This Week in Managed Care: January 9, 2016

Hello, I’m Justin Gallagher, associate publisher of The American Journal of Managed Care. Welcome to This Week in Managed Care, from the Managed Markets News Network.

 

Trouble for Afrezza

Sanofi has ended its deal to market Afrezza, the inhaled insulin that had strong reviews among the patients who used it, but sales that were well below targets. Analysts are blaming a restrictive FDA label and prior authorization requirements for Afrezza’s problems, and note that Sanofi’s action comes just as some benefit managers were ready to put Afrezza on formulary.

 

MannKind, the creator of Afrezza, must now find a buyer for the drug when its stock has lost 90% of its value. Read an overview of how Afrezza reached this point.

 

Working poor left behind by ACA

The working poor have been left behind by Affordable Care Act, especially in the 20 states that have not expanded Medicaid.

A special report by USA Today has found that both large businesses and state and local governments are farming out more and more tasks to part-time workers and independent contractors, in an effort to avoid paying benefits. Giant corporations, such as fast food restaurant chains, leave decisions about health benefits to franchisees. If an individual employer hires fewer than 100 workers–soon to be 50–that person can also avoid offering benefits.

 

Many employees say their hours are kept just below the 30-hour limit that would make them eligible for healthcare. And when coverage is offered, it can be up to 9.5% of income, which is often too expensive for individuals earning wages at the poverty level. In many states, Medicaid expansion offers an alternative–but in places like Texas, Florida, or much of the South, where governors say they do not want to expand a government program.

 

Aetna Leaves AHIP

America’s Health Insurance Plans, long the most powerful healthcare lobbying group in Washington, DC, sustained a second hit to its bottom line this week when Aetna announced it will not renew its membership.

The managed care giant, which is in the midst of a proposed merger with Humana, said this week that its representation in the nation’s capital through its own lawyers and lobbyists would be sufficient. Aetna faces a fierce antitrust battle in Washington and regulatory hearings in several states. AHIP lost the membership of UnitedHealth in 2015 after longtime president and CEO, Karen Ignagni, resigned to take over as the leader of EmblemHealth. She was replaced by Marilyn Tavenner, the former administrator of CMS.

 

FDA Approvals

The final numbers are in, and 2015 was one of the busiest on record at the FDA. The agency approved 51 new drugs, the largest number since 1950. This includes 20 that were first-in-class drugs. However, Forbes reports that 4 therapies that were not labeled first-in-class probably deserve that recognition, which would mean nearly half of all approvals were for groundbreaking therapies. Oncology drugs led the way, with a focus on drugs to treat blood disorders.

 

Bankruptcy for Cancer Survivors

The downside to all these new cancer treatments? They are expensive.

A study appearing this week in Health Affairs, using survey data gathered by LIVESTRONG, found that one-third of survivors had gone into debt, and 3% had filed for bankruptcy. Of those going into debt, 55% had obligations of $10,000 or more. Younger adult patients seem to be particularly hard hit due to their lower incomes.

The authors wrote, “Future longitudinal population-based studies are needed to improve understanding of financial hardship among US working-age cancer survivors throughout the cancer care trajectory and, ultimately, to help stakeholders develop evidence-based interventions and policies to reduce the financial hardship of cancer.”

Patient-Centered Diabetes Care 2016

Registration is open for Patient-Centered Diabetes Care, which will take place April 7^th and 8^th in Teaneck, New Jersey, just outside New York City. This year’s conference will feature sessions on the role of personal technology in diabetes care. Register now.

For all of us at the Managed Markets News Network, I’m Justin Gallagher. Thanks for joining us.