This Week in Managed Care: November 17, 2017

New hypertension guidelines lower the threshold for high blood pressure, Trump nominates a new HHS secretary, and many consumers now have access to less expensive ACA plans.

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

New Blood Pressure Guidelines

The threshold for high blood pressure is lower than it used to be. At the American Heart Association (AHA) Scientific Sessions, new hypertension guidelines were presented that now mean about half of Americans have high blood pressure, up from one-third.

The starting point for high blood pressure will now be 130 over 80. Even though another 14% of Americans will now be diagnosed with hypertension, only 1.9% more will need prescriptions, because the guidelines will rely heavily on lifestyle modification.

Key changes in the guidelines are:

• Blood pressure of 120 to 130 over 80 is now considered elevated. Lifestyle intervention is recommended.
• Stage 1 hypertension covers blood pressure of 130 to 139 over 80 to 89. Lifestyle intervention is generally recommended. Medication is recommended for patients with an elevated risk for atherosclerotic cardiovascular disease.
• Stage 2 hypertension begins at blood pressure of 140 over 90. Both lifestyle intervention and medication are recommended.
• Systolic BP above 120 mmHg and below 130 mmHg with diastolic BP below 80 mmHg is now considered elevated. Lifestyle intervention is recommended.
• Stage 1 hypertension covers systolic BP of 130-139 mmHg and diastolic BP of 80-89 mmHg. Lifestyle intervention is generally recommended. Medication is recommended for patients with an elevated risk for atherosclerotic cardiovascular disease.
• Stage 2 hypertension begins at systolic BP of 140 mmHg and diastolic BP of 90 mmHg. Both lifestyle intervention and medication are recommended.

Dr. Paul Whelton, chair of the guidelines committee, spoke to AJMC about how the new guidelines emphasize the need for measuring blood pressure out of the doctor’s office.

Other content from AHA includes the latest results of using PCSK9 inhibitors in the highest-risk patients and the impact on costs of giving patients with cardiovascular disease a combination of rivaroxaban and aspirin.

For more coverage from the 2017 AHA Scientific Sessions, visit ajmc.com.

Trump Nominates New HHS Secretary

The position of HHS secretary has been left vacant since Dr Tom Price resigned in late September, but President Donald Trump has finally nominated a replacement. Alex Azar is a former executive with Eli Lilly and he had been the rumored frontrunner. During his trip to Asia, Trump tweeted out the nomination.

Previously, Azar had been a deputy secretary at HHS during George W. Bush’s administration. He also clerked for the late Supreme Court justice Antonin Scalia.

Azar’s Senate confirmation will likely include tough questions about drug pricing and his ability to regulate his former industry. He has also been an outspoken critic of the Affordable Care Act (ACA), which may be a sticking point with Democrats. Senate Minority Leader Chuck Schumer said in a statement:

“The next Health and Human Services Secretary must demonstrate a commitment to lowering Americans’ healthcare premiums, not sabotaging the Affordable Care Act and our healthcare system with reckless actions that hurt families. I look forward to reviewing the nomination of Mr Azar.”

More Affordable ACA Plans

Many Americans might actually find it easier to afford their health coverage under the Affordable Care Act in 2018. A recent analysis from the Kaiser Family Foundation found that 4.5 million Americans who are uninsured and eligible for an ACA plan could actually get a bronze plan for free once they take the income-related premium tax credit.

The Foundation also determined that 5.8 million uninsured and eligible Americans can now buy a plan for less than the cost of the penalty for not having coverage.

However, the future of the individual mandate remains unclear as Republicans are tying a repeal of it in their tax plan.

Patient-Centered Oncology Care

Finally, Patient-Centered Oncology Care (PCOC) took place in Philadelphia this week.

AJMC presented Dr Ilana Graetz with the 2017 Seema S. Sonnad Emerging Leader in Managed Care Research Award. The award was established in honor of the late Dr Sonnad and recognizes the achievements of early career researchers in the field of managed care.

During his keynote at PCOC, Dr Michael Kolodziej highlighted the rising burden of cancer care costs on healthcare overall and recommended ways by which oncologists can ease some of the costs while still infusing value into the care equation.

For coverage from PCOC, visit ajmc.com.

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