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February 2013 - FRMC

Pertussis Vaccination and Increase in Cases
02/14/2013
Tori Socha
Despite an extensive and widely available childhood vaccination program, pertussis remains a poorly controlled vaccine-preventable disease in the United States. Infants have higher rates of pertussis compared with children in other age...
Despite an extensive and widely available childhood vaccination program, pertussis remains a poorly controlled vaccine-preventable disease in the United States. Infants have higher rates of pertussis compared with children in other age...
Despite an extensive and widely...
02/14/2013
First Report Managed Care
Combined BRAF and MEK Inhibition in Melanoma with BRAF V600 Mutations
02/14/2013
Kevin L. Carter
The treatment of metastatic melanoma has been greatly enhanced by pharmacologic inhibition of the mitogen-activated protein kinase (MAPK) pathway. Trametinib mediates blockade of MAPK kinase (MEK), which is downstream of BRAF in the MAPK...
The treatment of metastatic melanoma has been greatly enhanced by pharmacologic inhibition of the mitogen-activated protein kinase (MAPK) pathway. Trametinib mediates blockade of MAPK kinase (MEK), which is downstream of BRAF in the MAPK...
The treatment of metastatic...
02/14/2013
First Report Managed Care
Rasagiline and Dopamine to Treat Parkinson’s Disease
02/14/2013
Tim Casey
Berlin, Germany—After controlling for several variables, patients with Parkinson’s disease who began therapy with rasagiline had a significantly lower probability of being hospitalized, significantly fewer hospitalizations, and shorter length...
Berlin, Germany—After controlling for several variables, patients with Parkinson’s disease who began therapy with rasagiline had a significantly lower probability of being hospitalized, significantly fewer hospitalizations, and shorter length...
Berlin, Germany—After...
02/14/2013
First Report Managed Care
Comparison of Oral Contraceptive Therapies
02/14/2013
Tim Casey
Berlin, Germany—A database analysis of insured women found that those who took 84 days of levonorgestrel/ethinyl estradiol plus ethinyl estradiol 0.01 mg for 7 days were significantly less likely to become pregnant compared with those who...
Berlin, Germany—A database analysis of insured women found that those who took 84 days of levonorgestrel/ethinyl estradiol plus ethinyl estradiol 0.01 mg for 7 days were significantly less likely to become pregnant compared with those who...
Berlin, Germany—A database...
02/14/2013
First Report Managed Care
Costs and Healthcare Utilization with Myeloproliferative Neoplasms
02/14/2013
Tim Casey
Atlanta—A retrospective cohort analysis found that total healthcare costs for Medicare patients with myeloproliferative neoplasms (MPNs) were 1.5 to 3 times higher and hospitalizations were significantly higher compared with a matched control...
Atlanta—A retrospective cohort analysis found that total healthcare costs for Medicare patients with myeloproliferative neoplasms (MPNs) were 1.5 to 3 times higher and hospitalizations were significantly higher compared with a matched control...
Atlanta—A retrospective cohort...
02/14/2013
First Report Managed Care
Phase 2 Trial of Quizartinib in AML Patients
02/14/2013
Tim Casey
Atlanta—A phase 2, open-label trial found that a subset of patients with double refractory, treatment-resistant acute myeloid leukemia (AML) achieved a clinically meaningful high response rate when taking quizartinib, an oral investigational...
Atlanta—A phase 2, open-label trial found that a subset of patients with double refractory, treatment-resistant acute myeloid leukemia (AML) achieved a clinically meaningful high response rate when taking quizartinib, an oral investigational...
Atlanta—A phase 2, open-label...
02/14/2013
First Report Managed Care
Apixaban to Treat Venous Thromboembolism
02/14/2013
Tim Casey
Atlanta—Patients who took 2.5 mg or 5 mg of apixaban twice daily for 1 year had an 80% risk reduction in recurrent nonfatal or fatal venous thromboembolism (VTE) compared with those who received placebo, according to a randomized,...
Atlanta—Patients who took 2.5 mg or 5 mg of apixaban twice daily for 1 year had an 80% risk reduction in recurrent nonfatal or fatal venous thromboembolism (VTE) compared with those who received placebo, according to a randomized,...
Atlanta—Patients who took 2.5 mg...
02/14/2013
First Report Managed Care
Phase 1/2 Trial of MLN9708 for Multiple Myeloma
02/14/2013
Tim Casey
Atlanta—Patients with previously untreated multiple myeloma, who took the investigational agent MLN9708 in combination with lenalidomide and dexamethasone, responded well to the drug regimen and tolerated the treatment, according to a phase...
Atlanta—Patients with previously untreated multiple myeloma, who took the investigational agent MLN9708 in combination with lenalidomide and dexamethasone, responded well to the drug regimen and tolerated the treatment, according to a phase...
Atlanta—Patients with previously...
02/14/2013
First Report Managed Care
Conference Insider
Dabigatran Etexilate for Total Hip and Knee Replacement
02/14/2013
Tim Casey
Atlanta—Patients undergoing total hip or knee replacement who took 220 mg of dabigatran etexilate daily had few major bleeding events regardless of their body mass index (BMI), renal function, or age, according to an international,...
Atlanta—Patients undergoing total hip or knee replacement who took 220 mg of dabigatran etexilate daily had few major bleeding events regardless of their body mass index (BMI), renal function, or age, according to an international,...
Atlanta—Patients undergoing...
02/14/2013
First Report Managed Care
Ponatinib for Patients with Rare Types of Leukemia
02/14/2013
Tim Casey
Atlanta—After a median >12 months of treatment, patients with chronic myeloid leukemia (CML) and Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph+ ALL) who took ponatinib responded well to the drug, according to a phase 2,...
Atlanta—After a median >12 months of treatment, patients with chronic myeloid leukemia (CML) and Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph+ ALL) who took ponatinib responded well to the drug, according to a phase 2,...
Atlanta—After a median >12...
02/14/2013
First Report Managed Care
Conference Insider
Systemic Lupus Erythematosus in a Managed Care Setting
02/14/2013
Mary Beth Nierengarten
Washington, DC—Patients with newly diagnosed and existing systemic lupus erythematosus (SLE) incur high costs and resource use compared with healthy individuals, and the costs increase in patients with SLE-related conditions such as central...
Washington, DC—Patients with newly diagnosed and existing systemic lupus erythematosus (SLE) incur high costs and resource use compared with healthy individuals, and the costs increase in patients with SLE-related conditions such as central...
Washington, DC—Patients with...
02/14/2013
First Report Managed Care
Depression and Mortality Associated with Rheumatoid Arthritis
02/14/2013
Mary Beth Nierengarten
Washington, DC—Identifying and managing depression in people with rheumatoid arthritis (RA), particularly men, is important based on the results of a study showing an increase in all-cause mortality associated with depression in RA...
Washington, DC—Identifying and managing depression in people with rheumatoid arthritis (RA), particularly men, is important based on the results of a study showing an increase in all-cause mortality associated with depression in RA...
Washington, DC—Identifying and...
02/14/2013
First Report Managed Care
Updated Phase 3 Results of Tofacitinib Therapy Trial
02/14/2013
Mary Beth Nierengarten
Washington, DC—After 2 years of treatment with tofacitinib in combination with methotrexate (MTX), patients with active rheumatoid arthritis (RA) with prior inadequate response to MTX showed reduction in progression of structural damage as...
Washington, DC—After 2 years of treatment with tofacitinib in combination with methotrexate (MTX), patients with active rheumatoid arthritis (RA) with prior inadequate response to MTX showed reduction in progression of structural damage as...
Washington, DC—After 2 years of...
02/14/2013
First Report Managed Care
Managing Remission Using TNF Inhibitors or Maintenance Therapy
02/14/2013
Mary Beth Nierengarten
Washington, DC—For some patients with rheumatoid arthritis (RA) in clinical remission, tapering the dose of tumor necrosis factor (TNF) inhibitors used for maintenance therapy or extending the time between doses can be done without...
Washington, DC—For some patients with rheumatoid arthritis (RA) in clinical remission, tapering the dose of tumor necrosis factor (TNF) inhibitors used for maintenance therapy or extending the time between doses can be done without...
Washington, DC—For some patients...
02/14/2013
First Report Managed Care
Glucocorticoids in Older and Poorer Patients
02/14/2013
Mary Beth Nierengarten
Washington, DC—Despite current guidelines that recommend the use of disease-modifying antirheumatic drugs (DMARDs) for treatment of active rheumatoid arthritis (RA), many people are still treated with glucocorticoids alone for long periods of...
Washington, DC—Despite current guidelines that recommend the use of disease-modifying antirheumatic drugs (DMARDs) for treatment of active rheumatoid arthritis (RA), many people are still treated with glucocorticoids alone for long periods of...
Washington, DC—Despite current...
02/14/2013
First Report Managed Care
DMARDs to Treat Medicare Beneficiaries with Rheumatoid Arthritis
02/14/2013
Mary Beth Nierengarten
Washington, DC—Results of a recent study suggest that the choice of biologic disease-modifying antirheumatic drugs (DMARDs) for patients with rheumatoid arthritis (RA) who receive care through Medicare may be influenced by subsidy status...
Washington, DC—Results of a recent study suggest that the choice of biologic disease-modifying antirheumatic drugs (DMARDs) for patients with rheumatoid arthritis (RA) who receive care through Medicare may be influenced by subsidy status...
Washington, DC—Results of a...
02/14/2013
First Report Managed Care
Conference Insider
Costs of DMARDs and Methotrexate for Psoriatic Arthritis
02/14/2013
Mary Beth Nierengarten
Washington, DC—Retrospective data from a study conducted to describe healthcare costs associated with the management of psoriatic arthritis (PsA) in patients newly initiated on a biologic therapy or methotrexate (MTX) found that the average...
Washington, DC—Retrospective data from a study conducted to describe healthcare costs associated with the management of psoriatic arthritis (PsA) in patients newly initiated on a biologic therapy or methotrexate (MTX) found that the average...
Washington, DC—Retrospective...
02/14/2013
First Report Managed Care
Biologic Agents and Mortality Risk in Rheumatoid Arthritis
02/14/2013
Mary Beth Nierengarten
Washington, DC—Treatment of rheumatoid arthritis (RA) with biologic agents is associated with a significant reduction in mortality, Canadian researchers reported in a population-based cohort study presented at the ACR meeting. Although the...
Washington, DC—Treatment of rheumatoid arthritis (RA) with biologic agents is associated with a significant reduction in mortality, Canadian researchers reported in a population-based cohort study presented at the ACR meeting. Although the...
Washington, DC—Treatment of...
02/14/2013
First Report Managed Care
Conference Insider
Lifetime Risk of Knee Osteoarthritis
02/14/2013
Mary Beth Nierengarten
Washington, DC—Black females are at the greatest lifetime risk of being diagnosed with and needing a total knee replacement (TKR) for knee osteoarthritis (OA), investigators reported in a study presented at the ACR meeting that looked at race...
Washington, DC—Black females are at the greatest lifetime risk of being diagnosed with and needing a total knee replacement (TKR) for knee osteoarthritis (OA), investigators reported in a study presented at the ACR meeting that looked at race...
Washington, DC—Black females are...
02/14/2013
First Report Managed Care
Anti-TNF Drugs to Treat Rheumatoid Arthritis
02/14/2013
Mary Beth Nierengarten
Washington, DC—For patients with rheumatoid arthritis (RA), treatment with anti-tumor necrosis factor (anti-TNF) drugs may reduce the need for hip or knee surgeries as well as the need for hospital admissions. Despite the higher costs of...
Washington, DC—For patients with rheumatoid arthritis (RA), treatment with anti-tumor necrosis factor (anti-TNF) drugs may reduce the need for hip or knee surgeries as well as the need for hospital admissions. Despite the higher costs of...
Washington, DC—For patients with...
02/14/2013
First Report Managed Care
The Uninsured Low-Income Population in the United States
02/14/2013
Tori Socha
Many low-income adults in the United States live without health insurance. Most Americans receive health insurance through their employer as a fringe benefit; however, many people do not have access to such coverage either because they cannot...
Many low-income adults in the United States live without health insurance. Most Americans receive health insurance through their employer as a fringe benefit; however, many people do not have access to such coverage either because they cannot...
Many low-income adults in the...
02/14/2013
First Report Managed Care
Reducing Costs through a Medicare Premium Support System
02/14/2013
Tori Socha
Within the context of reducing federal debt and deficit, suggestions on transformation of Medicare to premium support have been raised.
Within the context of reducing federal debt and deficit, suggestions on transformation of Medicare to premium support have been raised.
Within the context of reducing...
02/14/2013
First Report Managed Care
OnabotulinumtoxinA for Urgency Urinary Incontinence
02/14/2013
Tori Socha
As many as 19% of women in the United States are affected by urgency urinary incontinence, a condition characterized by unpredictable loss of urine that occurs disproportionately in women. Primary treatment for urgency urinary incontinence...
As many as 19% of women in the United States are affected by urgency urinary incontinence, a condition characterized by unpredictable loss of urine that occurs disproportionately in women. Primary treatment for urgency urinary incontinence...
As many as 19% of women in the...
02/14/2013
First Report Managed Care
Longer Warfarin Therapy after AVR May Be Beneficial
02/14/2013
Eileen Koutnik-Fotopoulos
Although current guidelines recommend 3 months of warfarin treatment after bioprosthetic aortic valve replacement (AVR) surgery, this recommendation is limited to the results of a single retrospective study. Now a study of >4000 patients...
Although current guidelines recommend 3 months of warfarin treatment after bioprosthetic aortic valve replacement (AVR) surgery, this recommendation is limited to the results of a single retrospective study. Now a study of >4000 patients...
Although current guidelines...
02/14/2013
First Report Managed Care
Medicare Beneficiaries and Repeat Testing
02/14/2013
Tori Socha
The capacity for physicians to serve new patients and the ability to contain costs of healthcare are determined, in part, by the tendency to repeat examinations. Physicians who see their patients every 12 months can care for twice as many...
The capacity for physicians to serve new patients and the ability to contain costs of healthcare are determined, in part, by the tendency to repeat examinations. Physicians who see their patients every 12 months can care for twice as many...
The capacity for physicians to...
02/14/2013
First Report Managed Care
Preferred and Limited Pharmacy Networks Could Save Billions
02/14/2013
Tim Casey
In recent years, high-profile disagreements between pharmacies and pharmacy benefit managers (PBMs) have caused many companies to consider narrow pharmacy networks to generate savings. Rather than the typical process in which plans create a...
In recent years, high-profile disagreements between pharmacies and pharmacy benefit managers (PBMs) have caused many companies to consider narrow pharmacy networks to generate savings. Rather than the typical process in which plans create a...
In recent years, high-profile...
02/14/2013
First Report Managed Care
The Future of Medicare
02/14/2013
Tim Casey
For the past few years, Medicare spending has grown at a slower rate than most policy makers expected. Some attribute the trend to provisions from the Patient Protection and Affordable Care Act (ACA), while others note that poor economic...
For the past few years, Medicare spending has grown at a slower rate than most policy makers expected. Some attribute the trend to provisions from the Patient Protection and Affordable Care Act (ACA), while others note that poor economic...
For the past few years, Medicare...
02/14/2013
First Report Managed Care

Behind the Bill

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
BEHIND THE BILL
When Agencies Lose Power: How 3 Seismic Shifts are Transforming Pharmaceutical Regulation
05/07/2025
Katie Hayes, MJ
In the span of just 9 months, the landscape of administrative law has undergone a transformation so profound that pharmaceutical executives, health care providers, and patients alike are struggling to navigate the new terrain. The Supreme...
In the span of just 9 months, the landscape of administrative law has undergone a transformation so profound that pharmaceutical executives, health care providers, and patients alike are struggling to navigate the new terrain. The Supreme...
In the span of just 9 months,...
05/07/2025
First Report Managed Care
Behind the Bill
The Medicare Paradox, Part 3: Strategic Trade Doesn’t Have to be a Zero-Sum Game
05/07/2025
Katie Hayes, MJ
Over the past 2 weeks, I’ve examined the growing friction between the Section 232 pharmaceutical tariff investigations and the Medicare drug pricing reforms authorized by the Inflation Reduction Act (IRA). These 2 policy agendas—industrial...
Over the past 2 weeks, I’ve examined the growing friction between the Section 232 pharmaceutical tariff investigations and the Medicare drug pricing reforms authorized by the Inflation Reduction Act (IRA). These 2 policy agendas—industrial...
Over the past 2 weeks, I’ve...
05/07/2025
First Report Managed Care

Trending Articles

Commentary
Next-Generation Utilization Management: Managing Utilization and Cost Without Denial of Service​​​
03/01/2024
Amit Gupta, MD
Utilization management is evolving from a cost-centric process to a focus on quality of care, with trends including exception-based authorization handling and value-based arrangements to reduce administrative burden and provider abrasion.
Utilization management is evolving from a cost-centric process to a focus on quality of care, with trends including exception-based authorization handling and value-based arrangements to reduce administrative burden and provider abrasion.
Utilization management is...
03/01/2024
First Report Managed Care
Shannon Smith Headshot
Commentary
Adapting to Change: Navigating the New CMS Prior Authorization Guidelines in Health Care
04/02/2024

Shannon Smith, RN, BSN

Shannon Smith, RN, BSN
As the health care industry prepares for the Centers for Medicare & Medicaid Services (CMS) to implement new guidelines to streamline prior authorization procedures, significant operational changes are on the horizon for health care payers....
As the health care industry prepares for the Centers for Medicare & Medicaid Services (CMS) to implement new guidelines to streamline prior authorization procedures, significant operational changes are on the horizon for health care payers....
As the health care industry...
04/02/2024
First Report Managed Care
Conference Coverage
Rare Orphan, Oncology, and Specialty Drugs in Development: Review of Therapeutic Areas, Designations, and Launch Projections
05/01/2024
Danielle Sposato
The specialty pharmacy pipeline was the subject of one of many informative sessions at the annual Asembia Summit this year. Key insights were shared about current drugs in the pipeline according to their drug designations, the phase of each...
The specialty pharmacy pipeline was the subject of one of many informative sessions at the annual Asembia Summit this year. Key insights were shared about current drugs in the pipeline according to their drug designations, the phase of each...
The specialty pharmacy pipeline...
05/01/2024
First Report Managed Care
News
Using Mindfulness-Based Intervention to Improve Fatigue, Mood Challenges in Adolescents With Neuroimmune Disease
05/28/2024
Grace Taylor, MS, MA
Study examines the effectiveness of the Learning to BREATHE mindfulness-based intervention in improving fatigue and mood challenges in a adolescent population with neuroimmune disease.
Study examines the effectiveness of the Learning to BREATHE mindfulness-based intervention in improving fatigue and mood challenges in a adolescent population with neuroimmune disease.
Study examines the effectiveness...
05/28/2024
First Report Managed Care
Leyla Henderson
Conference Coverage
Strategies for Enhancing Infusion Patient Experiences
07/10/2024
Leyla Henderson
An NICA 2024 session speaker shares innovative strategies for enhancing patient satisfaction and improving outcomes in health care settings, emphasizing the importance of patient-centered care and individualized experiences.
An NICA 2024 session speaker shares innovative strategies for enhancing patient satisfaction and improving outcomes in health care settings, emphasizing the importance of patient-centered care and individualized experiences.
An NICA 2024 session speaker...
07/10/2024
First Report Managed Care

February 2013 Volume 10 Issue 2

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