Policy

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®.

Oncology drug costs affect those entering into risk-based arrangements, and these groups must rethink their approach to evaluating risk.

Proposed CMS rules would make it easier for state Medicaid programs to smooth the way for value-based contracts for high-cost gene therapies.

To reduce poor outcomes from heart failure care disparities, Danish researchers probed the link between individual socioeconomic factors and care quality for patients with reduced ejection fraction.

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.

AJMC interviews Jill A. Fisher, PhD, author of a new book, Adverse Events: Race, Inequality, and the Testing of New Pharmaceuticals. Her research took her inside clinical testing sites for phase 1 drug studies.

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.

Among Medicare enrollees, there was substantial between-practice variation in the use of second-generation diabetes drugs between 2007 and 2015, according to a study published in JAMA Network Open. Data also revealed a concentration of use among a few prescribers and practices, who were responsible for widespread early diffusion.

Between 1997 and 2012, the inpatient burden of migraine cost rapidly increased in the United States, according to a study published in PRS Global Open.

For patients with rheumatoid arthritis (RA), cost can play a role in patient adherence to medication, but the presence of comorbidities does not impact cost of care for patients, according to 2 abstracts presented at the Virtual 2020 International Society for Pharmacoeconomics and Outcomes Research meeting.

According to study findings, continuous duodenal levodopa/carbidopa infusion was indicated as the most expensive second-line therapy in advanced stage Parkinson disease compared with deep brain stimulation and continuous subcutaneous apomorphine infusion.

Transformational changes in cancer care can bring forth important innovations, but all those come at a cost, said Ray Page, DO, PhD, president and director of research at The Center for Cancer and Blood Disorders.

In a webinar moderated by Thomas Parry, PhD, president of the Integrated Benefits Institute, an employer panel discussed value, application, and barriers to strategies involving the integration of employee needs and interests into benefit programs.

A. Mark Fendrick, MD, director of the Center for Value-Based Insurance Design (V-BID) at the University of Michigan and co-editor-in-chief of The American Journal of Managed Care®, and Suzanne F. Delbanco, PhD, executive director of Catalyst for Payment Reform, discuss V-BID X for employers, a plan constructed through benefit-design and payment reform that works to promote high-value services and deter low-value care.

Implementing a claims-based algorithm and disease management program may be an effective strategy to reduce relapse and cost among patients with schizophrenia.

Cost-related barriers to access are a major problem for US patients with MS that will hopefully be addressed through innovations in medication affordability, said Aliza Ben-Zacharia, DNP, ANP, associate director at the Center for Nursing Research and Innovation at Mount Sinai.

Mercer’s 2019 National Survey of Employer-Sponsored Health Plans highlighted 3 key areas of focus for employers in 2019, which were balancing affordability and choice, empowering employees to improve their health through tech-enabled solutions, and addressing high-cost claims.

Encouraging patient adherence to medication is very important to managing the cost of multiple sclerosis (MS) therapies, said Patty Taddei-Allen, PharmD, MBA, BCACP, BCGP, director, outcomes research, WelldyneRx.

The revolution in cancer care cannot happen just in the laboratory—it must also take place among stakeholders who must agree on new models for financing very expensive life-saving therapies. The new issue of Evidence-Based Oncology™ looks at the people trying to change the way we pay for cures and their work.