Health Care Cost

Robert Groves, MD, executive vice president and chief medical officer, Banner|Aetna, discussed whether health systems should invest in social determinants of health.

CMS is highly likely to negotiate the price of the obesity medication semaglutide in the coming years; many health care providers are trying to determine whether their cyberattack insurance will help cover their losses after the Change Healthcare hack; the US life expectancy increased for the first time in 2 years.

This poster reported that photoprotection management of lupus is unaffordable for some patients, which may have an impact on sunscreen application frequency.

Physician-scientists play a vital role in bridging research and clinical practice, and ensuring diversity among them has emerged as a critical factor for fostering biomedical innovation and achieving equitable health care.

For more than a decade, certain high-value preventive care services have been covered at no cost to patients under the Affordable Care Act, but a current legal challenge has the coverage at risk.

The approval makes atidarsagene autotemcel (arsa-cel [Lenmeldy]; Orchard Therapeutics) the first approved treatment for metachromatic leukodystrophy, a disease caused by a mutation in the ARSA gene and marked by progressive declines in both the central and peripheral nervous systems.

AstraZeneca joins efforts to address high drug prices by capping out-of-pocket costs for its inhalers; Opill, the first OTC birth control pill, is now accessible through online sales; expansion prompts questions on the effectiveness and regulation of remote monitoring technology.

This week, the Center on Health Equity and Access highlighted expert opinions on a mental health paradigm shift in the workplace, the impact health care algorithms can have on patient outcomes, and social factors linked with hidradenitis suppurativa severity, in addition to addressing the health needs of justice-involved populations.

The fiscal 2025 budget will prioritize investments in rapid tests and antimicrobial drugs; women who were pregnant as teenagers are more likely to die before 31 years; leaders push for reform as part of spending bill for federal health agencies.

In this interview, Pat Van Burkleo, executive director of Feeding Louisiana, explains why food access initiatives are a top priority.

Since 2016, 5 targeted treatments have received accelerated approval from the FDA for use in Duchenne muscular dystrophy (DMD), and the total spend for just 3 of them is $3.1 billion.

After years of efforts to reduce low-value care, panelists at the 2024 Value-Based Insurance Design Summit proposed a new strategy: drawing a line in the sand that payers will not be on the hook for these services.

Stress has potential links to worse outcomes in cancer, such as decreased quality of life and greater risks of disease progression and metastasis. There is a complex mix of emotions patients with cancer experience.

Most private health insurers have yet to publish criteria for when they will cover postpartum depression drug, zuranolone; state lawmakers are increasingly opposing health care mergers that they believe do not serve the public interest; Medicaid extensions made in 2021 led to a 40% decline in postpartum lack of insurance.

The critical issue of mental health in the workplace was discussed by experts in the field at the recent Midwest Business Group on Health (MBGH) Mental Health Forum, shedding light on the growing concern surrounding alcohol use disorder and the pressing need for innovative therapies.

The FDA has pushed back its approval deadline for donanemab, Eli Lilly’s experimental Alzheimer’s treatment; Cigna recently announced the launch of a program on aimed at capping annual weight-loss drug cost increases for health insurance providers and employers at 15%; a new monoclonal antibody product to protect against respiratory syncytial virus (RSV) was 90% effective at preventing children from being hospitalized.

President Biden will preview his plan to more than double the size of Medicare’s new drug price negotiation program in the upcoming State of the Union address; Mexicans and Central Americans were most affected by the pandemic in terms of all-cause mortality; two Alabama fertility clinics said they expect to resume in vitro fertilization (IVF) services after a bill was passed to protect doctors.

Getting weight loss drugs into the hands of those who need them could be a matter of changing pricing models to give more patients access to the medication they need.

Demands for government action grow amid mounting pressures on health care; Opill offers convenient access to contraception without a prescription; the White House announces progress as drugmakers submit counteroffers for Medicare’s drug price negotiation program.

Out-of-pocket costs of diabetes medications other than insulin can be quite high for individuals with employer-sponsored health insurance.

Payer costs for COVID-19 ranged from a mean of $505 for asymptomatic cases to $126,094 for severe cases with post–COVID-19 condition.

Appeals court to review ruling wiping out some cost-free preventative services; a new legislation aims to boost reimbursement rates for medical providers; changes to coverage may limit elderly home care access

A collaborative service model between a managed care organization and an affordable housing provider reduced acute care use and costs.

WHO warns of global obesity epidemic challenges; doctors advised to conserve a certain type of tetanus shot; a new set of rules will bar medical debt from consumer credit reports

Among a cohort of insured patients with cancer, the median total monthly cost of oral lenvatinib was $17,253, and 75% of patients paid $100 or less out of pocket per month for the drug.

Researchers of the review are underscoring the potential for economic policies to improve the management of hypertension for the millions of people throughout the United States with the condition who are at risk for cardiovascular disease.

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.

Congress is unlikely to include many major health care priorities in the next government funding package; many adults continue to see racism as a problem across aspects of US society; the Endocrine Society will review its clinical guidelines for gender-affirming care.

In this final part of our interview with James Robinson, PhD, MPH, he underscores the need for employer education about the health plans they offer, fostering managed competition among hospital systems to drive down costs, and innovation in financing drug development.

Patients with cancer express shock and anxiety over the recent ruling by the Alabama Supreme Court regarding frozen embryos; doctors are beginning to charge fees for administrative tasks; some universities are implementing accelerated nursing programs to help with the shortage.