Alina Czekai, M.P.H., vice president of value-based care strategy at Cohere Health, a patient-centric, digital health company committed to streamlining the prior authorization process, is one of the 12 up-and-coming leaders in healthcare included in the annual Managed Healthcare Executive feature.
Healthcare beyond the doors of the doctor’s office has the potential to offer more care to more people. But payers need to think about how to ensure that care is consistent. Regardless of the setting, care decisions must be based on evidence-based content and supported with strong patient education.
The FDA has approved Reblozyl as first-line treatment in MDS-related anemia and the first generics of ADHD drug Vyvanse. The agency also issued a CRL for bevacizumab to treat wet AMD. Additionally, two companies have submitted supplemental applications. These include Janssen, which is seeking full approval for Balversa for urothelial carcinoma, and AbbVie, which is seeking approval of Skyrizi for ulcerative colitis.
A special registration process could strike the right balance between increasing access to the drug used to treat opioid use disorder while limiting diversion and possible misuse, say an MHE editorial advisory board member and two co-authors.
Magellan Rx Management has begun providing a multi-state solution in which they negotiate with drug manufacturers for value-based contracts for high-cost gene and cell therapies.
In this opinion piece, Karen shares some of the critical issues related to re-enrolling members subject to Medicaid redetermination and covers some of the most important critical success factors for organizations seeking to optimize their response.
Proponents hailed yesterday's announcement of the first 10 drugs subject to Medicare "maximum fair price" starting in 2026 as ushering in an era of lower drug prices and a political victory over pharma. Critics said it is price controls masquerading as negotiation and would smother innovation in one of the most innovative industries in the U.S.
Topping the list is Eliquis, which accounted for $16.48 billion in spending for the 3.7 million people in Medicare Part D who take the blood thinner.
By customizing collaborative models of at-home care to the health needs of the community and the business needs of key stakeholders, organizations can develop an innovative model that achieves mutual goals while strengthening health outcomes, access, and satisfaction.
Researchers of a recent study compared the clinical presentation and treatment outcomes of people with HIV and HIV-negative persons with monkeypox who were treated with tecovirimat, as it was previously unclear if treatment outcomes differed between those with and without HIV.
The FDA has approved the first biosimilar of MS drug Tysabri and granted additional approvals to Abrysvo to prevent RSV in infants, to a higher dose Eylea, and to Ingrezza for a disorder associated with Huntington’s disease. The agency has also set a review date for first-in-class therapy for MDS and granted priority review to Xtandi for earlier treatment in prostate cancer.
The rise in the volume, variety and complexity of tests holds great promise for improving healthcare for patients, but also poses challenges for providers and health plans
A retrospective study found that chronic hepatitis B-related hepatocellular carcinoma (HCC) patients with metabolic-associated fatty liver disease (MAFLD) had better outcomes than patients who did not have MAFLD.
Sandoz’s Tyruko, the first biosimilar to Biogen’s Tysabri, is expected to be available as soon as possible. Pricing has not yet been made available.
Cigna Healthcare has removed prior authorization requirements for a wide range of tests, treatments and medical equipment, but not prescription drugs.
Despite positive safety and quality of life results for FEIBA, the emergency of Hemlibra created difficulties for the FEIBA study and resulted in it being halted.
Since the introduction of direct-acting antiviral therapies, which boast a 95% cure rate, the reported number of HCV cases has fallen.
Patients with atopic dermatitis (AD) and caregivers of children with AD highlighted strategies that they felt would manage AD-related mental health burden.
In a study recently published in Neurology, researchers investigated the relationship between early treatment and the risk for long-term disability in patients with clinically isolated syndrome.
TimelyCare, a virtual care company focused on higher education, offers counseling and behavioral health services around the clock.
Cindy Gaines, MSN, RN, chief clinical transformation officer at Lumeon, shared how automation creates more efficiency in different facets of the workplace when it comes to balancing less staff with an increase of patients.
It was a busy week for the FDA. Regulators approved several new therapies, including the first for a rare bone disorder, a combination product for metastatic prostate cancer and a long-acting botulinum toxin for cervical dystonia, as well as an accelerated approved for multiple myeloma. The agency also set review dates for three products, including for full approval of Tarpeyo for a rare kidney disease, an additional indication for Tibsovo for myelodysplastic syndromes and a combination antibiotic for complicated UTIs.
About 20% to 30% of patients with ulcerative colitis will experience acute severe ulcerative colitis in their lifetime.
The patient was in her 70s and began experiencing the floaters the day after undergoing treatment.
Blue Shield is replacing CVS Caremark with Prime Therapeutics as the company that will negotiate with drug manufacturers beginning in January 2025. The insurer is also teaming up with Mark Cuban Cost Plus Drug Company and Amazon Pharmacy.
Cindy Gaines, MSN, RN, chief clinical transformation officer at Lumeon, addresses the current status of electronic health records in the healthcare industry and how automation is filling in its gaps through technology.
