Health Care Cost

On this episode of Managed Care Cast, we speak with the author of an article in the August issue of The American Journal of Managed Care® about the premium tax credits for health insurance purchased through the health care marketplace, which were recently extended for another 2 years with the signing of the Inflation Reduction Act.

Despite the Hospital Transparency Rule being in effect, the majority of 340B hospitals are not reporting their prices for top services and drugs, and those that have, reported on “egregious” markups, said Ted Okon, MBA, executive director, Community Oncology Alliance.

For vision-threatening diseases, such as diabetic macular edema (DME) understanding the economic value of treatments can help identify the direct and indirect benefits of different treatments, said Paul Hahn, MD, vitreoretinal surgeon at NJRetina.

Policy observers and industry stakeholders debate the possible spillover effects of Medicare drug pricing reform in the employer-based insurance market; a California federal judge rules Walgreens could be held liable for not investigating suspicious orders of opioids in San Francisco; a blood test performed the day of a traumatic brain injury (TBI) can predict which patients may die and who may survive with a disability.

The single-center study evaluated patients across multiple cancers to understand the utilization, safety, and financial outcomes of bevacizumab-awwb vs reference bevavizumab.

We estimate that the median 2021 premium tax credit for off-marketplace enrollees in California would be $311 if they switched to marketplace plans, with wide variation by age and plan size.

Allergen immunotherapy, especially given by the subcutaneous route, was shown to be cost-effective for children with house dust mite-driven allergic asthma, according to a recent study based in Portugal.

HR 5376, or the Inflation Reduction Act, is most significant piece of legislation affecting federal health policy since the passage of the Affordable Care Act in 2010; for Medicare beneficiaries, it caps insulin at $35 a month and includes other pricing reforms.

A recent study calculated the incidence and mortality rates for patients with Medicaid coverage who had nonventilator hospital-acquired pneumonia (NVHAP) and found possible associations between greater health care costs and NVHAP diagnosis.

Garo Owens, MD, is president of Gary Owens Associates, and here he discusses optimizing treatment goals for patients with pulmonary arterial hypertension (PAH) while reducing care costs.

Research presented at the American Society of Retina Specialists conference found that vitreoretinal surgery had cost and health implications in both Europe and the United States.

More people are eligible for screening, but a new analysis suggests lung cancer disparities are due to more than eligibility status.

Systemic corticosteroids were more commonly prescribed vs other systemic drug options in Germany for patients with atopic dermatitis (AD) despite their unfavorable risk-benefit profile, with a substantial economic burden cited among these populations.

Senator Joe Manchin, D-West Virginia, ended his opposition to the Inflation Reduction Act of 2022, paving the way for reductions in some Affordable Care Act subsidies and action on drug pricing; AbbVie’s Allergan agreed to pay more than $2 billion in opioid settlements; a study found vitamin D supplements do not reduce bone fracture risk.

Clinical trials and targeted agents do not appear to affect health care–related quality of life, however.

A team of investigators from across the United States investigated a potential connection between patients’ health insurance literacy and their reported financial hardship.

The Institute for Clinical and Economic Review (ICER) released the report, which supports the long-term value of betibeglogene autotemcel (beti-cel) for the treatment of beta thalassemia.

As part of the investigation into pharmacy benefit managers (PBMs), the Federal Trade Commission (FTC) should delve into how PBMs are impacting and fueling drug prices and set up guardrails to protect Americans, said Ted Okon, MBA, executive director, Community Oncology Alliance.

Long-term exposure to traffic-related air pollution was linked with higher annual emergency department and outpatient health care costs for older patients, particularly those with cardiovascular disease.

The budget allocates half of the money for the development of low-cost interchangeable insulin biosimilars and the other half for building an insulin manufacturing facility in the state.

Patients who experienced Clostridioides difficile infection had increased risks of mortality and hospital readmission, as well as greater length of stay and total hospital charges.

Increased atopic dermatitis severity in pediatric patients was associated with a greater physical, emotional, social, and economic impact on families.

An integrated primary care service may improve the health status of patients with severe chronic obstructive pulmonary disease (COPD) without increasing health care costs, according to a recent study.

This systematic review found that studies of case management interventions have adequate quality and, in many cases, show cost-effective or even cost-saving results.

Although prediabetes prevalence jumped 4.8 percentage points from 2010 to 2020, barriers to accessing diabetes prevention interventions persist, driven by cost, eligibility requirements, and data integration, leading to low participation rates.