Briana Contreras

Experts across healthcare debunk 15 common myths about GLP-1 medications—covering everything from access and cost to lifestyle changes and long-term effectiveness—to help patients and providers separate hype from reality.

Maria Lowe, Ph.D., associate vice president of Pharmaceutical Intelligence at Institute for Clinical and Economic Review (ICER) addresses the possible gene therapies that we could see reach the market this year.

Maria Lowe, Pharm.D., BCPS, associate vice president of pharmaceutical intelligence at the Institute for Clinical and Economic Review, described specialty drugs as high-cost treatments requiring complex handling or disease management and highlighted key upcoming approvals, including a new PCSK9 inhibitor for lipid lowering and tolebrutinib, a Bruton's tyrosine kinase (BTK) inhibitor, which could become the first in its class approved for multiple sclerosis.

Julie Patterson, Pharm.D., Ph.D., of the National Pharmaceutical Council, tells Managed Healthcare Executive at the annual AMCP meeting in Houston that the Inflation Reduction Act of 2022 is a policy that seems to be leading to more consequences than it is benefits.

At the AMCP 2025 meeting, Julie Patterson, Pharm.D., Ph.D., of the National Pharmaceutical Council, explained that the impact of the IRA drug negotiation program on patient access is still unclear, but early research shows that coverage for selected drugs has been strong. However, as Medicare Part D undergoes changes, there are concerns about how plan incentives, formulary design and utilization management might affect future access.

At the AMCP 2025 annual meeting, Sean Shirk, Pharm.D., stressed the need for payers to stay informed and engaged with legislation to sustain site-of-service efforts despite growing restrictions.

Co-presenter, Sean Shirk, Pharm.D., director of specialty clinical solutions at Prime Therapeutics, discussed this topic during a presentation on legislative impacts on site of service at the AMCP 2025 annual meeting in Houston on Tuesday.

Connie Estep, Pharm.D., BCGP, director of specialty clinical solutions at Prime Therapeutics, presented on legislative impacts on site of service at this year's AMCP meeting in Houston.

Originally approved by the FDA in September 2023, Biogen's Tofidence became the first tocilizumab biosimilar available in the U.S. market, launching in May 2024.

Finerenone, a nonsteroidal mineralocorticoid receptor antagonist, has been studied extensively in patients with mildly reduced or preserved ejection fraction.

Marc Humbert, M.D., Ph.D., professor of respiratory medicine at Université Paris-Saclay and Inserm, believes that recent clinical trials have reinforced the potential of Winrevair (sotatercept) as a breakthrough in pulmonary arterial hypertension (PAH) treatment.

Factor XI Inhibitors are the alternative to DOACs, which are highly effective at preventing strokes. However, their bleeding risks often limit their use, especially in high-risk patients.

Experts at City of Hope, a cancer research and treatment center, believe that AI tools will continue to improve precision medicine, streamline patient care and increase access to clinical trials.

In a recent conversation with Jennifer McGuigan Babcock, senior vice president for Medicaid policy at the Association for Community Affiliated Plans (ACAP), and Gabe Scott, a partner at K&L Gates Health Care Group, the two discussed efforts to protect Medicaid’s role in the healthcare system and the consequences of the budget cuts announced in February.

During last year’s enrollment period, millions of Medicare beneficiaries reviewed their coverage options and selected new Medicare plans for the 2025 calendar year due to changes including the plans being offered, increases in premiums and more, according to an eHealth analysis.

According to a Vertex spokesperson, the drug is seeing strong initial market adoption, with growing payer coverage and ongoing clinical studies aimed at expanding its use beyond acute pain management.

In a Q&A with Josef Witt-Doerring, M.D., former FDA medical officer in the division of psychiatry and the founder and CEO of TaperClinic, he shares the potential benefits and risks of the alternative non-opioid pain medication, expressing that while it could help cut down on opioid use, its long-term impact is unclear.

It was found that Microsoft 365 was the most frequently compromised platform, responsible for 43.3% of breaches.

Historically, RSV has been studied mainly in infants and older adults, but recent research shows that it also poses a significant threat to adults with asthma and COPD. However, research on the virus within these groups has been limited.

Trust remains a sensitive subject amongst employees as the shortage of mental health resources makes it even harder for them to build that trust with employers.

Jennifer McGuigan Babcock, senior vice president for Medicaid policy at the Association for Community Affiliated Plans (ACAP), and Gabe Scott, a partner at K&L Gates Health Care Group, spoke with Managed Healthcare Executive about what these cuts could mean for the healthcare system.

RSV leads to approximately 1.4 million hospitalizations and over 13,000 in-hospital deaths worldwide among infants under six months old.

Lissy Hu, M.D., MBA, CEO of Ascend Learning, was one of Managed Healthcare Executive’s 2022 Emerging Leaders in Healthcare winners. The editors caught up with Hu as part of our new “Where Are They Now?” series spotlighting the career paths of past emerging leaders.

David M. Cordani, chairman and CEO of The Cigna Group, expressed that these moves were made to “build upon our strengths for continued growth, enhance our customer focus, and deliver even greater value for those we serve."

When disasters occur, organizations such as SCAN Health Plan take a holistic approach, considering the needs of members, providers, brokers, employees and the broader community.

Findings from two recent surveys found that U.S. healthcare consumers lack much of their confidence in affordability and access to healthcare, as well as patient safety.

Arti Masturzo, M.D., chief medical officer of CCS, spoke with MHE in this third part of a video series to share how CCS helps patients with type 1 diabetes effectively use glucose monitors and insulin pumps by providing clear guidance and troubleshooting support, recognizing that even minor errors in management can have significant health consequences.