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The 2023 CMS Physician Fee Schedule Final Rule has been released, and in a mere 3,304 pages, CMS has largely finalized its proposals from over the summer.

The fight to put the consumer first in healthcare remains as many Americans feel the industry is still putting the mighty dollar ahead of patients.

The reference to “maximum fair price” in the act bodes poorly for manufacturers and suggests more of a take-it-or-leave-it situation rather than a negotiation where clinical evidence would be the prevailing factor in determining price.

In a busy week, the FDA approved the first drug to delay diabetes, a second interchangeable Lantus biosimilar, and an alternate dosing schedule for Rylaze. The agency also granted accelerated approval of a novel ovarian cancer therapy, updated the target date for pegcetacoplan NDA review, and proposed prescription-to-OTC naloxone. In addition, an advisory committee supported the use of Xphozah in CKD.

OptumRx will offer Amjevita and two other biosimilars alongside Humira. OptumRx is the first large PBM to make public its plans for the seven Humira biosimilars that may come on the market next year.

Job candidates need to be shown that the workplace is flexible and set up to accommodate their individual needs.

In this episode of Tuning In to the C-Suite, Briana Contreras, editor with Managed Healthcare Executive spoke with Dr. Yuri Fesko, oncologist and vice president of Medical Affairs at Quest Diagnostics. In the conversation, Dr. Fesko addressed the ongoing issue of long gaps of times between receiving a diagnosis for a type of cancer and finally getting the treatment for it. Dr. Fesko shared the benefits a number of sectors receive when treating patients sooner and the steps to get there.

Past studies have linked epicardial fat to a variety of other heart problems, including diastolic dysfunction, atrial inflammation and atrial systolic function disorders.

The FDA approved several new therapies for cancers, including the combination of Imfinzi and Imjudo to treat lung cancer, Libtayo for second indication in lung cancer, and Adcetris for younger patients with Hodgkin lymphoma. In COVID-19 news, the agency issued an EUA for Kineret for hospitalized, but indicated bebtelovimab does not neutralize new omicron subvariants. The regulatory agency also accepted NDAs for a Parkinson’s disease therapy and for a therapy used for stem cell mobilization.

More practices are directly dispensing oral cancer drugs, bypassing specialty pharmacies. What does this trend mean for patients and healthcare?

Adherence to follow-up examinations is crucial for early identification of recurrence of chronic rhinosinusitis with nasal polyps (CRSwNP).

The tool successfully identified children with high asthma risk as young as 3 years of age. The screening tool was found to be more accurate at predicting asthma, persistent wheezing, and related emergency room visits and hospitalizations than standard screening and diagnostic tools.

Despite differing characteristics, patients have similar responses to treatment regardless of when they were diagnosed with eosinophilic esophagitis (EoE).

Abortion access was a key issue in Pennsylvania and other battleground states. The Affordable Care Act receded into the political background, although voters in South Dakota approved a ballot measure that expanded Medicaid, leaving just 11 states that haven't done so.

The company has made digital health a major focus of its research pipeline in multiple sclerosis.

Symptoms of chronic rhinosinusitis with nasal polyps can be a burden for patients, but Dupixent was able to successfully reduce the number of days with severe symptoms.

Members who receive healthcare through Point32Health Inc.’s programs will now be able to access a device called Nerivio.

The FDA has approved a hepatitis B therapy for adolescents and an oral MEK inhibitor to treat blood cancers. The regulatory agency has granted priority review for an adult RSV vaccine but extended the review for a Pompe disease therapy. Additionally, CytoDyn has withdrawn its BLA for an HIV therapy.

Gilead Sciences reported results from several studies of its antiretroviral.

In a conversation with Managed Healthcare Executive®, Genoa Healthcare Sales Director Jennifer Finocchiaro discusses social determinants of health, the LGBTQ+ community and the demographic contours of the HIV/AIDS epidemic.

Overall survival is considered a more definitive end point. But according to Vinay Prasad, M.D., M.P.H., and colleagues , drugs approved based on progression-free survival and overall response rate were priced higher than those approved based on overall survival.

Thirty-seven percent of insured Americans whose annual income is $80,000 or more even said they avoided care because of cost concerns.

If South Dakota voters approve a ballot initiative on Nov. 8, that will leave 11 states that have not expanded their Medicaid programs under the ACA.

The FDA approved two new novel cancer treatments: a bispecific antibody for multiple myeloma and a regimen of two drugs for liver cancer. The agency also granted priority review to two therapies. One is a novel therapy for C. difficile and the other is for a acute myeloid leukemia drug. The FDA has postponed an advisory committee meeting for an OTC birth control pill and accepted an NDA for new dry eye therapy. Additionally, Genmab submitted applications for a bispecific therapy for large B-cell lymphoma.

This year, funding fell from $10.5 billion in the first quarter down to the lowest funding has been at $4.6 billion today, according to a report from HealthcareDive.

These areas in the new MA territory and existing ones can enjoy some of Cigna's new benefits this year.

The state's child uninsured rate dropped to 6.6% in 2021, its lowest level in recent history. This drop represents a 19% decline from a peak of 8.1% in 2018.

Cigna’s Express Scripts will now manage Centene’s pharmacy benefit services to make prescription medications more accessible and affordable for customers. The multi-year partnership is slated to officially begin Jan. 1, 2024.