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July 2015 - FRMC

Ixekizumab for the Treatment of Plaque Psoriasis
07/30/2015
Eileen Koutnik-Fotopoulos
The UNCOVER-2 study found that ixekizumab (anti-interleuekin-17A IgG4 monoclonal antibody) was superior to placebo and etanercept in psoriasis patients.
The UNCOVER-2 study found that ixekizumab (anti-interleuekin-17A IgG4 monoclonal antibody) was superior to placebo and etanercept in psoriasis patients.
The UNCOVER-2 study found that...
07/30/2015
First Report Managed Care
News
Study Examines Touch Avoidance in Psoriasis
07/30/2015
Eileen Koutnik-Fotopoulos
Vancouver, Canada—Severity of psoriasis has a significant impact on patient quality of life. In a new study, researchers conducted a cross-sectional survey among patients with psoriasis and included questions to assess the avoidance of...
Vancouver, Canada—Severity of psoriasis has a significant impact on patient quality of life. In a new study, researchers conducted a cross-sectional survey among patients with psoriasis and included questions to assess the avoidance of...
Vancouver, Canada—Severity of...
07/30/2015
First Report Managed Care
Emerging Evidence and Future Direction of Chemoprevention in Pancreatic Cancer
07/30/2015
Mary Beth Nierengarten
Chemoprevention is used to target populations with preneoplastic lesions such as ductal in situ carcinoma and familial adenomatous polyposis.
Chemoprevention is used to target populations with preneoplastic lesions such as ductal in situ carcinoma and familial adenomatous polyposis.
Chemoprevention is used to...
07/30/2015
First Report Managed Care
Psoriasis Study Examines Cost per Responder with Biologics
07/30/2015
Eileen Koutnik-Fotopoulos
In a new study, researchers sought to evaluate the cost per additional responder associated with 4 biologics to achieve PASI 75, PASI 90, and PASI 100.
In a new study, researchers sought to evaluate the cost per additional responder associated with 4 biologics to achieve PASI 75, PASI 90, and PASI 100.
In a new study, researchers...
07/30/2015
First Report Managed Care
Pharmacist Intervention Among Patients With Comorbidities
07/30/2015
Eileen Koutnik-Fotopoulos
Philadelphia, PA—A brief pharmacist telephone intervention resulted in significantly better proportion of days covered (PDCs) during the 6 months following the intervention among a group of nonadherent patients with comorbid hypertension and...
Philadelphia, PA—A brief pharmacist telephone intervention resulted in significantly better proportion of days covered (PDCs) during the 6 months following the intervention among a group of nonadherent patients with comorbid hypertension and...
Philadelphia, PA—A brief...
07/30/2015
First Report Managed Care
Navigation Services Contribute to Improved Oncology Care at Reduced Cost
07/30/2015
With advances in cancer treatment, patients face increasingly more complex treatment and follow-up decisions that require efficient coordination within the health care system to optimize outcomes. 
With advances in cancer treatment, patients face increasingly more complex treatment and follow-up decisions that require efficient coordination within the health care system to optimize outcomes. 
With advances in cancer...
07/30/2015
First Report Managed Care
Conference Insider
Antiplatelet Therapy for Acute Coronary Syndrome
07/30/2015
Eileen Koutnik-Fotopoulos
Orlando, FL—Antiplatelet and anticoagulant therapies are crucial in the management of patients with acute coronary syndrome (ACS). Platelet activation remains a major pathophysiological issue in ACS. Platelets upregulate the expression of...
Orlando, FL—Antiplatelet and anticoagulant therapies are crucial in the management of patients with acute coronary syndrome (ACS). Platelet activation remains a major pathophysiological issue in ACS. Platelets upregulate the expression of...
Orlando, FL—Antiplatelet...
07/30/2015
First Report Managed Care
Conference Insider
Adopting and Succeeding With Value-based Competition Model
07/30/2015
Mary Beth Nierengarten
Orlando, FL—Changes in the health care delivery system are placing demands on hospitals and physicians to become more competitive in a marketplace that is moving from fee-for-service payment models and pay-for-performance models to...
Orlando, FL—Changes in the health care delivery system are placing demands on hospitals and physicians to become more competitive in a marketplace that is moving from fee-for-service payment models and pay-for-performance models to...
Orlando, FL—Changes in the...
07/30/2015
First Report Managed Care
Conference Insider
Diagnosis and Management of IBD
07/30/2015
Inflammatory bowel disease (IBD) affects more than 1 million people in the United States. IBD encompasses a variety of clinical signs and symptoms including abdominal pain, diarrhea, and rectal bleeding.
Inflammatory bowel disease (IBD) affects more than 1 million people in the United States. IBD encompasses a variety of clinical signs and symptoms including abdominal pain, diarrhea, and rectal bleeding.
Inflammatory bowel disease (IBD)...
07/30/2015
First Report Managed Care
Look to Benefit Design Trends of Exchange Market for Formulary Management
07/30/2015
Mary Beth Nierengarten
“Although the exchange market is still small, it is important for the managed care industry to be on the forefront of trends in formulary management,” said Caroline Pearson, vice president, health reform and policy, Avalere Health,...
“Although the exchange market is still small, it is important for the managed care industry to be on the forefront of trends in formulary management,” said Caroline Pearson, vice president, health reform and policy, Avalere Health,...
“Although the exchange market is...
07/30/2015
First Report Managed Care
Pharmacists Play Key Role in Helping Manage Cost in ACOs
07/30/2015
Mary Beth Nierengarten
“Pharmacists can affect medication utilization and expenditures within an accountable care organization [ACO],” said Dan Dauner, PharmD, MSPH, BCPS-AQ ID, pharmacy manager, Population Care Management Department, Essentia Health, during a...
“Pharmacists can affect medication utilization and expenditures within an accountable care organization [ACO],” said Dan Dauner, PharmD, MSPH, BCPS-AQ ID, pharmacy manager, Population Care Management Department, Essentia Health, during a...
“Pharmacists can affect...
07/30/2015
First Report Managed Care
Value of Analytics in Managing Expensive Drugs
07/30/2015
Eileen Koutnik-Fotopoulos
As specialty pharmacy spend continues to skyrocket, payers will need to implement innovative strategies that minimize cost, increase plan value, and improve overall member health outcomes. These strategies must also address comorbidities,...
As specialty pharmacy spend continues to skyrocket, payers will need to implement innovative strategies that minimize cost, increase plan value, and improve overall member health outcomes. These strategies must also address comorbidities,...
As specialty pharmacy spend...
07/30/2015
First Report Managed Care
Leading the Way for Biosimilars: Managed Care’s Lonely Road
07/30/2015
Kathleen P. Wolff, MBA
Forging a pathway of innovation is typically either with allies, but in the world of biosimilars, where stakeholders are still sizing each other up, allies are scarce. 
Forging a pathway of innovation is typically either with allies, but in the world of biosimilars, where stakeholders are still sizing each other up, allies are scarce. 
Forging a pathway of innovation...
07/30/2015
First Report Managed Care
News
The Relationship Between Hodgkin Lymphoma Survival Rate and Insurance Status
07/30/2015
Melissa D. Cooper
The estimated overall survival rate of patients diagnosed with Stage I Hodgkin lymphoma is 90%, while Stage IV has a 65% survival rate.
The estimated overall survival rate of patients diagnosed with Stage I Hodgkin lymphoma is 90%, while Stage IV has a 65% survival rate.
The estimated overall survival...
07/30/2015
First Report Managed Care
News
Economic Burden of Unintended Pregnancy on Employer-Sponsored Health Insurance
07/30/2015
Melissa D. Cooper
Approximately 28.8% of pregnancies are unintended under employer-sponsored insurance plans, and they account for 27.4% of annual delivery costs to employers.
Approximately 28.8% of pregnancies are unintended under employer-sponsored insurance plans, and they account for 27.4% of annual delivery costs to employers.
Approximately 28.8% of...
07/30/2015
First Report Managed Care
Conference Insider
Low Testosterone Linked to CVD; Individualized Treatment Needed
07/30/2015
Jill Sederstorm
Several studies have found that prescribing testosterone to men with low levels of the hormone could increase therisk of cardiovascular events.    
Several studies have found that prescribing testosterone to men with low levels of the hormone could increase therisk of cardiovascular events.    
Several studies have found that...
07/30/2015
First Report Managed Care
Conference Insider
Patients With Celiac Disease Incur Significantly Higher Direct Costs
07/30/2015
Mary Mihalovic
Retrospective claims analysis points to the likely reasons, and compares cost burden to that of ulcerative colitis.
Retrospective claims analysis points to the likely reasons, and compares cost burden to that of ulcerative colitis.
Retrospective claims analysis...
07/30/2015
First Report Managed Care
Accurate, Inexpensive Risk Prediction Tools Needed to Justify Tailored Colorectal Cancer Screening
07/30/2015
Mary Mihalovic
Researchers adapted a validated decision analytic model of CRC screening to explore potential effectiveness and cost-effectiveness.
Researchers adapted a validated decision analytic model of CRC screening to explore potential effectiveness and cost-effectiveness.
Researchers adapted a validated...
07/30/2015
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

July 2015 Volume 12 Issue 7

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