This Week in Managed Care: June 16, 2017

Millions sign up for ACA plans but never pay; a study finds lower cardiovascular risk with canagliflozin; and a Supreme Court ruling should make it easier to bring biosimilar products to the market.

Welcome to This Week in Managed Care, I’m Laura Joszt.

CMS Reports 2 Million Canceled ACA Coverage

A new report from CMS finds that nearly 2 million people who signed up for health coverage under the Affordable Care Act for 2017 had not paid premiums two months later.

The Health Insurance Exchanges Trends Report found that those who canceled coverage or had it terminated were less likely to have financial assistance than those who paid on time. Those who failed to maintain coverage also had higher premiums.

CMS Administrator Seema Verma said the report shows that coverage under the ACA is too expensive. “Consumers are sending a clear message that cost and affordability are major factors in their decision to cancel or terminate coverage.”

CANVAS Study Results at ADA 2017

A new study finds a lower risk of cardiovascular events for patients taking canagliflozin, the type 2 diabetes drug sold as Invokana.

Long-awaited results for the CANVAS trial were presented Monday at the 77th Scientific Sessions of the American Diabetes Association in San Diego. A related study on renal function, called CANVAS-R, found a 40% drop in overall renal decline.

The study’s lead author, Bruce Neal, MB, ChB, PhD, said the findings show the need to balance the benefits of canagliflozin against risk of harm for a subset of patients, including those with a history of peripheral vascular disease.

Dr Neal spoke with AJMC^® about the different groups of patients included in the CANVAS study, and what the results tell us about the effect of canagliflozin on heart failure. Watch the interview.

See full coverage of the ADA Scientific Sessions.

Supreme Court Win for Biosimilars

Biosimilars will have an easier time getting to market following this week’s unanimous ruling from the US Supreme Court in the case Sandoz v Amgen. Makers of biosimilars won on 2 key grounds:

• They don’t need FDA approval to serve the branded drugmaker with a required 180-day notice
• They can opt out of the so-called “patent dance”—a series of disclosure requirements—without risking an injunction

The ruling is expected to bring lower-cost versions of drugs to the market faster and save health systems money.

To learn more about the ruling and what’s happening in this emerging healthcare field, visit the Center for Biosimilars.

AMA's Names 2018 President-Elect

The American Medical Association (AMA) has announced that an oncologist will serve as its president for the first time in 2018.

Barbara McAneny, MD, will take the reins at AMA in June 2018. She is well known for her work with the COME HOME medical home project, which is funded by the CMS Innovation Center. McAneny is an advocate for the Patient-Centered Oncology Payment Model, which she discussed in a recent article in AJMC^®’s Evidence-Based Oncology^TM.

Read this article.

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