Peter Wehrwein, Managing Editor

This part of the month's cover story series features Ivan Jarry, CEO of Obviohealth. According to Jarry, companies like his that run decentralized clinical trials can solve many of the problems that bedevil clinical trials, making them cheaper, faster and more inclusive and their results more reliable. This months cover story shines a light on the companies, trends and ideas that are shaking things up and reshaping the contour of how healthcare is paid for and delivered.

Diabetes management may lend itself to digital health interventions for a whole set reasons. DarioHealth reported good results recently, and a meta-analysis published in Lancet Digital Health this month showed that smartphone applications and SMS-based interventions are associated with effective management of type 2 diabetes in adults.

Patient groups and lawmakers such as Sen. Bernie Sanders want Sanofi and Novo Nordisk to follow Eli Lilly's example and reduce the prices of their insulin products. Both companies said they already have programs that bring down the cost.

Program reached the Marshallese workers who have moved from the island nation in the central Pacific Ocean to work in the poultry and meatpacking industry in northwest Arkansas.

The new factor VIII product is part of a surge of research and drug development for hemophilia.

As with the controversial drug Aduhelm, coverage is limited to people enrolled in clinical trials. The Alzheimer’s Association had petitioned for a change.

Rituximab is cheaper and just as effective as the other monoclonal antibodies used to treat MS, says an ICER report that came out today.

A 72-year-old man developed worsening myalgia while taking Paxlovid. The FDA and authors of a case report in JAMA Internal Medicine today says patients who would benefit from Paxlovid should be advised to temporarily stop taking statins and other drugs with potentially serious drug-drug interactions with Paxlovid.

Leaders of the Digital Therapeutics Alliance hope to get a Congressional Budget Office score on the legislation that would extend Medicare coverage so members of Congress can weigh budget implications.

Senators and witnesses said at a Commerce Committee hearing today that pharmacy benefit managers are putting independent pharmacies out of business and siphoning money from the drug supply chain. A University of Chicago economist and the industry trade association pushed backed, saying they bargain to save payers and patients money.

At a placeholder price of $19,000, resmetirom would produce cost savings, says the drug evaluation group. Obeticholic acid’s price would need to be slashed to meet a commonly used cost-effectiveness threshold.

Cuban, of "Shark Tank' fame and owner of the Dallas Mavericks, called drugs prices ‘insane’ and used some profanity when talking pharmacy benefit managers at the annual meeting of the Association for Accessible Medicines yesterday. Cuban has co-founded an online pharmacy that he says will make drug prices lower and transparent.

Our guest on this month’s episode of the “What's on Your Mind” podcast is Margaret Murray, M.P.A., founding CEO of the Association for Community Affiliated Plans (ACAP) and a longtime member of Managed Healthcare Executive® editorial advisory board. Murray is an expert on Medicaid and healthcare policies that affect people with low incomes. In the interview with Managing Editor of MHE, Peter Wehrwein, she discusses ACAP’s growth and its legislative wins, Medicaid redetermination, “junk insurance,” and state Medicaid programs carving out pharmacy benefits.

The announcement of the $10.6 billion acquisition comes a few months after the company announced it was buying Signify Health, a home health provider, for $8 billion.

Testing and effective treatment of hepatitis C with the direct-acting antivirals is the most explanation.

Gastroesophageal reflux disease is a risk factor for what is now the more common type of esophageal cancer, adenocarcinoma. Immunotherapy is coming on strong as a treatment.

In this month’s episode of Tuning In to the C-Suite, Managing Editor Peter Wehrwein talks with Rick Bates, MBA, president and CEO of RxSense. In his conversation with Wehrwein, Bates described RxSense as a “technology platform company that has expertise in the direct-to-consumer business.” He emphasized that RxSense is not a pharmacy benefit manager (PBM) — but, rather, a company that supplies PBMs with technology, including some of the up-and-coming PBMs, such as EmsanaRx and Vivid Clear Rx. Bates and Wehrwein also discussed the Mark Cuban Cost Plus Drug and RxSense launching a standalone business intelligence product called Rx IQ.

Larger payers have plenty of cash on hand to do deals but will look for “adjacencies” rather than merger and acquisition with other payers because of the regulatory environment, say Bain experts.

Amgen says it will sell the first biosimilar to Humira on the U.S. market at two prices.

The Risk Adjustment Data Validation (RADV) rule was finalized today. The new rule for governing how CMS audits Medicare Advantage plans for overpayment due to inflated risk adjustment could cost insurers billions of dollars.

How successful accountable care organizations (ACOs) have been in bringing about value-based care hinges, of course, on how success is defined. CMS’ comprehensive end-stage renal disease (ESRD) care model is a good example.