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May 2018 - FRMC

Viewpoint
Using Predictive Analytics to Address Social Determinants of Health
05/31/2018
Virginia Gurley, MD, MPH
Recognizing the importance of social determinants of health, many health plans are expanding their care management capabilities to help members overcome nonmedical barriers.
Recognizing the importance of social determinants of health, many health plans are expanding their care management capabilities to help members overcome nonmedical barriers.
Recognizing the importance of...
05/31/2018
First Report Managed Care
Managed Care Q&A
How URAC Specialty Pharmacy Accreditation Improves Pharmacy Outcomes
05/31/2018
David Costill
An interview with Heather Bonome, PharmD, Director of Pharmacy at URAC.
An interview with Heather Bonome, PharmD, Director of Pharmacy at URAC.
An interview with Heather...
05/31/2018
First Report Managed Care
Conference Insider
Eptinezumab Reduced Migraine Activity, Utilization of Triptan/Ergotamine
05/31/2018
Two presentations at the 2018 American Academy of Neurology Annual Meeting highlighted the benefits of the intravenous migraine treatment eptinezumab.
Two presentations at the 2018 American Academy of Neurology Annual Meeting highlighted the benefits of the intravenous migraine treatment eptinezumab.
Two presentations at the 2018...
05/31/2018
First Report Managed Care
Conference Insider
Aimovig Safe, Effective at Reducing Monthly Migraine Days
05/31/2018
A recent study presented at the 2018 American Academy of Neurology Annual Meeting found that Aimovig (erenumab; Novartis/Amgen) significantly reduced monthly migraine days among patients who failed two to four prior preventive migraine...
A recent study presented at the 2018 American Academy of Neurology Annual Meeting found that Aimovig (erenumab; Novartis/Amgen) significantly reduced monthly migraine days among patients who failed two to four prior preventive migraine...
A recent study presented at the...
05/31/2018
First Report Managed Care
Conference Insider
Entresto Reduces Health Care Costs in Heart Failure Patients
05/31/2018
Data presented at the AMCP 2018 Annual Meeting demonstrated that Entresto (sacubitril/valsartan; Novartis) reduced all-cause hospitalizations and health care costs in patients with heart failure with reduced ejection fraction.
Data presented at the AMCP 2018 Annual Meeting demonstrated that Entresto (sacubitril/valsartan; Novartis) reduced all-cause hospitalizations and health care costs in patients with heart failure with reduced ejection fraction.
Data presented at the AMCP 2018...
05/31/2018
First Report Managed Care
Conference Insider
Study Examines Costs of Oral vs Injectable Immunotherapies
05/31/2018
A study at the AMCP 2018 Annual Meeting compared health care utilization, medication switching, and costs among patients taking oral immunotherapies and injectable immunotherapies.
A study at the AMCP 2018 Annual Meeting compared health care utilization, medication switching, and costs among patients taking oral immunotherapies and injectable immunotherapies.
A study at the AMCP 2018 Annual...
05/31/2018
First Report Managed Care
Conference Insider
New Shingles Vaccine Cost-Effective, Cost-Saving Compared With Zostavax
05/31/2018
Research presented at the AMCP 2018 Annual Meeting found that Shingrix (non-live adjuvanted subunit vaccine; GlaxosmithKline) is cost-effective when compared with no vaccination and cost-saving compared with an older shingles vaccine.
Research presented at the AMCP 2018 Annual Meeting found that Shingrix (non-live adjuvanted subunit vaccine; GlaxosmithKline) is cost-effective when compared with no vaccination and cost-saving compared with an older shingles vaccine.
Research presented at the AMCP...
05/31/2018
First Report Managed Care
Conference Insider
Patients Taking Haegarda Used Less On-Demand Therapy, Reduce Plan Spending
05/31/2018
A poster presented at the AMCP 2018 Annual Meeting showed that patients with hereditary angioedema who received Haegarda (C1 esterase inhibitor subcutaneous; CSL Behring) took less on-demand therapy during prophylactic treatment.
A poster presented at the AMCP 2018 Annual Meeting showed that patients with hereditary angioedema who received Haegarda (C1 esterase inhibitor subcutaneous; CSL Behring) took less on-demand therapy during prophylactic treatment.
A poster presented at the AMCP...
05/31/2018
First Report Managed Care
Conference Insider
Diabetes Patients With Multiple Daily Injections Have Low Persistence, High Medical Costs
05/31/2018
An award-winning poster at the AMCP 2018 Annual Meeting found that type 2 diabetes patients who need multiple daily injections of basal-bosul insulin have low 1-year persistence and higher medial costs
An award-winning poster at the AMCP 2018 Annual Meeting found that type 2 diabetes patients who need multiple daily injections of basal-bosul insulin have low 1-year persistence and higher medial costs
An award-winning poster at the...
05/31/2018
First Report Managed Care
Conference Insider
Pharma Trends in 2018: Generic Drugs in “Race to the Bottom,” Biosimilars Fail to Launch, Market Access Faces Challenges
05/31/2018
During his presentation at the AMCP 2018 Annual Meeting, “2017-2018 Pharmaceutical Marketplace Trends,” Douglas Long, BS, MBA, vice president of Industry Relations at IQVIA, outlined the market trends impacting the pharmaceutical...
During his presentation at the AMCP 2018 Annual Meeting, “2017-2018 Pharmaceutical Marketplace Trends,” Douglas Long, BS, MBA, vice president of Industry Relations at IQVIA, outlined the market trends impacting the pharmaceutical...
During his presentation at the...
05/31/2018
First Report Managed Care
Conference Insider
Payers Say HCEI Sharing Needs Improvement Despite 21st Cures Act Implementation
05/31/2018
A study at the AMCP 2018 Annual Meeting surveyed payer experiences sharing health care economics information (HCEI) after passage of the 21st Century Cures Act and highlighted areas for improvement. 
A study at the AMCP 2018 Annual Meeting surveyed payer experiences sharing health care economics information (HCEI) after passage of the 21st Century Cures Act and highlighted areas for improvement. 
A study at the AMCP 2018 Annual...
05/31/2018
First Report Managed Care
Conference Insider
Navigating the Emerging Challenges of Gene Therapy
05/31/2018
During a session at the AMCP 2018 Annual Meeting, Nicole Trask, PharmD, clinical consultant pharmacist at the University of Massachusetts, discussed the challenges payers will face as gene therapies gain popularity and feasibility across a...
During a session at the AMCP 2018 Annual Meeting, Nicole Trask, PharmD, clinical consultant pharmacist at the University of Massachusetts, discussed the challenges payers will face as gene therapies gain popularity and feasibility across a...
During a session at the AMCP...
05/31/2018
First Report Managed Care
Department
Specialty Pharmacy Pipeline Session Highlights Cancer, Orphan Drug Development
05/31/2018
Aimee Tharaldson, PharmD, senior clinical consultant of emerging therapeutics at Express Scripts, kicked off the AMCP 2018 Annual Meeting with an overview of the specialty drug pipeline.
Aimee Tharaldson, PharmD, senior clinical consultant of emerging therapeutics at Express Scripts, kicked off the AMCP 2018 Annual Meeting with an overview of the specialty drug pipeline.
Aimee Tharaldson, PharmD, senior...
05/31/2018
First Report Managed Care
Negotiating and Contracting With Pharmacy Benefits Managers
05/24/2018
Dean Celia
In this Payer Roundtable, an expert panel discussed practices that can help even the playing field and ensure that your PBM partner is creating maximum value.
In this Payer Roundtable, an expert panel discussed practices that can help even the playing field and ensure that your PBM partner is creating maximum value.
In this Payer Roundtable, an...
05/24/2018
First Report Managed Care
Silver Loading: Impact on 2019 Premiums
05/18/2018
Mary Beth Nierengarten
Repealing the cost-sharing subsidies for insurers has led to the practice of “silver-loading,” in which payers increase the prices of silver plans to maximize federal subsidies.
Repealing the cost-sharing subsidies for insurers has led to the practice of “silver-loading,” in which payers increase the prices of silver plans to maximize federal subsidies.
Repealing the...
05/18/2018
First Report Managed Care
Department
Value of Novel HER2+ Breast Cancer Therapies
05/15/2018
Sreejata Raychaudhuri, MD; Adam Brufsky, MD, PhD
Adam Brufsky, MD, PhD, and Sreejata Raychaudhuri, MD, recently discussed how the novel HER2+ therapies fit into breast cancer treatment.
Adam Brufsky, MD, PhD, and Sreejata Raychaudhuri, MD, recently discussed how the novel HER2+ therapies fit into breast cancer treatment.
Adam Brufsky, MD, PhD, and...
05/15/2018
First Report Managed Care
Department
Understanding the Role of PARP Inhibitors
05/14/2018
David Costill
In an interview with First Report Managed Care, Don S Dizon MD FACP, FASCO, Director of Women’s Cancers at the Lifespan Cancer Institute, discussed the role PARP inhibitors play in the treatment of ovarian cancer.
In an interview with First Report Managed Care, Don S Dizon MD FACP, FASCO, Director of Women’s Cancers at the Lifespan Cancer Institute, discussed the role PARP inhibitors play in the treatment of ovarian cancer.
In an interview with First...
05/14/2018
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

May 2018 Volume 15 Issue 5

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