News

Abarca’s Javier Gonzalez discussed the advantage of health plans insourcing PBM services in an à la carte fashion.

Treatments aimed at certain mutations have proliferated and moved upstream to earlier-stage lung cancers. But there are many questions about insurance coverage and which tests to use to identify the biomarkers that help guide treatment.

Government regulations are designed to encourage data fluidity in healthcare, which could "radically empower" consumers, said Kim Diehl-Boyd, CoverMyMeds vice president of industry relations and government affairs, at the 2021 Annual National Conference of the Pharmacy Benefit Management Institute.

Amazon is gearing up for an era that includes telehealth and home testing, but the former FDA commissioner says the new model is more than a logistics challenge and that healthcare companies will prevail.

OptumRx SVP Kerri Tanner, RPh, Pharm.D., said management of specialty medications cannot be delivered in pieces and that innovation is needed to curb the tendency toward fragmentation.

Senior Vice President of OptumRx, Savitha Vivian, shares with MHE when expected upcoming biosimilars are coming to market and the challenges she's seeing with biosimilar acceptance.

High hopes for COVID-19 vaccine for children before the end of the year, Breakthrough Designation for Jardiance, thumbs down on an EUA for cytokine storm therapy and no decision yet on Juul's vaping products.

In an interview with MHE, SVP Savitha Vivian said the biosimilars to Humira and Novolog that are expected to be on the market in the next few years could have the kind of impact that proponents of biosimilars have been hoping for.

The former FDA commissioner's presentation on Monday will kick off three-day meeting that will cover contracting, drug benefit design, cost containment and a wide range of other pharmacy benefit topics.

Community health workers can address social determinants of health, and some programs have been shown to reduce healthcare costs.

Point32Health is the name of the not-for-profit health care organization formed by the merger of Harvard Pilgrim Health Care and Tufts Health Plan.

A genomic analysis of the lung cancer tumors of 232 never smokers grouped them into three categories with musical names: piano, mezzo-forte and forte.

Medicare funding shortfalls may trickle down to the Medicare Advantage plans and the Star Rating program bonuses, which have quadrupled in recent years.

Japanese researchers say their study suggests that atrial fibrillation may trigger adverse events in HCM patients.

With healthcare costs outpacing income growth and health insurance deductibles increasing by 212% over the past decade, many patients are left feeling that their health insurance doesn’t provide as much value as it did 10 years ago.

Investigators find there is strong adherence soon after patients fill prescriptions but less consistent use after initial treatment.

Prices in American healthcare are difficult to nail down because they are obscured by secret negotiations between payers and providers and, in the case of drugs, pharmaceutical manufacturers. But that is beginning to change.

For an assortment of reasons, the federal government hasn’t taken any action on regulating drug prices, so a handful of states have taken matters into their own hands.

Patients faced with high out-of-pocket costs sometimes delay seeking care for appendicitis or diverticulitis, which can result in higher overall costs, increased risk of mortality, and a worse quality of life.

A large Netherlands study demonstrated that rituximab biosimilars (R-biosimilars) produced a 43% reduction in annual costs. In addition, three-year overall survival did not differ between diffuse large B-cell lymphoma (DLBCL) and those receiving rituximab, according to the researchers.

The CDC and the FDA have updated their recommendations for the 2021-2022 flu season.

Lack of antibodies from vaccination mainly affects patients with B cell cancers. Experts say antibodies are just one piece of the puzzle and that other aspects of the immune system fend off serious cases of COVID-19.

The researchers suggest that additional support may be needed to ensure continuous and potentially increased use of antiretroviral treatment and medication for opioid use disorders and subsequent viral suppression.

Approvals for a twice-yearly schizophrenia therapy and a seizure drug for infants, a full approval for Keytruda, and a revised EUA for a COVID-19 therapy round out the week.

U.S. hospitals are spending $310 million annually to manage the additional clinical, operational, logistical, and patient care work associated with white and brown bagging requirements, according to a new report.

Almost 21% of adults were uninsured in states that failed to expand Medicaid, compared to about 10% of adults in expansion states.

Three notable medications to treat liver diseases are expected to come online in the third quarter of 2021 and in 2022, according to PBM OptumRx.