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April 2017 - FRMC

Department
Xarelto Reduces VTE Recurrence Compared to Aspirin
04/19/2017
Researchers showed that a low dose of Xarelto reduced the risk of venous thromboembolism (VTE) in patients at high risk for a recurrence of blood clots.
Researchers showed that a low dose of Xarelto reduced the risk of venous thromboembolism (VTE) in patients at high risk for a recurrence of blood clots.
Researchers showed that a low...
04/19/2017
First Report Managed Care
Department
SGLT-2 Inhibitors Reduce Risk of Hospitalization Among Type 2 Diabetes Patients
04/19/2017
Treatment with sodium glucose cotransporter-2 (SGLT-2) inhibitors significantly reduced risk of hospitalization for heart failure and all-cause mortality.
Treatment with sodium glucose cotransporter-2 (SGLT-2) inhibitors significantly reduced risk of hospitalization for heart failure and all-cause mortality.
Treatment with sodium glucose...
04/19/2017
First Report Managed Care
Department
Repatha Decreases Risk of Cardiovascular Disease-Related Death
04/19/2017
According to research, use of the PCSK9 inhibitor Repatha reduced the risk for death by lowering levels of low-density lipoprotein, also known as “bad cholesterol.”
According to research, use of the PCSK9 inhibitor Repatha reduced the risk for death by lowering levels of low-density lipoprotein, also known as “bad cholesterol.”
According to research, use of...
04/19/2017
First Report Managed Care
Department
Novel Intranasal Naloxone Device Successfully Reduces Opioid Overdose Deaths
04/19/2017
A study found that deployment of intranasal naloxone delivery devices in emergency overdose situations reduces the risk of death from opioid overdose.
A study found that deployment of intranasal naloxone delivery devices in emergency overdose situations reduces the risk of death from opioid overdose.
A study found that deployment of...
04/19/2017
First Report Managed Care
Department
PCPs May Be Exacerbating Opioid Misuse Through Preemptive Dispensing
04/19/2017
According to a study, primary care providers may be dispensing too many opioids before a proper pain diagnosis is made.
According to a study, primary care providers may be dispensing too many opioids before a proper pain diagnosis is made.
According to a study, primary...
04/19/2017
First Report Managed Care
Department
Pain Rehabilitation Program Benefits Older Adults With Chronic Pain
04/19/2017
Research showed that an interdisciplinary chronic rehabilitation program helped to treat older patients with chronic pain. 
Research showed that an interdisciplinary chronic rehabilitation program helped to treat older patients with chronic pain. 
Research showed that an...
04/19/2017
First Report Managed Care
Department
Intensive Outpatient Pain Management Cuts Costs of Treating Chronic Pain Patients
04/19/2017
According to a study presented at the American Academy of Pain Medicine 2017 Annual Meeting, an intensive outpatient program, known as the Medical Pain Service, helped to reduce the costs associated with treating high utilization patients...
According to a study presented at the American Academy of Pain Medicine 2017 Annual Meeting, an intensive outpatient program, known as the Medical Pain Service, helped to reduce the costs associated with treating high utilization patients...
According to a study presented...
04/19/2017
First Report Managed Care
Department
PBMs Must Leverage Power to Manage Costs, Improve Access
04/19/2017
Steve Miller, MD, discussed the negative trends in drug pricing that will require pharmacy benefit managers to leverage their power to stabilize health care costs.
Steve Miller, MD, discussed the negative trends in drug pricing that will require pharmacy benefit managers to leverage their power to stabilize health care costs.
Steve Miller, MD, discussed the...
04/19/2017
First Report Managed Care
Department
New Pricing Strategies Needed to Curb Unsustainable Oncology Drug Spending
04/19/2017
At the PBMI 2017 Drug Benefit Conference, Peter B Bach, MD, discussed how oncology drug spending is accelerating at an unsustainable pace.
At the PBMI 2017 Drug Benefit Conference, Peter B Bach, MD, discussed how oncology drug spending is accelerating at an unsustainable pace.
At the PBMI 2017 Drug Benefit...
04/19/2017
First Report Managed Care
Department
Scott Gottlieb Discusses Policy Solutions for High Drug Prices at PBMI
04/19/2017
At the PBMI 2017 Drug Benefit Conference, Scott Gottlieb, MD, spoke about the political trends affecting drug prices and offered policy solutions.
At the PBMI 2017 Drug Benefit Conference, Scott Gottlieb, MD, spoke about the political trends affecting drug prices and offered policy solutions.
At the PBMI 2017 Drug Benefit...
04/19/2017
First Report Managed Care
News Connection
FDA Grants Fast Track Designation for Investigational Opioid Analgesic
04/19/2017
The FDA granted fast track designation for NKTR-181 (Nektar), a first-in-class opioid analgesic, designed to relieve pain while significantly lowering the risk for abuse compared  with oxycodone, according to a press release from the...
The FDA granted fast track designation for NKTR-181 (Nektar), a first-in-class opioid analgesic, designed to relieve pain while significantly lowering the risk for abuse compared  with oxycodone, according to a press release from the...
The FDA granted fast track...
04/19/2017
First Report Managed Care
News Connection
Dupixent Injection Approved for Atopic Dermatitis
04/19/2017
Dupixent Injection received approval from the FDA for the treatment of adults with atopic dermatitis not adequately controlled with topical prescription therapies.
Dupixent Injection received approval from the FDA for the treatment of adults with atopic dermatitis not adequately controlled with topical prescription therapies.
Dupixent Injection received...
04/19/2017
First Report Managed Care
News Connection
FDA Approves Ocrevus for Primary Progressive MS
04/19/2017
The FDA recently approved Ocrevus (ocrelizumab; Roche) for both relapsing and primary progressive forms of multiple sclerosis (MS). Ocrevus is the first disease-modifying therapy approved to treat primary progressive MS, one of the most...
The FDA recently approved Ocrevus (ocrelizumab; Roche) for both relapsing and primary progressive forms of multiple sclerosis (MS). Ocrevus is the first disease-modifying therapy approved to treat primary progressive MS, one of the most...
The FDA recently approved...
04/19/2017
First Report Managed Care
News Connection
CMS Announces Higher Medicare Advantage, Part D Rate Hikes
04/19/2017
The Centers for Medicare and Medicaid Services (CMS) recently released final rate updates to its Medicare Advantage and Part D Prescriptions Drug Programs for 2018, increasing the reimbursement rate for insurers.  
The Centers for Medicare and Medicaid Services (CMS) recently released final rate updates to its Medicare Advantage and Part D Prescriptions Drug Programs for 2018, increasing the reimbursement rate for insurers.  
The Centers for Medicare and...
04/19/2017
First Report Managed Care
News Connection
CVS Health, Novo Nordisk Launch Affordable Insulin Program
04/19/2017
Novo Nordisk recently announced it will partner with CVS Health to launch a prescription savings program—Reduced Rx—that will offer direct-to-patient discounts on insulin medications through CVS Caremark. 
Novo Nordisk recently announced it will partner with CVS Health to launch a prescription savings program—Reduced Rx—that will offer direct-to-patient discounts on insulin medications through CVS Caremark. 
Novo Nordisk recently announced...
04/19/2017
First Report Managed Care
News Connection
Voter Turnout, Medicaid Expansion Programs Linked in Study
04/19/2017
Increases in Medicaid enrollment may be related to higher voter turnout in states that expanded Medicaid, according to Jake Haselswerdt, assistant professor at the University of Missouri. 
Increases in Medicaid enrollment may be related to higher voter turnout in states that expanded Medicaid, according to Jake Haselswerdt, assistant professor at the University of Missouri. 
Increases in Medicaid enrollment...
04/19/2017
First Report Managed Care
Department
Maryland House Passes Bill to Stop Generic Price Gouging
04/19/2017
The Maryland House of Delegates recently passed a bill aimed at preventing drugmakers from price gouging for generic drugs, according to recent reports.
The Maryland House of Delegates recently passed a bill aimed at preventing drugmakers from price gouging for generic drugs, according to recent reports.
The Maryland House of Delegates...
04/19/2017
First Report Managed Care
News Connection
State Senators Propose Single-Payer Health Bill in California
04/19/2017
In an effort to create a universal health system in California, Senators Ricardo Lara (D-Bell Gardens) and Toni G Atkins (D-San Diego) recently announced new, key provisions to their proposed health care bill, the Healthy California Act...
In an effort to create a universal health system in California, Senators Ricardo Lara (D-Bell Gardens) and Toni G Atkins (D-San Diego) recently announced new, key provisions to their proposed health care bill, the Healthy California Act...
In an effort to create a...
04/19/2017
First Report Managed Care
News Connection
House Republicans Pull AHCA Bill Before Vote
04/19/2017
After 7 years of vows to repeal and replace the Patient Protection and Affordable Care Act (ACA), Republicans in the US House of Representatives pulled the American Health Care Act of 2017 (AHCA) bill from the House floor March 24 after it...
After 7 years of vows to repeal and replace the Patient Protection and Affordable Care Act (ACA), Republicans in the US House of Representatives pulled the American Health Care Act of 2017 (AHCA) bill from the House floor March 24 after it...
After 7 years of vows to repeal...
04/19/2017
First Report Managed Care
Managed Care Q&A
Applying Advancements in Clinical Genomics to Reduce Costs
04/18/2017
David Costill
An Interview with Robert Bruce, vice president of reimbursement at Clinical Genomics
An Interview with Robert Bruce, vice president of reimbursement at Clinical Genomics
An Interview with Robert Bruce,...
04/18/2017
First Report Managed Care
News
Navigating the Medical Marijuana Landscape
04/13/2017
Eileen Koutnik-Fotopoulos
As legal adoption of medical marijuana continues, questions regarding the variation in laws between states continue to challenge managed care professionals.
As legal adoption of medical marijuana continues, questions regarding the variation in laws between states continue to challenge managed care professionals.
As legal adoption of medical...
04/13/2017
First Report Managed Care
Managed Care Q&A
Managed Care Innovator: Michael S Barr, MD
04/13/2017
Dean Celia
Michael S Barr, MD, discusses PCMH’s evolution, explains NCQA’s revised recognition program process, and reveals what practices can do now to get ready.
Michael S Barr, MD, discusses PCMH’s evolution, explains NCQA’s revised recognition program process, and reveals what practices can do now to get ready.
Michael S Barr, MD, discusses...
04/13/2017
First Report Managed Care
Department
Health Care Reform: Both Democrats and Republicans Miss the Mark
04/07/2017
Larry Altshuler, MD
Larry Altshuler, MD, shares his insights on both the Republican and Democratic health care reform approaches.
Larry Altshuler, MD, shares his insights on both the Republican and Democratic health care reform approaches.
Larry Altshuler, MD, shares his...
04/07/2017
First Report Managed Care
News
Challenges in Pain Management: Looking to The Future of Pain Management Therapy
04/07/2017
Mary Beth Nierengarten
With a shift away from use of opioid medications, providers and payers are unsure which therapies warrant prescribing and covering.
With a shift away from use of opioid medications, providers and payers are unsure which therapies warrant prescribing and covering.
With a shift away from use of...
04/07/2017
First Report Managed Care
News
The Rise of Genomics Presents Challenges For Managed Care
04/07/2017
Jill Sederstorm
Genomic testing is increasingly being used in clinical settings, but challenges in reimbursement and physician education impact the industry and slow down adoption.
Genomic testing is increasingly being used in clinical settings, but challenges in reimbursement and physician education impact the industry and slow down adoption.
Genomic testing is increasingly...
04/07/2017
First Report Managed Care
Department
Nicotine Dependence Treatment: Keeping an Eye on the Prize
04/07/2017
Scott McIntosh, PhD; Deborah J. Ossip, PhD
Currently, nicotine dependence, particularly smoking, remains the leading cause of morbidity and mortality.
Currently, nicotine dependence, particularly smoking, remains the leading cause of morbidity and mortality.
Currently, nicotine dependence,...
04/07/2017
First Report Managed Care

Pipeline Projections

PIPELINE PROJECTIONS
Emerging Therapies Reshaping Atopic Dermatitis Care
03/26/2026
Roy Moore
Roy Moore outlines how a rapidly expanding atopic dermatitis pipeline is intensifying competition, reshaping payer strategies, and raising the bar for new therapies.
Roy Moore outlines how a rapidly expanding atopic dermatitis pipeline is intensifying competition, reshaping payer strategies, and raising the bar for new therapies.
Roy Moore outlines how a rapidly...
03/26/2026
First Report Managed Care
Pipe
Pipeline Projections
Emerging Migraine Treatments Challenge a Mature Market
11/20/2025
Roy Moore
Roy Moore of Clarivate’s market access team discussed the evolving migraine treatment landscape, highlighting the maturation of the acute and prophylactic markets, the emergence of new therapies such as triptan-COX-2 combinations, gepants,...
Roy Moore of Clarivate’s market access team discussed the evolving migraine treatment landscape, highlighting the maturation of the acute and prophylactic markets, the emergence of new therapies such as triptan-COX-2 combinations, gepants,...
Roy Moore of Clarivate’s market...
11/20/2025
First Report Managed Care
Pipeline Projections
Pipeline Projections
Redefining Asthma Management With Emerging Anti-Inflammatories
10/01/2025
Roy Moore
Roy Moore, a market access expert, discusses the evolving asthma drug pipeline, highlighting upcoming therapies—including Breztri, depemokimab, and masitinib—their potential to improve adherence and outcomes, payer considerations around cost...
Roy Moore, a market access expert, discusses the evolving asthma drug pipeline, highlighting upcoming therapies—including Breztri, depemokimab, and masitinib—their potential to improve adherence and outcomes, payer considerations around cost...
Roy Moore, a market access...
10/01/2025
First Report Managed Care
Pipeline Projections
The Shift in MS Care as Biologics and BTK Inhibitors Advance
07/25/2025
Roy Moore
In this edition of Pipeline Projections, Roy Moore breaks down the rapidly evolving landscape of multiple sclerosis treatments—highlighting the shift from injectables to orals, the rise of monoclonal antibodies, and the promise of innovative...
In this edition of Pipeline Projections, Roy Moore breaks down the rapidly evolving landscape of multiple sclerosis treatments—highlighting the shift from injectables to orals, the rise of monoclonal antibodies, and the promise of innovative...
In this edition of Pipeline...
07/25/2025
First Report Managed Care
Pipeline Projections
How Biosimilars Are Shaping RA Treatment and Reimbursement Strategies
04/29/2025
Roy Moore
In this episode of Pipeline Projections, Roy Moore—Senior Healthcare Research & Data Analyst at Clarivate—discusses the expanding biosimilar pipeline for autoimmune diseases. He highlights recent FDA approvals, formulary and pricing...
In this episode of Pipeline Projections, Roy Moore—Senior Healthcare Research & Data Analyst at Clarivate—discusses the expanding biosimilar pipeline for autoimmune diseases. He highlights recent FDA approvals, formulary and pricing...
In this episode of Pipeline...
04/29/2025
First Report Managed Care

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Behind the Bill

Behind the Bill
HHS Hits Reset on 340B Rebate Model After Court Setbacks
02/11/2026
Juliet Gallagher
The US Department of Health and Human Services (HHS) has formally scrapped its 340B Rebate Model Pilot Program following a series of court rulings that blocked its implementation—signaling a significant pause in one of the most closely...
The US Department of Health and Human Services (HHS) has formally scrapped its 340B Rebate Model Pilot Program following a series of court rulings that blocked its implementation—signaling a significant pause in one of the most closely...
The US Department of Health and...
02/11/2026
First Report Managed Care
Behind the Bill
Funding Package Extends Medicare Telehealth, Enacts PBM Reforms, and Updates Hospital Oversight
02/05/2026
Juliet Gallagher
On February 3, 2026, President Donald Trump signed a broad government funding package that includes multi-year extensions for Medicare teleath and hospital-at-home programs, new oversight requirements for pharmacy benefit managers (PBMs), and...
On February 3, 2026, President Donald Trump signed a broad government funding package that includes multi-year extensions for Medicare teleath and hospital-at-home programs, new oversight requirements for pharmacy benefit managers (PBMs), and...
On February 3, 2026, President...
02/05/2026
First Report Managed Care
Behind the Bill
The Senate’s $3 Trillion Deal. Tax Relief Now, Medicaid Coverage Loss Later?
07/02/2025
Katie Hayes, MJ
The Senate has done it. After weeks of behind-the-scenes wrangling and last-minute amendments, lawmakers have passed a sprawling tax-and-spending megabill that makes good on a long-standing Republican goal: making the 2017 Trump tax cuts...
The Senate has done it. After weeks of behind-the-scenes wrangling and last-minute amendments, lawmakers have passed a sprawling tax-and-spending megabill that makes good on a long-standing Republican goal: making the 2017 Trump tax cuts...
The Senate has done it. After...
07/02/2025
First Report Managed Care
Behind the Bill
When a Cap Isn’t Just a Cap: How a Provider Tax Proposal Could Reshape Medicaid Financing
06/25/2025
Katie Hayes, MJ
In Washington, the most consequential policies are often buried in the fine print. One such detail in the Senate Finance Committee’s latest tax and spending proposal would gradually cap provider taxes—a core funding tool states use to pull in...
In Washington, the most consequential policies are often buried in the fine print. One such detail in the Senate Finance Committee’s latest tax and spending proposal would gradually cap provider taxes—a core funding tool states use to pull in...
In Washington, the most...
06/25/2025
First Report Managed Care
Behind the Bill
Rewriting the Safety Net? Inside the Senate’s Changes to Medicaid and the ACA
06/18/2025
Katie Hayes, MJ
Over the past few weeks, I’ve been following the progress of the One Big Beautiful Bill Act (OBBBA), which started in the House with sweeping tax reforms and some eye-catching health care proposals. Now, the Senate has released its (highly...
Over the past few weeks, I’ve been following the progress of the One Big Beautiful Bill Act (OBBBA), which started in the House with sweeping tax reforms and some eye-catching health care proposals. Now, the Senate has released its (highly...
Over the past few weeks, I’ve...
06/18/2025
First Report Managed Care
Behind the Bill
How States Might Respond to the One Big Beautiful Bill Act
06/11/2025
Katie Hayes, MJ
With the One Big Beautiful Bill Act (OBBBA) still in the hands of the Senate, much of the national conversation has centered on what this legislation would do to federal coverage programs. But regardless of how the federal process unfolds,...
With the One Big Beautiful Bill Act (OBBBA) still in the hands of the Senate, much of the national conversation has centered on what this legislation would do to federal coverage programs. But regardless of how the federal process unfolds,...
With the One Big Beautiful Bill...
06/11/2025
First Report Managed Care
Behind the Bill
Is the Affordable Care Act on the Chopping Block? What the One Big Beautiful Bill Act Tells Us.
06/04/2025
Katie Hayes, MJ
It’s been weeks of headline-grabbing debate over Medicaid work requirements, and the “One Big Beautiful Bill Act” remains in the Senate as they deliberate over several health care provisions. While the Medicaid provisions sparked most of the...
It’s been weeks of headline-grabbing debate over Medicaid work requirements, and the “One Big Beautiful Bill Act” remains in the Senate as they deliberate over several health care provisions. While the Medicaid provisions sparked most of the...
It’s been weeks of...
06/04/2025
First Report Managed Care
Behind the Bill
From House to Senate: The Journey of Cutting Medicaid
05/28/2025
Katie Hayes, MJ
Last week, the House of Representatives narrowly passed the One Big Beautiful Bill Act (HR 1, 119th Congress) by a single vote, sending the sweeping tax and spending reconciliation package, backed by President Trump, to the Senate. With its...
Last week, the House of Representatives narrowly passed the One Big Beautiful Bill Act (HR 1, 119th Congress) by a single vote, sending the sweeping tax and spending reconciliation package, backed by President Trump, to the Senate. With its...
Last week, the House of...
05/28/2025
First Report Managed Care
Behind the Bill
Eligibility, Paperwork, and Penalties: The Not-So-Hidden Costs of Medicaid ‘Reform’
05/21/2025
Katie Hayes, MJ
It’s been another eventful week in health policy—a phrase that’s quickly becoming routine. This time, House Republicans advanced a sweeping budget reconciliation bill, designed to implement elements of the March budget resolution, with a...
It’s been another eventful week in health policy—a phrase that’s quickly becoming routine. This time, House Republicans advanced a sweeping budget reconciliation bill, designed to implement elements of the March budget resolution, with a...
It’s been another eventful week...
05/21/2025
First Report Managed Care
Behind the Bill
A Busy Week in Drug Pricing Policy: Aligning US Drug Prices With Global Standards?
05/14/2025
Katie Hayes, MJ
It’s been a busy few days for drug pricing policy. While I’d love to dig into the details of both President Trump’s latest executive order and the newest Republican bill that would cut Medicaid spending, we don’t have the time—and this isn’t...
It’s been a busy few days for drug pricing policy. While I’d love to dig into the details of both President Trump’s latest executive order and the newest Republican bill that would cut Medicaid spending, we don’t have the time—and this isn’t...
It’s been a busy few days for...
05/14/2025
First Report Managed Care

April 2017 Volume 14 Issue 4

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