Health Care Cost

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.

This week, the Center on Health Equity and Access highlights a variety of gaps that exist in health care, spanning women's health, the rising rate of metabolic disease, and policy for LGBTQ+ and immigrant populations. The consensus among featured experts points to comprehensive care models.

Leaders at 49 accountable care organizations (ACOs) shared their perspectives on the Medicare Shared Savings Program, as well as a range of strategies for success and ongoing challenges.

While the novel payment models for expensive cell and gene therapies have been effective, they need to continue evolving, said Joe DePinto, MBA, of McKesson.

Representatives from ICON plc and Symphony Health joined forces at AXS24 to discuss the challenges of managing high-cost specialty drugs and how they influence self-funded employer benefit plan design and employee access to specialty medications.

There are multiple levers that need to be pulled to allow biosimilars to come to market more broadly in the US, explained Fran Gregory, PharmD, MBA, vice president of emerging therapies, Cardinal Health.

Doug Long, MBA, vice president of industry relations at IQVIA, covered a bevy of stakeholder investment–related topics in his presentation at AXS24 on trends in specialty pharmacy, chief among them challenges facing the industry, obesity medications, generics and biosimilars, new product launches, and the outlook for the US market.

When the same product comes to market with additional indications, irrational pricing decisions result in ever-increasing prices instead of volume translating to lower costs, said Jon Mahrt, MBA, of OptumRX.

Makers of medical tests will have about 4 years to show the FDA that their new offerings deliver accurate results; after previously decreasing for 27 years, US tuberculosis (TB) cases increased every year since 2020; a US district judge rejected a challenge by Bristol Myers Squibb and Johnson & Johnson to the Medicare drug price negotiation program.

A new court ruling has the future use of skinny labels in question, but skinny-label generics have saved Medicare a lot of money over 5 years.

End of reporting mandate signals shift in real-time tracking of airborne pathogens; high rates of psychiatric conditions seen among patients with long COVID; new rule reinforces notification requirements for digital health records and apps.

Racial disparities in end-of-life care, the role of wellness and faith in minority health, award-winning research on health disparities, societal factors impacting cardiometabolic health, and rising mental health challenges among US youth are all covered this week in the Center on Health Equity and Access.

The 340B hospitals not receiving an offsetting lump-sum payment from CMS following 2018-2022 cuts later ruled unlawful are disproportionately rural, publicly owned, and nonacademic, according to a new study.

The FDA recently approved an antibiotic for the treatment of urinary tract infections (UTIs) in women; a Senate committee recently launched an investigation into the prices of Novo Nordisk’s diabetes and weight loss drugs; US births fell last year, resuming a national slide after a previous increase during the pandemic.

The Federal Trade Commission's (FTC's) vote to ban most employers from issuing and enforcing noncompete clauses could have varying impacts on the health care workforce; federal regulators vastly under-enforced antitrust laws in the hospital sector during the last 2 decades, resulting in increased health costs; the FDA recently found genetic evidence of the H5N1 bird flu virus in pasteurized commercially purchased milk.

With the high burden of metabolic disease increasing in the US, Sophia Humphreys, PharmD, Sutter Health, explains how this impacts health equity.

New health privacy rules aim to protect patients and providers in an evolving abortion landscape; some physicians express concerns about efficacy, risks, and entrenched beliefs in treating Alzheimer disease; CMS addresses longstanding staffing deficits in nursing homes.

The FDA granted accelerated approval to talquetamab on August 9, 2023, as a treatment option for adult patients with relapsed/refractory multiple myeloma (RRMM) who have failed at least 4 prior lines of therapy.

In an interview during The American Journal of Managed Care®'s Institute for Value-Based Medicine® event, held with Sutter Health, Ryan Stice, PharmD, BCPS, explains the impact virtual population health teams can have on improving access to care for patients with cardiometabolic conditions.

The Center on Health Equity and Access provides the latest developments related to the progress, challenges and gaps in health care with new research, ongoing meetings, and expert insights.

Douglas M. Long, BA, MBA, was featured as the keynote speaker on the closing day of The Academy of Managed Care Pharmacy 2024 annual meeting, with a session dedicated to surveying the health care and pharmaceutical trends of the last year.

Leslie Fish, PharmD, senior vice president of pharmacy at IDP Analytics, LLC, reflects on the future of biosimilars and the impact they will have on managed care pharmacy settings to improve patient access to medications.

A cost-utility analysis conducted from the perspective of the Italian health system found that pegcetacoplan was more effective and less costly than 2 complement 5 (C5) inhibitors for the treatment of paroxysmal nocturnal hemoglobinuria (PNH).

Prices for care at hospital trauma centers vary across hospitals; drug shortages reached a record high during the first quarter of 2024; although 3 of the biggest makers of asthma inhalers pledged to cap out-of-pocket costs for some US patients at $35, these do not apply to daily inhalers used by the youngest kids with asthma.

Using 25 health system performance indicators, the Commonwealth Fund 2024 State Health Disparities Report evaluated racial and ethnic disparities in health care and health outcomes both within and across US states and highlighted the urgent need for equitable health care policies and practices in the US.

Public health campaigns are imperative to alleviating food insecurity, Pat Van Burkleo, executive director of Feeding Louisiana, the Louisiana Food Bank Association, explained in an interview.