatient departments by 2.6% next year.

CMS recently launched a voluntary, nationwide dementia care program; the number of physicians who reported at least 1 symptom of burnout has dropped below 50% for the first time since the onset of the COVID-19 pandemic; diabetes drugs have all been in short supply over the last 18 months, partly due to people using them off label for weight loss.

A long-awaited report from the Federal Trade Commission (FTC) finds that vertical integration and consolidation have worked against consumers and independent pharmacies.

AJMC's Center on Health Equity & Access shares new developments in HIV treatment, gynecological and multidisciplinary cancer care, and health care barriers faced by older Americans.

Investigators compared cost-effectiveness of the KRAS inhibitor sotorasib against the taxane docetaxel in the second line for non–small cell lung cancer (NSCLC).

Crystal S. Denlinger, MD, FACP, CEO of the National Comprehensive Cancer Network, breaks down the causes of the ongoing cancer drug shortage, as well as its impact on clinical trials.

Sindhuja Kadambi, MD, MS, University of Rochester Medical Center, discussed in detail the unique considerations necessary for oncology care in the aging population.

Insurers continue to raise consumer costs despite covering fewer drugs and having more drug coverage restrictions; the Biden Administration is investing hundreds of millions of dollars to train geriatricians; the Federal Trade Commission has opened an investigation into Teva Pharmaceuticals after the company refused to take down patents for its asthma and chronic obstructive pulmonary disease inhalers.

Charlie Borowicz, manager of trans and gender diverse health at Allegheny Health Network, shares how the program offers comprehensive patient-first care to those in the LGBTQ+ and gender diverse community.

This new report reveals that the US has made minimal progress in advancing health care equity over the past 2 decades.

The use of Plan B fell by 60% in states that implemented near-total abortion bans after Roe v. Wade was overturned; the Biden administration will impose inflation penalties on 64 prescription drugs in the third quarter of 2024; the FDA recently released draft guidance to ensure that drug companies and medical device makers enroll more women and people of color in clinical trials.

On this episode of Managed Care Cast, we're talking with the author of a study published in the June 2024 issue of The American Journal of Managed Care® about how annual high-deductible insurance plans increase maternity care costs when pregnancies cross 2 calendar years.

The CDC issued a warning to doctors on Tuesday to look out for dengue cases amid a global surge; HHS has finalized disincentives to prevent health care organizations from unreasonably blocking the exchange of electronic health record (EHR) information; patients in some states, like West Virginia, cannot afford weight-loss medications due to the high costs and lack of insurance coverage.

In our fourth Pride Month podcast episode, we are speaking with Domenico Ruggerio, executive director of We Are Family, in Charleston, South Carolina, the state's oldest nonprofit to provide life-affirming and life-saving programs for lesbian, gay, bisexual, transgender, queer, plus (LGBTQ+) youth.

Beneficiaries who switched from traditional Medicare to a Medicare Advantage plan experienced no additional protection from medical costs compared with those who stayed in a traditional Medicare plan.