Peter Wehrwein, Managing Editor

At this year's PBMI Annual National Conference in Orlando Ben Urick, principal health outcomes researcher at Prime Therapeutics, shared methods for medical cost savings through adherence improvement using integrated medical and pharmacy claims data.

Sampson Davis, M.D., an emergency medicine physician and best-selling author, says a tailored approach is needed.

Case and care management can help health plans cope with seven-figure cell and gene therapies, according to panelists at the Pharmacy Benefit Management Institute’s annual meeting.

The mortality rate has dropped for Black premature infants, but they are still 1.4 times more likely to die than White premature infants, according to findings reported in JAMA Pediatrics today.

A special registration process could strike the right balance between increasing access to the drug used to treat opioid use disorder while limiting diversion and possible misuse, say an MHE editorial advisory board member and two co-authors.

Proponents hailed yesterday's announcement of the first 10 drugs subject to Medicare "maximum fair price" starting in 2026 as ushering in an era of lower drug prices and a political victory over pharma. Critics said it is price controls masquerading as negotiation and would smother innovation in one of the most innovative industries in the U.S.

Topping the list is Eliquis, which accounted for $16.48 billion in spending for the 3.7 million people in Medicare Part D who take the blood thinner.

Chronic prurigo is a chronic itchiness can set in motion an itching -scratching cycle that results in scarring. A case series at a hospital in Zurich, Switzerland, shows Dupixent (dupilumab) injections are an effective treatment.

AXNOO7, an investigational agent for geographic atrophy, did not affect geographic atrophy lesions but showed positive effects of tests of visual acuity. A novel, neuroprotective mechanism of action may be why.

The manufacturer has reported seven causes of retinal vasculitis associated with Syfovre. Results of an open-label, extension study presented at the American Society of Retina Specialists meeting today show favorable results among those who crossed over from sham to active treatment.

The approval of an ophthalmic bevacizumab biosimilar might mean the end of low-cost, repackaged Avastin as an anti-VEGF treatment for retinal diseases, with the unintended consequence of adding $457 million to Medicare B spending.

In an interview with MHE, Parikh, a retina specialist in New York and director of healthcare delivery research for the Department of Ophthalmology at NYU Grossman School of Medicine, described the current situation of biosimilars in retinal medicine and the attitudes of retinal specialists about using the lower-cost alternatives.

Researchers used the American Academy of Ophthalmology's IRIS database to quantify the risk of endophthalmitis — inflammation of intraocular fluids — after injections with anti-VEGF drugs. They found that post-injection endophthalmitis occurs, on average, once every 3,500 injections.

Samsung Bioepsis' SB15 was comparable to Eylea (aflibercept) in a 56-week randomized clinical trial that included a rerandomization at 32 weeks. The rerandomization resulted in 111 study volunteers switching from Eylea to the biosimilar for the last part of the study.

About 20% of patients in the trial of a high-dose, longer-interval regimen of Eylea (aflibercept )switched to shorter intervals, according to data presented today at the American Society of Retinal Specialists annual scientific meeting, which is being held in Seattle. Researchers didn't find any clues as to why in their baseline characteristics.

Research shows a $12,575 savings over two years and no difference in outcome, which result in an incremental cost-effectiveness ratio (ICER) of $873,000.

A post-hoc analysis didn’t reveal any differences in outcomes by race, macular thickness or baseline visual acuity.

In an interview with Managed Healthcare Executive prior to the meeting, Keyvan Koushan, M.D., a retina specialist at the Toronto Retina Institute and a lecturer in the Department of Ophthalmology and Vision Sciences at the University of Toronto, briefly described the design of the PULSAR trial and the positive results that have been reported so far.

Various hypotheses have been proposed. Mechanical pressure from the silicone oil may result in ischemia, said Lihteh Wu, M,.D., at the American Society of Retinal Specialists.

Results from the PULSAR study of high-dose Eylea are scheduled to be presented Saturday morning at the American Society of Retinal Specialists annual scientific meeting, which is being held in Seattle this weekend.

Pros and cons of Syfovre (pegcetacoplan), the newly approved drug for geographic atrophy will be discussed at the American Society of Retinal Specialists annual scientific meeting in Seattle this weekend, predicts leading member of the society. Biosimilars are also on the agenda.

Charles Wykoff, M.D., Ph.D., director of clinical research at Retina Consultants of Texas, noted new treatments for geographic atrophy are predicted to be a hot topic at the American Society of Retina Specialists annual scientific meeting that starts today in Seattle.

Findings reported in JAMA Ophthalmology chip away at one of the reasons for expanding optometrist scope of practice to include office-based laser procedures. But travel time is not the whole story.

Vaccinations at birth are particularly low, according to a report in Morbidity and Mortality Weekly Report. Models suggest that more than 500,000 hepatitis B-related deaths would be averted if some key vaccination goals were met.

In addition to a health plan for employees, Johns Hopkins Health Plans has a Medicare Advantage plan, a Medicaid managed care plan and a plan for the families of people who are on active duty in the U.S. military.

Researchers at the University of Wisconsin also found that the length of stays in inpatient rehabilitation facilities decreased during the 2020 pandemic months relative to 2019 but that payments per episode increased.

In their annual projections of healthcare spending, the actuaries foresee spending on home healthcare growing at annual rate of 7.7% from 2025 to 2031, which is faster than annual growth of 5.6% for health expenditures overall.