Policy

The authors examine 4 alternative payment models for oncology care that shift away from fee-for-service and move progressively toward greater bundling, either across providers or across payments.

The use of an 80% threshold or other binary cut point may be insufficient for characterizing the relationship between medication adherence and Medicare spending.

Venous thromboembolism during or after recent hospitalization for medical illness contributes a substantial economic burden to society across all hospital and ambulatory care delivered.

While the marketing of the first biosimilar to be approved in the US market, Zarxio, has been delayed due to a court order, the FDA is providing guidance to manufacturers to help them effectively navigate the process of product development.

The appeals court decision has ensured that Novartis cannot bring its biosimilar Zarxio (filgrastim), which provides immune support to cancer patients, to the market at least till June 3.

Pharmacy and therapeutic committees view potential cost savings as the most important factor when recommending formulary placement, according to a new survey.

While lawmakers, payers, and patient advocates are raising a voice against the sky-rocketing costs of the newer breakthorugh agents in cancer, the drug developers can boast a strong start to the year with big sales figures.

Medigap, the Medicare supplement coverage that helps fee-for-service beneficiaries fill gaps in their benefits, continues to be important for low-income beneficiaries and especially those living in rural areas, according to America's Health Insurance Plans.

A study published in the journal Health Servcies Research found that veterans enrolled in dual programs, the VA care program and a Medicare Advantage plan, did not perform better or worse than those using the VA alone. This is important considering the duplicate spending associated with dual enrollment.

More pharmaceutical companies are buying drugs that they see as undervalued, then raising the prices. It is one of a number of industry tactics, driving up the cost of drugs.

The study found that despite an increase in the armamentarium of drugs to treat multiple sclerosis, the cost of the drugs has skyrocketed and not dropped.

While brachytherapy improved progression-free survival in men with prostate cancer, compared with traditional readiotherapy, the study found that overall survival was not very different between the 2 groups.

The use of a tiered network was associated with the increased use of hospitals on the preferred and middle tiers for planned hospital admissions compared with the nonpreferred tier, according to a paper in Health Services Research.

A one-minute look at managed care news during the week of April 20, 2015, including the how payment reform could hurt emergency care and Americans want the government to do something about high drug prices.

A cancer diagnosis is a very emotional experience, and besides for lifestyle issues, medications are one of the best ways to fight the disease, according to Jan Berger, MD, MJ.

CMS wasted nearly $251 million in taxpayer dollars on infusion drugs in just 18 months by using outdated drug pricing estimates, which drove up the cost of prescription injectable drugs for an aging baby boomer population.

With the rising prices of innovative oncology treatments, many of which fall under specialty pharmaceuticals, curbing the cost of care is high on the agenda of healthcare providers.

Given the high cost of oncology medications, many specialty pharmacies have dedicated teams to help patients overcome the financial burden, said Kirby Eng, RPh, executive director of clinical oncology management services at Onco360.

Hospital patients felt an increased financial burden in 2014 due to a combination of rising procedure costs and higher deductibles, according to TransUnion Healthcare's Q4 2014 report.

This study describes the small number of individuals responsible for larger shares of healthcare cost persistently over a 3-year period.

While statins can prevent disease in older adults, they can also cause potentially serious side effects that could outweigh the benefits, according to a study published in the Annals of Internal Medicine.

Sandoz's biosimilar will be sold under the trade name Zarxio but the FDA has held off on releasing a naming policy for biosimilars, giving the product a "placeholder nonproprietary name" of "filgrastim-sndz."

In a session at AMCP's 27th Annual Meeting & Expo that was so popular that attendees were being directed to an overflow room, Aimee Tharaldson, PharmD, senior clinical consultant in emerging therapeutics at Express Scripts, highlighted specialty pharmaceuticals that are currently in development and expected to come to the market in the next few years.

Trends in healthcare are driven by innovation, which is largely being driven by specialty innovation, Douglas M. Long, MBA, vice president of industry relations at IMS Health, said during the headline session "Marketplace Trends" at the Academy of Managed Care Pharmacy's 27th Annual Meeting & Expo.

The battle is being closely watched for signs that brand-name drug makers may be able to delay the introduction of biosimilars, which are cheaper versions of brand-name biologics.

Zarxio was approved earlier this month, the first biosimilar to be approved in the United States.

While the PBM Express Scripts declared plans to bring cancer drug plans down, the drug manufacturers and investors aren't too worried about the high cost of some of the specialty drugs, according to this article in Bloomberg.

At a state-of-the-art facility in Thousand Oaks, California, drugmaker Amgen Inc. is perfecting the art of copying others, and it must work fast because copycats are already coming for Amgen's drugs.

A one-minute look at managed care news during the week of March 2, 2015, including oral arguments for King v. Burwell and the approval of the first biosimilar in the United States.