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The $56,000 price tag is a rational response to an irrational insurance system, says a Berkeley Public Health economist in an opinion piece in this week’s New England Journal of Medicine.

Briana Contreras, associate editor of Managed Healthcare Executive spoke with WellRight CEO, Neepa Patel, on the topic of wellness programs in healthcare and the need for employers and health plans to roll out new, effective, holistic and innovative programs for patients. Patel did discuss the challenges that some organization can face when rolling out these programs, but she explained how accessible, affordable and beneficial these programs are for patients mental health and wellbeing.

When women are underrepresented in healthcare — half of our world’s population becomes at-risk.

The traditional dividing line between transmission by droplets and smaller aerosols is incorrect, say the authors of a Annals of Internal Medicine review paper, and infection control measures need to reflect the new understanding that respiratory viruses spread in respiratory particles of all sizes and perhaps mainly in aerosols.

The incidence of brain swelling was highest in the group of patients who received the highest doses of Aduhelm, as well as the group of patients who are carriers of the APoE gene.

The shift to value-based care in the U.S. has been slow in coming, in large part because providers have continued to cling to the traditional “fee for service” healthcare model that historically has worked well for them.

Several new generics have launched in the United States, including for the migraine therapy Zomig, the anticancer therapy Doxil, and an anti-inflammatory used to treat respiratory conditions associated with COVID-19.

Two key health provisions in the House “BBB “ would empower CMS to negotiate the prices of 10 drugs starting in 2023 and put a limit of $2,000 on Medicare Part D annual out-of-pocket costs.

U.S. workers plan to spend more time reviewing their healthcare options and enrolling in new benefits during this enrollment period

Momentum is building for biosimialrs but robust coverage for lower-cost agents, including biosimilars, is needed.

As industries across the board move towards a digital-only world, pharma companies must account for the different technologies that are transforming the R&D process.

In COVID-19 news, FDA expands EUA for Moderna/Pfizer boosters and Pfizer seeks EUA for oral antiviral. Keytruda receives another indication, first therapy is approved for dwarfism, FDA extends review of mavacamten, and Gilead submits application for chronic hepatitis therapy.

The decision on the fate of the novel therapy for hypertrophic cardiomyopathy was delayed because the agency said it needed more time to consider the risk evaluation and mitigation strategy (REMS) for the drug.

Using predictive analytics to address social determinants of Health and transportation barriers.

JAMA Internal Medicine editor and a UCSF colleague wrote in a New England Journ of Medicine opinion piece that the decision highlights the need to establish a new requirement that would make coverage decisions contingent on evidence of benefit for Medicare population.

Seventy-one percent of healthcare executives agree that shifting home-based cancer care to their healthcare organizations as soon as possible will create "organizational success," according to a Reimagine Care survey.

In this week’s episode Briana Contreras, associate editor of Managed Healthcare Executive, met with Greg Miller, vice president of Industry Strategy, Healthcare and Life Sciences at Talkdesk. The two discussed that while virtual care has become a convenient tool in healthcare during the pandemic and has helped treat more patients, this form of care isn’t completely solving patient’s underlying issues. However, Miller shared how AI is helping ease the patient experience and improving care in this conversation.

ICER’s review indicates that Humira’s price increases are not supported by new clinical evidence.

Despite advances in medical science and technology, our healthcare system doesn’t always translate knowledge into practice. All too often, this leaves healthcare providers questioning the key business decisions that impact patient care. What caregivers need is a model for applying new technology safely and appropriately. Thankfully, such a model exists: the High Reliability Organization (HRO) model.

A new study suggests clinicians might be able to use metabolic “fingerprints” to better understand the likely severity of individual cases.

Collaboration among stakeholders is needed to increase transparency of pharmacy payment programs and to better align the design of these models with good patient care.

Branded and unbranded versions of the interchangeable biosimilar to treat patients with diabetes are now available.

Investigators in Japan have developed a new, noninvasive method for screening for spinal muscular atrophy using saliva analyzed with conventional PCR as an alternative to blood-based genetic screening.

The integration of virtual and in-person care, and expansion of mental health services is among the top health and well-being trends for next year.

Long term care industry facing worst job loss among all healthcare providers.

President Biden nominates new FDA commissioner, and the agency has approved a liquid form of a seizure medication and a new treatment for a rare blood disease. The FDA also accepted a supplemental NDA for Jardiance this week.

For health insurance executives, pursuing the Quadruple Aim is the name of the game.