The IQVIA vice president and frequent speaker at pharmaceutical and managed care meetings shares some insights after he delivered the keynote talk at 2024 PBMI Annual National Conference held last week in Orlando, Florida. Long, a well-known figure in managed care circles, announced at the PBMI meeting that he is retiring in 2025.
The rule places new requirements on plans, including making sure prior authorization and other utilization management tools for mental health are not stricter than those used for medical benefits.
Women with disadvantaged backgrounds may also benefit more than women with a higher socioeconomic status, study results show.
Kerri Tanner, Pharm.D., chief pharmacy officer of PayerAlly, discusses the dynamic pricing models of Waltz Health and Free Market Health as a way for independent specialty pharmacies to compete.
The researchers took what they said was a conservative approach when plugging variables such as one-time and future costs into their updated model.
Many provisions of the Affordable Care Act are popular and the healthcare reform law has brought the proportion of Americans without healthcare insurance down to an all-time low. As president, Donald Trump backed "repeal and replace" efforts.
Entyvio (vedolizumab) and Xeljanz (tofacitinib) are the most commonly studied therapies, according to the Pfizer-sponsored review, and when the two were compared, Xeljanz showed higher remission rates.
The two clinical trials will enroll patients recovering from surgical procedures.
Here's what you missed this week on Managed Healthcare Executive.
Kerri Tanner, Pharm.D., the chief pharmacy officer of PayerAlly, says payers are looking for ways to rein in the escalating costs of specialty pharmacy drugs beyond the traditional techniques used by pharmacy benefit managers.
Patrick Cooney, president of The Federal Group, says elimination of spread pricing is one of the three key elements of the PBM legislation that he believes is likely to pass during the lame-duck session of Congress after the Nov. 5 election.
Greg Baker, CEO of AffirmedRx, did not hold back in criticizing CVS Caremark, Optum Rx and Express Scripts and their group purchasing organizations today at the PBMI Annual National Conference.
Patrick Cooney, president of The Federal Group, a Washington, D.C., lobbying firm says prospects for legislation passing this year, albeit during the post-election lameduck session, are good partly because the PBM legislation would produce Medicare savings that could be put toward other uses.
Telehealth has become a permanent part of U.S. healthcare delivery, and states are taking steps to regulate it
The IQVIA vice president and frequent speaker at pharmacy and managed care meetings said he will retire in May 2025.
HIV treatments using a single pill improve adherence and are cheaper to maintain.
Pharmacy benefit managers aren't getting mentioned on the campaign trail, but there are some signs Congress could enact reform legislation after the Nov. 5 election.
Joseph Shields of TransparencyRx predicts there will be more lawsuits against self-funded employers alleging they’ve mismanaged prescription drug benefits through PBMs.
During an interview, Joseph Shields of TransparencyRx discusses the PBM legislation that is expected to move forward in Congress in the next few months.
Breast cancer patients were also less likely to have a breast reconstruction than patients living elsewhere.
A nomogram based on four pulmonary factors is helpful but not a substitute for clinical judgment, say the authors.
Reproductive rights and abortion: The hottest healthcare issue
Individualized digital twins offer the prospect of better predicting individual patients’ disease progression and response to therapy.
Cell and gene therapies are becoming almost an everyday clinical reality. But the price tags? They still have shock value. Payers and providers are working out single-case agreements ahead of when the therapies are given.
A positive result for Bruton’s tyrosine kinase inhibitor after the drug had been put on partial clinical hold due to concerns about liver toxicity.
Sebetralstat would be the first oral, on-demand treatment for hereditary angioedema if approved.
As supplemental screening for breast cancer becomes more common, the modeling study supplies long-term projections of how many deaths could be averted but also how many false-positive biopsy recommendations would be added.
The approval comes five months after the FDA approved Winrevair.
