Coverage models evolving to drive out waste, improve care

Treating hidradenitis suppurativa is complex and often requires taking a number of medications, including antibiotics, hormone therapies and immunosuppressants. However, many of these treatments are used off-label, and at this time, only two biologic therapies—Humira (adalimumab) and Cosentyx (secukinumab)— are approved by the FDA for HS treatment.

Perry Cohen, Pharm.D., a longtime member of the Managed Healthcare Executive editorial advisory board, is host of the Conversations with Perry and Friends podcast. His guest this episode is John Baackes, the former CEO of L.A. Care Health Plan.

Payers and providers, often depicted as rivals, are on the same side when it comes to the 340B program that allows some hospitals to buy drugs at steep discounts, according to Milliman experts.

Featured in this latest episode of Tuning In to the C-Suite podcast is Paul Fronstin, director of health benefits research at EBRI, who shed light on the evolving landscape of health benefits with editors of Managed Healthcare Executive.

During the first quarter of 2025, CVS Health recorded a premium deficiency reserve of $448 million within its individual exchange business.

Effective July 1, 2025, CVS Caremark will place Wegovy injection 2.4 mg as preferred on its commercial template formularies.