Health Care Cost

HHS officials are moving forward with a plan to produce 4.8 million doses of H5N1 avian flu vaccine; Novo Nordisk’s long-acting insulin had a greater risk of excessively lowering patients’ blood sugar without offering better sugar level management; Los Angeles County launched an ambitious effort to tackle medical debt.

Compared with usual care, a dementia care management program improved various cost of care and utilization metrics in a Medicare managed care population at 12 months.

The CDC has asked local and state health officials to maintain peak-season flu surveillance operation levels over the summer to watch for any signs of human-to-human spread of the H5N1 bird flu virus; the drug industry’s top lobbying group faced thorough questioning at a Senate Judiciary Committee hearing about the impact of patent system abuse on high prescription drug prices; FDA staff reviewers have raised concerns that Guardant Health’s colorectal cancer (CRC) blood test may fail to detect precancerous tumors.

A new program from Optum Rx would offer greater predictability by using a guarantee-based pricing model.

Patients struggle to afford glucagon-like peptide-1 (GLP-1) medications for diabetes; doctors see potential and pitfalls in new ChatGPT model’s humanlike conversations; Medicare payment reform efforts focus on inflation adjustments and payment model overhauls.

Kimberly Westrich, MA, chief strategy officer of the National Pharmaceutical Council, shares 3 key recommendations to improve the accuracy and quality of drug pricing data.

Areas of focus in the annual report included health system utilization and recovery from the pandemic, patterns of medicine use, drug pricing, and patient out-of-pocket costs.

The results of T1International’s 2022 Out-of-Pocket Expenses survey highlight many huge inequities in the US and around the world relating to insulin and diabetes care supplies.

The US Senate hosted a panel addressing physician and health care shortages and efforts to increase minority representation in the medical field. An expert discussed initiatives to prevent senior homelessness. Advocates called for the repeal of the Comstock Act. Regulatory reforms are called for to improve rural cancer patients' access to pharmacies. Research reveals the impact of denials on patient access to immunology treatments.

The findings add to recent research on the growing utilization, expenditure, and prices of Duchenne muscular dystrophy (DMD) therapies in the current landscape, an area health care policy could potentially address.

Projected savings from biosimilar natalizumab were $452,611 over 3 years, driven by decreased drug acquisition costs and a utilization shift from reference to biosimilar natalizumab.

The senate hearing held by the US Senate Committee on Health, Education, Labor, and Pensions, led by Sen. Bernie Sanders (I, Vermont), chairman of the committee, and ranking member Sen. Bill Cassidy, MD, (R, Louisiana), addressed the critical issue of physician and health care worker shortages, as well as the maternal health crisis, in the US.

This real-world US study describes individuals with hemophilia B who experience bleeds despite factor replacement therapy and quantifies the associated comorbidity and health care resource utilization burden.

A new study highlights significant disparity in reimbursement rates across states between hospitals and Medicare; the first patient to receive a genetically modified pig kidney has died; research examines outcomes of over 500 patients receiving medication abortion pills by mail.

Session speakers at the 2024 meeting of ISPOR—The Professional Society for Health Economics and Outcomes Research share their favorite parts of the conference.

The CEO of SCAN Health Plan discusses its first-ever Environmental, Social, and Governance Report.

Challenges in developing next-generation cancer therapies persist; research indicates widespread utilization and hurdles in affordability and access to glucagon-like peptide-1 (GLP-1) medications; legislation seeks to legalize therapeutic use of psychedelics in California.

Public hospitals were significantly more likely to sustain access to unprofitable services following 340B Drug Pricing Program participation, while nonprofit hospitals were mostly unaffected, according to a recent study.

Results featured at the Academy of Managed Care Pharmacy 2024 annual meeting revealed a pattern of prior authorization rejections that could delay necessary therapeutic treatments for various patient groups.

In the series debut episode of "Frameworks for Advancing Health Equity," Mary Sligh, CRNP, and Chelsea Chappars, of Allegheny Health Network, explain how the Urban Health Outreach program aims to improve health equity for individuals experiencing homelessness.

For patients prescribed diabetes, hypertension, and hyperlipidemia medications, nonadherence to CMS Star Ratings quality measures of medication adherence was associated with increased health care resource utilization and costs.

New therapies are helping patients, but are also driving up overall costs of care.

William Padula, PhD, MSc, MS, assistant professor of pharmaceutical and health economics, University of California Alfred E. Mann School of Pharmacy and Pharmaceutical Sciences, discusses the benefits and advancements of cost-effectiveness analysis to improve decision-making and efficiency.

A CMS official discusses a draft guidance on the second round of drug pricing negotiations amid uncertainties over the first round of talks under the Inflation Reduction Act (IRA).

Fifty percent of US rural hospitals are facing financial problems; US lawmakers have called out the corporate spending of 3 large nursing home companies; hospice patients under Medicare Advantage are now facing uncertainty after the government ended its pilot program.

Kimberly Westrich, MA, of the National Pharmaceutical Council, explains how the 340B program is linked to increased drug spending and the hidden costs associated with it.

Research into the Inflation Reduction Act evaluated payer concerns, patient and physician behavior, which patients will benefit from the first 10 drugs selected for price negotiation, and the ripple effect into Medicaid at the state level.

The Medicare trust fund is now expected to deplete in 2036, with the Inflation Reduction Act being credited for at least some of the extension.

With more therapies available in bladder, kidney, and prostate cancers, collaboration among health care providers can help ensure patients are getting the most appropriate care for their type and stage of cancer, said Mary Dunn, MSN, NP-C, OCN, RN, of University of North Carolina.

In 2024, the Asembia Specialty Pharmacy Summit celebrated 20 years and speakers highlighted the conversations around improving access and affordability taking place at the meeting.