Health Care Cost

US Senate to vote this week on legislation seeking to codify abortion rights into law; hospitals aiming to raise treatment prices in response to increasing nurse salaries; shortage of infant formula worsening nationwide.

UPMC Health Plan, RxAnte, and Mosaic Pharmacy Services outlined how they are operating a value-based pharmacy care management program within Community HealthChoices, Pennsylvania’s managed Medicaid long-term services and supports (LTSS) program, at a recent conference.

Future quality conversations must recognize what the pandemic has illustrated over the past 2 years—that patients who were in the most dire need of health care, including those with multiple chronic conditions, had the least amount of access, said Jonathan Blum, MPP, the principal deputy administrator and chief operating officer of CMS.

Coverage, equity, and value-based payments are critical areas of focus for the Biden administration’s health care agenda leading up to the midterm elections, according to 3 experts from Avalere.

Limited evidence from a literature review suggests that co-pay assistance was associated with improved treatment persistence/adherence across various diseases, with indirect evidence suggesting improvements in clinical outcomes.

At the Pharmacy Quality Alliance (PQA) 2022 Annual Meeting Wednesday, participants heard about some unexpected insights arising from a workshop held this week between patients and pharmacists who are creating a patient-centered outcomes research agenda focused on addressing social determinants of health (SDOH) in the community pharmacy setting.

Atopic dermatitis was associated with the greatest burden of disease compared with 2 other types of dermatitis, in which high incidence and disability-adjusted life-years rates corresponded with high sociodemographic index areas.

Using socioeconomic status (SES) as their primary exposure, investigators from McGill University, University of Manitoba, Institut National de Santé Publique du Québec, and Laval University investigated reasons behind insulin pump uptake disparities in the Canadian provinces of Manitoba and Québec.

Adam Fein, PhD, of Drug Channels Institute, and Doug Long of IQVIA discussed trends in the specialty pharmacy market in the United States.

Representatives from employers, pharmacy benefit managers, and others discussed methods of improving pharmacy access and affordability in health plans.

Value-based payments were a benefit during the pandemic, but it remains to be seen if patients are interested in keeping those changes in care delivery as the pandemic recedes, said Jayson Slotnik, partner, Health Policy Strategies, Inc.

On this episode of Managed Care Cast, Ari D. Panzer, BS, lead author and researcher, then at Tufts Medical Center—now at Duke University—discusses the findings from his team’s investigation into coverage decisions by health plan insurers of the 66 drugs approved by the FDA in 2018.

Scott Gottlieb, MD, and Adam Fein, PhD, discussed potential fallout of the FDA Aduhelm approval and lessons learned from the COVID-19 pandemic.

In his talk, "340B at 30 and the Impending Cliff on the Road to 40," Tim Paine outlines how the program came to be and what needs to happen to improve future implementation.

Avalere is presenting at Asembia’s 2022 Specialty Pharmacy Summit, and Ryan Urgo, MPAP, managing director, health policy, discusses possible drug pricing policy options on the table for the Biden administration to consider in a midterm election year.

Chronic kidney disease is the fastest-growing noncontagious disease in the United States. On this episode of Managed Care Cast, we speak with Mike Spigler, vice president of patient support and education for the American Kidney Fund, who is spearheading the Unknown Causes of Kidney Disease Project, which aims to help underserved patients get to the root cause of their kidney disease, while also helping to solve this mystery for a broader patient population.

Coverage of our peer-reviewed research and news reporting in the health care and mainstream press.

Increased uptake of biosimilars on par with the utilization rates of filgrastim biosimilars could have saved Medicare Part D $84 million in 2019.

The research, conducted in Germany, found that biologic treatment for asthma resulted in reduced health care resource utilization (HCRU), as seen in fewer hospitalizations and oral corticosteroid prescriptions as well as less sick leave.

Key opinion leaders addressed cost, accessibility, and other barriers limiting use of comprehensive genomic profiling (CGP), and how employers can help drive preventive care and precision medicine through CGP.

In a talk presented by The Hastings Center, Gary Cohen, president of Health Care Without Harm, explains how the health care industry can fight climate change, mitigate social determinants of health, and reduce costs through a series of targeted efforts.

Findings of a survey of large employers indicate that utilization management tools are ineffective in controlling health care costs for employees and may lead to barriers to treatment.

Reducing low-value care means saving money, reducing potential harm, and creating room for high-value care to be delivered in the United States.

CMS issues final plan for aducanumab (Aduhelm) coverage; 2021 sees further drop in US life expectancy; individuals have presented with symptoms of trauma throughout the COVID-19 pandemic.

Without addressing rising costs, the problem of underinsurance in health care coverage will remain, said panelists at the 2022 V-BID Summit, discussing some of the smaller steps that are being proposed or are already in place to try to ease the financial burden.

Mitigating the high cost of prescription drugs is a win-win to address the complex, multipronged problem of getting patients to take their medications as advised.

With more people living with HIV now reaching advanced ages and qualifying for Medicare coverage, this new study investigated HIV-related influences on their health care spending, particularly antiretroviral therapy (ART), compared with a population who does not have HIV.

New research published in Health Affairs details the rates of specialty medication noninitiation among Medicare Part D beneficiaries.

Implementing changes in a health system to promote biosimilar adoption is not easy, but by implementing a program, there could be substantial savings.

New research presented at the American College of Cardiology's 71st Annual Scientific Session & Expo highlights the high costs of heart failure in the United States and the benefits of healthy eating and exercise as preventive measures.