News

A recent study predicts a $34 to $145 billion annual cost for semaglutide due to Medicare’s decision to cover semaglutide for overweight patients with cardiovascular disease.

Here’s what you missed this week on Managed Healthcare Executive.

CMS will provide key logistical support to states that participate in its outcomes-based funding model for gene therapy treatment for sickle cell disease.

Virtual care offers a significant opportunity to bridge the gap between supply and demand in behavioral health services. However, there are risks associated with the lack of integration between virtual care and traditional healthcare systems, particularly in medication management.

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.

Specialty drugs and catastrophic claims are among those that contribute to the increase.

Having a first-degree relative with colorectal cancer increases risk by two to four times.

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

Manuka honey inhibited the growth of breast cancer tumors by 84% in mice.

Death and infection rates this year caused by the latest clade 1b strain have already surpassed last year's numbers. At this time, it’s unclear if having HIV increases the risk of mpox.

Gene therapy is enormously complicated, inefficient and slow. Early tests of a newly developed machine learning model show how much faster, and more efficient, it might be.

The key to lowering gene therapy costs – and getting treatments to where they are most needed – could be making them in middle- low-income countries, argue the authors of a recent commentary in Nature.

Here’s what you missed this week on Managed Healthcare Executive.

The Rx Save Card is a new, employer-funded, pre-paid pharmacy discount service that allows consumers to pick between PBM prices and prices available through traditional discount cards.

The Medicare program is expected to see some aggregate savings from the negotiated drug prices. Beneficiaries, because of out-of-pocket caps next year, may not see the benefit, that is until the next round or two of negotiations if CMS choses drugs that are not heavily rebated.

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

This therapy is a first-in-class treatment for chronic graft-versus-host disease, which develops in roughly 42% of those who receive a stem cell of bone marrow transplant.

The negotiated prices range from 38% to 79% discounts off of list prices, according to the Department of Health and Human Services.

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

The system, called ThecaFlex DRx, allows subcutaneous administration of Spinraza (nusinersen) directly into the cerebrospinal fluid, and aims to replace the current administrative route through lumbar punctures.

In 2016, Medicare expenses for traumatic brain injuries totaled more than $16 billion and car crashes were the third-leading cause of hospitalizations, emergency room visits and deaths.

The KFF analysis reported on the number of prior authorizations by plans, but found the data do not contain enough information to assess prior authorization by type of service, type of plan or reasons for denials.

Although half of all BRCA1 and BRCA2 mutation carriers are men, cancer screening rates lag when compared with women.

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

Healthcare organizations need prompt, actionable advice to enhance their cyber resilience, ensuring more secure and convenient communications and services for patients, shareholders, third parties, staff, and other affiliates moving forward.

Director, specialty clinical solutions, Prime Therapeutics LLC, a pharmacy benefits manager in Eagan, Minnesota