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May 2017 - FRMC

Formulary Frontlines®
Latest Drug Treatment Developments for Type 2 Diabetes in Patients With Cardiovascular Risk
05/23/2017
Vanita Pindolia, PharmD; Whitney Aultman, PharmD
Cardiovascular (CV) disease is the leading cause of early death in diabetic patients, and multiple clinical trials have assessed new antidiabetic medication classes.
Cardiovascular (CV) disease is the leading cause of early death in diabetic patients, and multiple clinical trials have assessed new antidiabetic medication classes.
Cardiovascular (CV) disease is...
05/23/2017
First Report Managed Care
Managed Care Q&A
Cutting Diabetes Drug Costs Through Innovative Programs
05/22/2017
David Costill
Troyen Brennan, MD, executive vice president and chief medical officer at CVS Health, discusses how CVS Health's prescription savings program offers discounts on certain medications directly to patients.
Troyen Brennan, MD, executive vice president and chief medical officer at CVS Health, discusses how CVS Health's prescription savings program offers discounts on certain medications directly to patients.
Troyen Brennan, MD, executive...
05/22/2017
First Report Managed Care
Viewpoint
Fourier Study Outcomes: Are PCSK9 Inhibitors Worth the Cost?
05/22/2017
Thomas Morrow, MD
Tom Morrow, MD, discusses the cost of PCSK9 Inhibitors and how they impacted patient response rates in a recent study. 
Tom Morrow, MD, discusses the cost of PCSK9 Inhibitors and how they impacted patient response rates in a recent study. 
Tom Morrow, MD, discusses the...
05/22/2017
First Report Managed Care
News Connection
Care Coordination, Access Crucial to PCMH Success
05/22/2017
Elements of the patient-centered medical home (PCMH) model most strongly linked with clinical quality are care coordination, access, continuity, and communication, according to a recent study in JAMA Internal Medicine.
Elements of the patient-centered medical home (PCMH) model most strongly linked with clinical quality are care coordination, access, continuity, and communication, according to a recent study in JAMA Internal Medicine.
Elements of the patient-centered...
05/22/2017
First Report Managed Care
News Connection
Express Scripts May Lose Anthem as Pharmacy Client Amid Lawsuit
05/22/2017
Express Scripts, the leading pharmacy benefit manager (PBM) in the country, recently announced that its largest client, Anthem Inc, will likely not renew its contract once the current agreement expires December 31, 2019.
Express Scripts, the leading pharmacy benefit manager (PBM) in the country, recently announced that its largest client, Anthem Inc, will likely not renew its contract once the current agreement expires December 31, 2019.
Express Scripts, the leading...
05/22/2017
First Report Managed Care
News Connection
Rise in Insured Americans Did Not Hurt Access to Care
05/22/2017
The boost in the number of newly insured Americans as a result of the ACA did not hamper access to care for Americans who already had health insurance, according to a study in Health Affairs.
The boost in the number of newly insured Americans as a result of the ACA did not hamper access to care for Americans who already had health insurance, according to a study in Health Affairs.
The boost in the number of newly...
05/22/2017
First Report Managed Care
News Connection
House Introduces Bill to Loosen Communication Restrictions for Off-Label Use
05/22/2017
Representative Morgan Griffith (R-Virginia) recently introduced a new bill aimed at reducing the restrictions on off-label communications between pharmaceuticals companies, payers, and providers—allowing drugmakers to discuss unapproved uses...
Representative Morgan Griffith (R-Virginia) recently introduced a new bill aimed at reducing the restrictions on off-label communications between pharmaceuticals companies, payers, and providers—allowing drugmakers to discuss unapproved uses...
Representative Morgan Griffith...
05/22/2017
First Report Managed Care
News Connection
House of Representatives Passes American Health Care Act
05/22/2017
After months of political wrangling, House Republicans have finally passed their health care reform bill, the American Health Care Act, which will give states the right to waive essential health benefits.
After months of political wrangling, House Republicans have finally passed their health care reform bill, the American Health Care Act, which will give states the right to waive essential health benefits.
After months of political...
05/22/2017
First Report Managed Care
News Connection
Maine, Wisconsin Pursue Additional Requirements for Medicaid Eligibility
05/22/2017
Maine and Wisconsin officials have announced plans to implement reforms mandating proof of employment, substance sobriety, and other requirements among Medicaid participants, according to releases from each state’s health department.
Maine and Wisconsin officials have announced plans to implement reforms mandating proof of employment, substance sobriety, and other requirements among Medicaid participants, according to releases from each state’s health department.
Maine and Wisconsin officials...
05/22/2017
First Report Managed Care
News
Oncology Clinical Trials: A Win-Win for Payers
05/12/2017
Paul Nicolaus
Clinical trials could represent a unique opportunity for significant cost savings while getting patients access to cutting-edge treatments.
Clinical trials could represent a unique opportunity for significant cost savings while getting patients access to cutting-edge treatments.
Clinical trials could represent...
05/12/2017
First Report Managed Care
Conference Insider
Switching Patients With Primary Immunodeficiency Disease to Hizentra May Reduce Costs
05/10/2017
A presentation suggested that switching patients to 20% Hizentra at equivalent dose ratios could decrease costs for primary immunodeficiency disease.
A presentation suggested that switching patients to 20% Hizentra at equivalent dose ratios could decrease costs for primary immunodeficiency disease.
A presentation suggested that...
05/10/2017
First Report Managed Care
Conference Insider
Patient-Centered Strategies Reduce Cardiovascular Risks in Patients With Type 2 Diabetes
05/10/2017
A recent presentation during the Managed Care Review Board’s symposium demonstrated how patient-centered strategies can minimize cardiovascular risks in patients in a managed care setting.
A recent presentation during the Managed Care Review Board’s symposium demonstrated how patient-centered strategies can minimize cardiovascular risks in patients in a managed care setting.
A recent presentation during the...
05/10/2017
First Report Managed Care
Conference Insider
Eliminating Diabetes Drug Cost-Sharing Increases Adherence, Reduces Costs
05/10/2017
Research presented at the AMCP 2017 Annual Meeting found that reducing member cost sharing to zero dollars for diabetes drugs improved diabetes drug adherence rates and reduced annual out-of-pocket costs.
Research presented at the AMCP 2017 Annual Meeting found that reducing member cost sharing to zero dollars for diabetes drugs improved diabetes drug adherence rates and reduced annual out-of-pocket costs.
Research presented at the AMCP...
05/10/2017
First Report Managed Care
Conference Insider
PCMH Model Reduces Costs Among Long-Term Cancer Survivors
05/10/2017
Health care costs, emergency department (ED) visits, and hospitalizations were reduced among long-term cancer survivors through use of the patient-centered medical home (PCMH)care model, according to a poster presented at the AMCP 2017 Annual...
Health care costs, emergency department (ED) visits, and hospitalizations were reduced among long-term cancer survivors through use of the patient-centered medical home (PCMH)care model, according to a poster presented at the AMCP 2017 Annual...
Health care costs, emergency...
05/10/2017
First Report Managed Care
Conference Insider
Patients on Basal Insulin Remain Uncontrolled After Initiation, Require Intensification
05/10/2017
A poster presentation at the AMCP 2017 Annual Meeting found that patients who manage their type 2 diabetes with basal insulin remain uncontrolled after 6 months, requiring intensification of treatment. 
A poster presentation at the AMCP 2017 Annual Meeting found that patients who manage their type 2 diabetes with basal insulin remain uncontrolled after 6 months, requiring intensification of treatment. 
A poster presentation at the...
05/10/2017
First Report Managed Care
Conference Insider
Integration of a Clinical Pharmacist Reduces Managed Care Plan Costs
05/10/2017
According to an award-winning poster presented at the AMCP 2017 Annual Meeting, integration of a clinical pharmacist into a managed care plan helped to significantly reduce both medical and pharmacy costs by optimizing drug utilization. 
According to an award-winning poster presented at the AMCP 2017 Annual Meeting, integration of a clinical pharmacist into a managed care plan helped to significantly reduce both medical and pharmacy costs by optimizing drug utilization. 
According to an award-winning...
05/10/2017
First Report Managed Care
Conference Insider
Zarxio Switching Fails to Meet Budget Impact Model Expectations
05/10/2017
According to research presented at the AMCP 2017 Annual Meeting, Zarxio (filgrastim-sndz; Sandoz) cost savings, predicted using a budget impact model, failed to meet the expectations of researchers due to the drug’s higher price.
According to research presented at the AMCP 2017 Annual Meeting, Zarxio (filgrastim-sndz; Sandoz) cost savings, predicted using a budget impact model, failed to meet the expectations of researchers due to the drug’s higher price.
According to research presented...
05/10/2017
First Report Managed Care
Conference Insider
Medicaid Spends More For Branded Drugs After Generics Become Available
05/10/2017
According to research presented at the AMCP 2017 Annual Meeting, Medicaid formulary approaches generally lead branded drugs to become more expensive after a generic competitor is released. This cost trend runs counter to the expected trend...
According to research presented at the AMCP 2017 Annual Meeting, Medicaid formulary approaches generally lead branded drugs to become more expensive after a generic competitor is released. This cost trend runs counter to the expected trend...
According to research presented...
05/10/2017
First Report Managed Care
Conference Insider
Trulance Improves Quality of Life for Patients With Chronic Idiopathic Constipation
05/10/2017
According to an award-winning poster presented at the AMCP 2017 Annual Meeting, Trulance (plecanatide; Synergy) significantly reduced bowel symptoms and improved quality of life for patients with chronic idiopathic constipation.
According to an award-winning poster presented at the AMCP 2017 Annual Meeting, Trulance (plecanatide; Synergy) significantly reduced bowel symptoms and improved quality of life for patients with chronic idiopathic constipation.
According to an award-winning...
05/10/2017
First Report Managed Care
Conference Insider
Specialty Pharmacy Pipeline Suggests New Drug Approvals Will Bounce Back in 2017
05/10/2017
During a presentation at the AMCP 2017 Annual Meeting, Aimee Tharaldson, PharmD, senior clinical consultant in the Emerging Therapeutics department at Express Scripts, updated managed care professionals on the upcoming specialty pharmacy...
During a presentation at the AMCP 2017 Annual Meeting, Aimee Tharaldson, PharmD, senior clinical consultant in the Emerging Therapeutics department at Express Scripts, updated managed care professionals on the upcoming specialty pharmacy...
During a presentation at the...
05/10/2017
First Report Managed Care
Conference Insider
Implementing Clinical Pathways for Multiple Myeloma
05/10/2017
In one survey of payers, 47.6% reported having pathways for multiple myeloma, with another 19.1% citing the cancer type as a high priority for pathway development, Edmund Pezalla, MD, MPH, chief executive officer of Enlightenment BioConsult,...
In one survey of payers, 47.6% reported having pathways for multiple myeloma, with another 19.1% citing the cancer type as a high priority for pathway development, Edmund Pezalla, MD, MPH, chief executive officer of Enlightenment BioConsult,...
In one survey of payers, 47.6%...
05/10/2017
First Report Managed Care
Conference Insider
Specialty Pharmacy Pipeline Suggests New Drug Approvals Will Bounce Back in 2017
05/10/2017
During a presentation at the AMCP 2017 Annual Meeting, Aimee Tharaldson, PharmD, senior clinical consultant in the Emerging Therapeutics department at Express Scripts, updated managed care professionals on the upcoming specialty pharmacy...
During a presentation at the AMCP 2017 Annual Meeting, Aimee Tharaldson, PharmD, senior clinical consultant in the Emerging Therapeutics department at Express Scripts, updated managed care professionals on the upcoming specialty pharmacy...
During a presentation at the...
05/10/2017
First Report Managed Care
News
Addressing Unmet Medical Needs in Neuropathic Pain
05/05/2017
Eileen Koutnik-Fotopoulos
Challenges addressing pain are coming to a head at a time when the prevalence of comorbid neuropathic pain is on the rise.
Challenges addressing pain are coming to a head at a time when the prevalence of comorbid neuropathic pain is on the rise.
Challenges addressing pain are...
05/05/2017
First Report Managed Care
News
List Vs Net Price: Are High Price Tags Really That High?
05/05/2017
Jill Sederstorm
Industry experts argue that too much emphasis is put on the list prices of certain high-ticket drugs, when most patients are shielded by pharmacy benefits.
Industry experts argue that too much emphasis is put on the list prices of certain high-ticket drugs, when most patients are shielded by pharmacy benefits.
Industry experts argue that too...
05/05/2017
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

News
Task Force Publishes Target-To-Treat Guidance for GCA and PMR
03/12/2024
Jolynn Tumolo
An international task force recently published the first target-to-treat (T2T) recommendations for patients with giant cell arteritis (GCA) and polymyalgia rheumatica (PMR) in the Annals of the Rheumatic Diseases.
An international task force recently published the first target-to-treat (T2T) recommendations for patients with giant cell arteritis (GCA) and polymyalgia rheumatica (PMR) in the Annals of the Rheumatic Diseases.
An international task force...
03/12/2024
First Report Managed Care
Asembia: More Than an Annual Conference
04/15/2024

Emry Lloyd

Emry Lloyd
Asembia, established in 2005, pioneered the recognition and promotion of specialty pharmacies, focusing on becoming a leader in the specialty pharmacy group purchasing organization sector. Offering scalable solutions, including prescription...
Asembia, established in 2005, pioneered the recognition and promotion of specialty pharmacies, focusing on becoming a leader in the specialty pharmacy group purchasing organization sector. Offering scalable solutions, including prescription...
Asembia, established in 2005,...
04/15/2024
First Report Managed Care
Conference Coverage
Addressing Suicidal Ideation in Persons With Multiple Sclerosis: Developing a Predictive Nomogram
05/22/2024
Hannah Musick
New research explored the development of a predictive nomogram to identify persons with multiple sclerosis at higher risk of suicidal ideation, emphasizing the importance of behavioral risk factors in this vulnerable population.
New research explored the development of a predictive nomogram to identify persons with multiple sclerosis at higher risk of suicidal ideation, emphasizing the importance of behavioral risk factors in this vulnerable population.
New research explored the...
05/22/2024
First Report Managed Care
News
Johnson & Johnson Expands Use of Prezcobix for Pediatric Patients in the US
06/21/2024
Hannah Musick
Johnson & Johnson aims to expand use of its HIV-1 therapy, Prezcobix, for younger patients in the US, potentially paving the way for improved treatment options for pediatric patients with the virus.
Johnson & Johnson aims to expand use of its HIV-1 therapy, Prezcobix, for younger patients in the US, potentially paving the way for improved treatment options for pediatric patients with the virus.
Johnson & Johnson aims to expand...
06/21/2024
First Report Managed Care
Brian Esterly Headshot
Interview
Insights on the 2024 Medicare Physician Fee Schedule: Implications and Opportunities for Virtual Care Management Services
07/26/2024
The current Medicare Physician Fee Schedule brought many significant changes to increase access to much needed virtual care management (VCM) services to underserved populations. Learn more about the potential implications of these fee...
The current Medicare Physician Fee Schedule brought many significant changes to increase access to much needed virtual care management (VCM) services to underserved populations. Learn more about the potential implications of these fee...
The current Medicare Physician...
07/26/2024
First Report Managed Care

May 2017 Volume 14 Issue 5

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