Health Care Cost

Heart failure with reduced ejection fraction (HFrEF) is when the heart’s left ventricle can only pump out 40% or less of the blood it contains, resulting in less oxygen-rich blood being disseminated to the body than it actually needs.

2020 is the 25th anniversary of The American Journal of Managed Care® and the October’s issue of the journal features an interview with Dr Kavita Patel, a nonresident fellow at the Brookings Institution and a primary care physician.

Challenges remain, in light of new guidelines, when making treatment decisions for patients with severe asthma, noted Megan Althoff, MD, PhD, second year fellow, University of Colorado, Division of Pulmonary Sciences and Critical Care Medicine.

Marty Makary, MD, MPH, kicked off the Academy of Managed Care Pharmacy Nexus 2020 meeting with a call to action around reducing overprescribing, increasing price transparency, and recapturing the public’s trust in the health care system.

Attendees at the Academy of Managed Care Pharmacy (AMCP) Nexus 2020 meeting will hear a keynote from a surgeon who has become more visible over the past year and a half discussing what he says are “structural problems” behind the cost of US health care.

The authors, from RxCrossroads by McKesson, discuss the impact of copay accumulator and maximizer programs.

Newly published data suggests most patients are opting for second- or third-generation tyrosine kinase inhibitors instead of a generic form of imatinib.

Orphan drug spending to treat rare conditions in children is increasingly burdening payers and families, a recent study said.

Family premiums for employer-sponsored health insurance rose 4% over the past year, averaging $21,342, according to Kaiser Family Foundation (KFF) study findings, with workers contributing $5588 in out-of-pocket costs.

Two neurologists discuss what is known and unknown in switching patients with migraine from one calcitonin gene-related peptide (CGRP) inhibitor to another.

A House panel found pharmaceutical companies exponentially increased drug prices to boost profits; CDC data show an increase in alcohol-related deaths, especially among women; 4 million more Americans enroll in Medicaid.

Speakers at Patient-Centered Oncology Care® highlighted injustices in the US health care system, the risk of financial toxicity, and how providers can do a better job to ensure their patients achieve health equity, during a panel discussion.

The survey was released to mark Pain Awareness Month.

A cost-saving provision made possible by the recent COVID-19 relief CARES Act now allows Americans to leverage pre-tax funds from their flexible spending arrangements [FSAs] or health savings accounts [HSAs] to purchase over-the-counter medicines and menstrual care products.

Sickle cell disease is a costly disease for patients, but when those patients suffer from end-organ damage, the costs jump significantly.

A decision-analytic model could save more than $7 million in overall ineffective health care costs per 1000 patients by predicting which patients with rheumatoid arthritis (RA) will have an inadequate response to anti–tumor necrosis factor therapies.

Patients with spinal muscular atrophy (SMA) incur significant health care resource utilization and cost burden, particularly those with infantile-onset SMA.

A review warns against delaying or ignoring the concerns of individuals with chronic pain during the coronavirus disease 2019 (COVID-19) pandemic.

Kidney failure is one of the expensive conditions in health care, but new results from the DAPA-CKD trial could change the equation in favor of prevention.

In this episode of Managed Care Cast, we talk with Michael N. Abrams, a cofounder and managing partner of Numerof & Associates, about the fifth annual report on the state of population health.

In this episode of Managed Care Cast, we share a little bit of our forthcoming interview with Georges C. Benjamin, MD, executive director of the American Public Health Association, which will appear in the September issue of The American Journal of Managed Care®.

Children receiving intensive chemotherapy benefit from prophylaxis with levofloxacin to an extent that would justify the cost of the drug, a new analysis finds.

Current therapeutic options for multiple myeloma and best practices in dispensing medications throughout the COVID-19 pandemic.

Through the partnership between Innovaccer and Emtiro Health, data utilization will work to delineate and address social aspects known to affect the health of populations nationwide, said Kelly Garrison, CEO at Emtiro Health, and Paul Grundy, MD, chief transformation officer at Innovaccer.

The challenges of complying with payer mandates in biosimilars were discussed in a webinar sponsored by The American Journal of Managed Care® and The Center for Biosimilars®.

Given the constraints prevalent post-COVID-19, Dr Mark Fendrick, director of the University of Michigan Center for Value-Based Insurance Design, stresses that it is now more important than ever for the health care industry to prioritize payment reform, value-based benefit design, and novel policy initiatives.

Despite concerns, legislation to cap out-of-pocket payments for specialty drugs has not been shown to shift costs to health plans, thereby increasing insurance premiums, according to a study published in New England Journal of Medicine.

The coronavirus disease 2019 (COVID-19) vaccines that are leading the pack are utilizing a new vaccine technology that has never been approved for human use by the FDA. As a result, there are a lot of unknowns.

The ruling reversed a lower court ruling regarding the drug discount program for hospitals that serve patients covered by Medicaid.

End-stage renal disease has long been one of the most expensive and debilitating conditions that affects Medicare beneficiaries. Not only does dialysis cost $90,000 a year—those awaiting a kidney transplant automatically qualify for Medicare—but the need to travel to a dialysis center multiple times a week disrupts employment and home life.