Peter Wehrwein, Managing Editor

Luke Greenwalt, MBA, vice president and lead, IQVIA Market Access Center of Excellence, has joined the editorial advisory board of Managed Healthcare Executive.

The 2024 Pharmacy Benefit Management Institute (PBMI) Annual National Conference was held Sep. 4-6 in Orlando, Florida. Managed Healthcare Executive is the official publication of the institute. Here is a sample of our coverage.

Sen. J.D. Vance credited Donald Trump with "salvaging" the Affordable Care Act (ACA). Gov. Tim Walz said Trump worked to repeal the ACA and Vance has proposals that would bring back pre-ACA limitations on health insurance for people with preexisting conditions.

With this year's Breast Cancer Awareness Month now underway, we are sharing eight facts and updates about breast cancer that you might not know about.

A news release about the complaint says the "big 3 " pharmacy benefit managers — CVS Caremark, Optum Rx and Express Scripts — have kept hundreds of millions of dollars of rebates while excluding insulin products with lower list prices from their formularies.

The company said that it will submit a new drug application for the IPF drug, called nerandomilast, based on the positive results.

The advantage of the glucago-like peptide 1s did not include people who had already developed cirrhosis,

The Minnesota-based PBM is also officially folding Magellan Rx Management into its name. Prime acquired Magellan in 2022.

The IQVIA vice president of industry relations and his talks featuring rapid-fire delivery of voluminous slide decks is a familiar figure in managed care circles. He is retiring in May 2025.

The IQVIA vice president and frequent speaker at pharmaceutical and managed care meetings shares some insights after he delivered the keynote talk at 2024 PBMI Annual National Conference held last week in Orlando, Florida. Long, a well-known figure in managed care circles, announced at the PBMI meeting that he is retiring in 2025.

Kerri Tanner, Pharm.D., chief pharmacy officer of PayerAlly, discusses the dynamic pricing models of Waltz Health and Free Market Health as a way for independent specialty pharmacies to compete.

The president and CEO of CareOregon discussed the merger with SCAN Health that didn’t go through, Medicaid redetermination and the 2024 election with Managed Healthcare Executive (MHE) editors. Hunter is a member of MHE's editorial advisory board.

Kerri Tanner, Pharm.D., the chief pharmacy officer of PayerAlly, says payers are looking for ways to rein in the escalating costs of specialty pharmacy drugs beyond the traditional techniques used by pharmacy benefit managers.

Patrick Cooney, president of The Federal Group, says elimination of spread pricing is one of the three key elements of the PBM legislation that he believes is likely to pass during the lame-duck session of Congress after the Nov. 5 election.

Greg Baker, CEO of AffirmedRx, did not hold back in criticizing CVS Caremark, Optum Rx and Express Scripts and their group purchasing organizations today at the PBMI Annual National Conference.

Patrick Cooney, president of The Federal Group, a Washington, D.C., lobbying firm says prospects for legislation passing this year, albeit during the post-election lameduck session, are good partly because the PBM legislation would produce Medicare savings that could be put toward other uses.

The IQVIA vice president and frequent speaker at pharmacy and managed care meetings said he will retire in May 2025.

Cell and gene therapies are becoming almost an everyday clinical reality. But the price tags? They still have shock value. Payers and providers are working out single-case agreements ahead of when the therapies are given.

Projections calculated for AARP show that 8.4% of Part D enrollees will benefit from the Inflation Reduction Act's $2,000 cap on out-of-pocket costs that goes into effect in 2025.

Perceptions of affordability don't show an advantage to Medicare Advantage, say former and current Commonwealth Fund leaders.

Results presented at the 25th AIDS Conference showed that switching to Biktarvy resulted in approximately twice as much weight gain, on average, than switching to Dovato.

Intrauterine insemination is the procedure that Democratic vice presidential nominee Gov. Tim Walz and his wife Gwen used to get pregnant.

Research published today in JAMA Health Forum Shows primary care physicians faced an average of 57 quality measures. The authors argue that many may interfere with care improvement and contribute to physician burnout.

They work by inhibiting inflammatory cytokines. But in a small percentage of patients antiinflammatory biologics may stir up “paradoxical psoriasis.”

Authors say their findings support current CDC recommendations for testing for the bacterial sexually transmitted infections, especially gonorrhea.

Associate director of healthcare and public health programs at the Digital Medicine Society (DiMe), a global nonprofit and professional home for digital medicine

Chief product and technology officer, Arcadia, a healthcare data company headquartered in Boston

Vice president of legal and compliance at Abarca Health, a pharmacy benefits manager and healthcare technology company.

Chief medical officer, complex care, AbsoluteCare, an integrated healthcare provider headquartered in Columbia, Maryland

Health Equity Officer at UCare, an independent, nonprofit health plan company with members in Minnesota and western Wisconsin