Peter Wehrwein, Managing Editor

How health plans are implementing strategies to leverage biosimilars to lower costs for both payers and patients, according to Javier Gonzalez, Pharm.D., chief growth and commercial officer of Abarca

Cynthiya Ruban, Ph.D., M.S., Director of Digital Solutions at Cencora says to keep the following in mind as AI use accelerates.

Ways AI is increasingly used in healthcare and how it can benefit healthcare decision makers, according to Cynthiya Ruban, Ph.D., M.S., Director of Digital Solutions at Cencora.

It's not the multimillion dollar prices, says Kevin Niehoff, Pharm.D., of IPD Analytics. The pool of sickle cell disease patients who are prime candidates for sickle cell disease gene therapy was overestimated, according to Niehoff.

Only a small group of patients have started the process to receive the new gene therapies for sickle cell disease, says Kevin Niehoff, Pharm.D., of IPD Analytics.

The 2024 increase is the same as last year's increase for family coverage. The foundation’s annual survey of employer health benefits also found that only 18% of large employers (200 employees are more) are covering the GLP-1 weight loss drugs.

Studies measuring patient preference stacked up in subcutaneous administration’s favor, according to a recently published review. The difference between subcutaneous and intravenous administration were less clear cut among the studies measuring health-related quality of life.

More research on clinical meaningfulness is on the way, according to Stephanie Graff, M.D., FACP, FASCO.

People living with HIV in neighborhoods that had been redlined by federal housing officials had a longer time interval between HIV diagnosis and achievement of viral suppression, a marker of successful treatment and access to healthcare, according to findings published in JAMA Internal Medicine.

The International AIDS Society's meeting, AIDS 2024, the 25th International AIDS Conference, was held July 22-26 in Munich, Germany. Approximately 10,000 people attended the meeting, the largest in the world devoted to HIV and AIDS. Many of the sessions were live streamed and could be viewed remotely. Here is a sample of our coverage of the meeting.

The American Society of Retina Specialists (ASRS) held its annual scientific meeting July 17-20 in Stockholm, Sweden. Here is a sample of our coverage.

Stephanie Graff, M.D., FACP, FASCO, director of breast oncology at the Lifespan Cancer Institute, explains the importance of the term “clinically meaningful” and shares some of the ways it can be defined.

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.