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Who Will Benefit Under the Medicare Part D Out-of-Pocket Spending Cap?

02/27/2024

Starting in 2024, Medicare Part D enrollees could benefit from a cap placed on out-of-pocket drug spending, thanks to a provision in the Inflation Reduction Act of 2022 (IRA).

Starting in 2024, Medicare Part...

02/27/2024

First Report Managed Care

News

Alternative Funding Programs: A Tempting Choice Laden With Risks

02/26/2024

Dean Celia ;

The escalating concern over specialty drug costs for employers and health plan executives is driven by significant spending increases, reaching $315 billion in 2022, with specialty drugs comprising 50% of total spending despite their low...

The escalating concern over...

02/26/2024

First Report Managed Care

News

Latest Formulary Exclusions from Top PBMs Demonstrate Issues in the Drug Pricing Landscape

02/21/2024

Dean Celia ;

Experts highlight the impact of the "warped incentives" in drug pricing's gross-to-net bubble, revealing that despite significant discounts, certain biosimilars are excluded from the formularies of major pharmacy benefit managers, leading to...

Experts highlight the impact of...

02/21/2024

First Report Managed Care

News

Assessing the 2024 Medicare Fee Changes: Impact on Physicians, Payers, and Value-Based Care

02/20/2024

Dean Celia ;

The 2024 Medicare physician fee schedule final rule, after evaluation using the fee schedule look-up tool and input from 2 experts, presents a mixed picture for primary care physicians (PCPs) and potential improvements for specialists, though...

The 2024 Medicare physician fee...

02/20/2024

First Report Managed Care

News

FTC and HHS Launch Joint Inquiry into Generic Drug Shortages: Seeking Public Input on GPOs and Wholesalers

02/16/2024

Danielle Sposato ;

In a news release published on February 14, 2024, the US Department of Health and Human Services (HHS) issued a "Request for Information" in collaboration with the Federal Trade Commission (FTC). This request aims to gain insight into how...

In a news release published on...

02/16/2024

First Report Managed Care

News

Medicare Drug Price Negotiations and Anticipated Ripple Effects

02/15/2024

Paul Nicolaus ;

The arrival of the Inflation Reduction Act has ushered in a new era of drug price regulation, giving the Centers for Medicare & Medicaid Services (CMS) the ability to negotiate directly with companies that make some of the costliest drugs...

The arrival of the Inflation...

02/15/2024

First Report Managed Care

News

Dairy, Gluten Show No Major Effect on MS Activity and Quality of Life

02/15/2024

Jolynn Tumolo ;

Dairy and gluten intake had no substantial effects on disease activity and quality of life in a retrospective study of 186 patients with multiple sclerosis (MS). Researchers published their findings online in Multiple Sclerosis Journal –...

Dairy and gluten intake had no...

02/15/2024

First Report Managed Care

News

What Do the Drug Price Changes Announced in January Tell Us?

02/14/2024

Dean Celia ;

The initial findings regarding the changes in prescription drug prices for 2024 have arrived. In this summary, we’ll outline shifts and seek insights from Edmund J Pezalla, MD, founder and CEO, Enlightenment Bioconsult, examine underlying...

The initial findings regarding...

02/14/2024

First Report Managed Care

News

Comparative Effectiveness for Bronchodilator Responsiveness Testing

02/09/2024

Emry Lloyd ;

A new study compares the efficacy of salbutamol administration via a nebulizer vs a metered-dose inhaler with a spacer for bronchodilator responsiveness testing.

A new study compares the...

02/09/2024

First Report Managed Care

News

Impact of Brolucizumab on Choroidal Morphology in Neovascular AMD: Insights From a Comparative Study

02/07/2024

Lisa Kuhns , PhD, MD;

Brolucizumab significantly impacts choroidal morphology in eyes affected by type 1 neovascular AMD, according to a study published in Scientific Reports.

Brolucizumab significantly...

02/07/2024

First Report Managed Care

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Projections of Hepatitis C and Advanced Liver Disease

10/22/2012

San Diego—Between 2008 and 2015, the number of patients with advanced liver disease is expected to increase from 195,000 to 601,000, with people born from 1945 to 1964 representing >75% of the cases, according to a study of adjudicated...

San Diego—Between 2008 and 2015,...

10/22/2012

First Report Managed Care

News

CMS to Investigate Improper Steering of Medicare, Medicaid Patients to ACA Plans

08/19/2016

The CMS told provider and provider-affliated organizations to stop steering Medicare eligible patients into insurance plans on the ACA Marketplace.

The CMS told provider and...

08/19/2016

First Report Managed Care

News

Categorizing Disease Activity in Ankylosing Spondylitis: SASDAS vs ASDAS

09/09/2022

Jolynn Tumolo ;

Researchers compared the Ankylosing Spondylitis Disease Activity Score to a simplified version of the tool to categorize patients’ disease.

Researchers compared the...

09/09/2022

First Report Managed Care

News Connection

Platelet Inhibition to Bridge Patients for CABG

03/16/2012

Mary Mihalovic ;

The use of cangrelor, an intravenous antagonist of the P2Y12 receptor, to bridge patients after they discontinue antiplatelet therapy in preparation for coronary artery bypass graft (CABG) surgery, was shown to effectively provide platelet...

The use of cangrelor, an...

03/16/2012

First Report Managed Care

News

The Basic Health Program Option under Federal Health Reform: Issues for Consumers and States

04/08/2011

First Report Managed Care

Video Insights

Videos

Bridging the Gaps in Prior Authorization: Challenges, Solutions, and Collaboration for Better Patient Care

11/13/2024

David Sand, MD, MBA, chief medical officer at ZeOmega, discusses the challenges of prior authorization, emphasizing the need for transparency, evidence-based standards, collaboration between payers and providers, and the potential for...

David Sand, MD, MBA, chief...

11/13/2024

First Report Managed Care

Videos

The Evolving Role of CGRP-targeting Therapies in Migraine Prevention

10/31/2024

Richard Lipton, MD, provides insights on the American Headache Society’s position statement update on calcitonin gene-related peptide (CGRP)-targeting therapies as a first-line option for the prevention of migraine.

Richard Lipton, MD, provides...

10/31/2024

First Report Managed Care

Videos

Unmet Needs in the Treatment and Management of Non–Small Cell Lung Cancer

09/26/2024

Alexander Spira , MD, PhD;

Alexander I. Spira, MD, PhD, discusses significant unmet needs in the treatment and management of non–small cell lung cancer (NSCLC).

Alexander I. Spira, MD, PhD,...

09/26/2024

First Report Managed Care

Videos

Treatment Options for NSCLC: A Discussion on Coverage, Clinical Outcomes, and Payer Perspectives

09/25/2024

Learn about research developments in 1L therapy for NSCLC patients with EGFR mutations and how outcomes may impact coverage and reimbursement decisions for insurers.

Learn about research...

09/25/2024

First Report Managed Care

Videos

Addressing the Root Cause of a Common Ocular Condition: A Virtual Roundtable

09/04/2024

View a roundtable discussion on Demodex blepharitis, a prevalent ocular condition that often goes undiagnosed in patients.

View a roundtable discussion on...

09/04/2024

First Report Managed Care

Videos

Addressing Health Disparities and Promoting Equity: The Role of Advanced Imaging Solutions

08/15/2024

Guest expert Jordan Bazinsky discusses the challenges facing the medical imaging industry, the potential of AI and emerging technologies, the role of advanced imaging solutions in promoting health equity, and the key trends and challenges...

Guest expert Jordan Bazinsky...

08/15/2024

First Report Managed Care

Videos

Promising Therapies and Clinical Trials for Chronic Lymphocytic Leukemia

08/14/2024

Farrukh T. Awan , MD;

Farrukh Awan, MD, highlights promising therapies and clinical trials within the field of chronic lymphocytic leukemia (CLL).

Farrukh Awan, MD, highlights...

08/14/2024

Journal of Clinical Pathways

Videos

Evolving Health Care Contact Centers Into Drivers of Value-Based Care

07/31/2024

Discover how health care contact centers can transform into drivers of value-based care through AI, automation, upskilling agents, and rethinking workflows and metrics to improve patient outcomes and population health.

Discover how health care contact...

07/31/2024

First Report Managed Care

Videos

Enhancing Patient Medication Adherence: Insights and Strategies From Asembia 2024

06/11/2024

Lucille Accetta, PharmD, MBA, MSPH, Senior Vice President of CVS Specialty Operations

Key stakeholders in the health care industry gathered to discuss prevalent topics at this year's Asembia annual summit. Medication adherence emerged as one of the most talked-about issues. In a session led by Lucille Accetta, PharmD, MBA,...

Key stakeholders in the health...

06/11/2024

First Report Managed Care

Melissa Andel, Principal, CommonHealth Solutions, LLC

Videos

Navigating the Impact of the Inflation Reduction Act: Implications for Payers, Patients, and Manufacturers

05/24/2024

Melissa Andel, Principal, CommonHealth Solutions, LLC

Learn about the impacts of the Inflation Reduction Act on payers and patients, highlighting the changes in Medicare benefits and drug coverage coming in 2025 and 2026.

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