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November 2014 - FRMC

Investigation of Canagliflozin Use in a Real-World Setting
11/14/2014
Eileen Koutnik-Fotopoulos
In a new study, researchers investigated the demographic and clinical factors of patients initiating canagliflozin or DPP-4 therapy in a large commercially insured US population.
In a new study, researchers investigated the demographic and clinical factors of patients initiating canagliflozin or DPP-4 therapy in a large commercially insured US population.
In a new study, researchers...
11/14/2014
First Report Managed Care
Study Examines Cost-Effectiveness of Interferon for MS
11/14/2014
Eileen Koutnik-Fotopoulos
Clinical data from the EVIDENCE study found that the cost-effectiveness of subcutaneous interferon (IFN) ß-1a 44 mcg given 3 times weekly was favorable compared with intramuscular IFN ß-1a 30 mcg given once weekly for relapsing forms of...
Clinical data from the EVIDENCE study found that the cost-effectiveness of subcutaneous interferon (IFN) ß-1a 44 mcg given 3 times weekly was favorable compared with intramuscular IFN ß-1a 30 mcg given once weekly for relapsing forms of...
Clinical data from the EVIDENCE...
11/14/2014
First Report Managed Care
News
Study Examines Costs for Various Psoriasis Treatments
11/14/2014
Eileen Koutnik-Fotopoulos
The economic burden of psoriasis in the United States is significant, as it is estimated to cost $11.25 billion annually in total direct and indirect healthcare costs, according to statistics from the National Psoriasis Foundation.
The economic burden of psoriasis in the United States is significant, as it is estimated to cost $11.25 billion annually in total direct and indirect healthcare costs, according to statistics from the National Psoriasis Foundation.
The economic burden of psoriasis...
11/14/2014
First Report Managed Care
Examining Breakthrough Designation Labeling
11/14/2014
Kerri Fitzgerald
Breakthrough therapy designation was established as part of the FDA Safety and Innovation Act of 2012.
Breakthrough therapy designation was established as part of the FDA Safety and Innovation Act of 2012.
Breakthrough therapy designation...
11/14/2014
First Report Managed Care
Budget Model Analyzes Formulary Costs for Obesity Drugs
11/14/2014
Eileen Koutnik-Fotopoulos
A recent study evaluated formulary cost implications associated with the addition of naltrexone/bupropion for the treatment of obesity in the United States.
A recent study evaluated formulary cost implications associated with the addition of naltrexone/bupropion for the treatment of obesity in the United States.
A recent study evaluated...
11/14/2014
First Report Managed Care
Tbo-Filgrastim Shows Significant Cost Saving for Payers
11/14/2014
Eileen Koutnik-Fotopoulos
A pharmacy budget impact model to estimate, from a payer perspective, the impact of the introduction of tbo-filgrastim as an alternative short-acting granulocyte colony-stimulating factor on a pharmacy budget showed a total annual plan cost...
A pharmacy budget impact model to estimate, from a payer perspective, the impact of the introduction of tbo-filgrastim as an alternative short-acting granulocyte colony-stimulating factor on a pharmacy budget showed a total annual plan cost...
A pharmacy budget impact model...
11/14/2014
First Report Managed Care
More Generics, Biosimilars, and Orphan Drugs on the Horizon
11/14/2014
Jill Sederstorm
As patented products expire, >$13 billion in brand-name specialty medications are expected to face generic competition in the next 5 years, and it is projected that there is a $31.8 billion opportunity in the market for biosimilars through...
As patented products expire, >$13 billion in brand-name specialty medications are expected to face generic competition in the next 5 years, and it is projected that there is a $31.8 billion opportunity in the market for biosimilars through...
As patented products expire,...
11/14/2014
First Report Managed Care
Conference Insider
AMCP Addresses Stance on Federal and State Legislative and Regulatory Moves
11/14/2014
Jill Sederstorm
Legislation on medication therapy management expansion and Medicare drug price negotiations are being discussed on the federal level, while states are considering legislation in the areas of biosimilars, controlled substances, and benefit...
Legislation on medication therapy management expansion and Medicare drug price negotiations are being discussed on the federal level, while states are considering legislation in the areas of biosimilars, controlled substances, and benefit...
Legislation on medication...
11/14/2014
First Report Managed Care
Tools to Help Payers Manage Growing Drug Costs
11/14/2014
Mary Beth Nierengarten
As with other specialty drugs, the high cost of medications to treat hepatitis C presents payers with the challenge of helping their members get the medications they need, while attempting to maintain healthcare costs.
As with other specialty drugs, the high cost of medications to treat hepatitis C presents payers with the challenge of helping their members get the medications they need, while attempting to maintain healthcare costs.
As with other specialty drugs,...
11/14/2014
First Report Managed Care
Conference Insider
Paradigm Change: New Guidelines on Managing Cholesterol
11/14/2014
Mary Beth Nierengarten
“This is a large paradigm change for clinicians,” said Joseph Saseen, PharmD, professor, vice chair, department of clinical pharmacy, professor, department of family medicine, University of Colorado Skaggs School of Pharmacy and...
“This is a large paradigm change for clinicians,” said Joseph Saseen, PharmD, professor, vice chair, department of clinical pharmacy, professor, department of family medicine, University of Colorado Skaggs School of Pharmacy and...
“This is a large paradigm change...
11/14/2014
First Report Managed Care
Conference Insider
MTM Provides Value for Patients and Payers
11/14/2014
Eileen Koutnik-Fotopoulos
In recent years, medication therapy management (MTM) has become a staple for Medicare Part D. The Patient Protection and Affordable Care Act requires improvements in Part D MTM programs, which are thought to lead to better outcomes in patient...
In recent years, medication therapy management (MTM) has become a staple for Medicare Part D. The Patient Protection and Affordable Care Act requires improvements in Part D MTM programs, which are thought to lead to better outcomes in patient...
In recent years, medication...
11/14/2014
First Report Managed Care
Conference Insider
Using CER to Evaluate Companion Diagnostics
11/14/2014
Eileen Koutnik-Fotopoulos
Personalized medicine is playing an increasing role in drug development, and many drugs already have biomarkers to treat diseases, particularly cancer, and more are on the horizon.
Personalized medicine is playing an increasing role in drug development, and many drugs already have biomarkers to treat diseases, particularly cancer, and more are on the horizon.
Personalized medicine is playing...
11/14/2014
First Report Managed Care
Assessing Value of Drugs for Formulary: A Challenge for Stakeholders
11/14/2014
Eileen Koutnik-Fotopoulos
Many developed countries with a national health service have a single dominant method used by the national insurer to assess and compare the value of health services. Yet, the United States lacks a uniform system to assess the value of drugs...
Many developed countries with a national health service have a single dominant method used by the national insurer to assess and compare the value of health services. Yet, the United States lacks a uniform system to assess the value of drugs...
Many developed countries with a...
11/14/2014
First Report Managed Care
COPD Projected to be Third Leading Cause of Death by 2020
11/14/2014
Kerri Fitzgerald
Chronic obstructive pulmonary disease (COPD) is the leading cause of morbidity and mortality worldwide, and by 2020, COPD will be the third leading cause of mortality.
Chronic obstructive pulmonary disease (COPD) is the leading cause of morbidity and mortality worldwide, and by 2020, COPD will be the third leading cause of mortality.
Chronic obstructive pulmonary...
11/14/2014
First Report Managed Care
Empagliflozin Breaks into Type 2 Diabetes Market
11/14/2014
Kerri Fitzgerald
“[Type 2 diabetes is an] expensive and challenging disease state to treat,” said Ron Dasher, RPh, at the AMCP meeting during a product theater covering the recent approval of empagliflozin.
“[Type 2 diabetes is an] expensive and challenging disease state to treat,” said Ron Dasher, RPh, at the AMCP meeting during a product theater covering the recent approval of empagliflozin.
“[Type 2 diabetes is an]...
11/14/2014
First Report Managed Care
Recent and Future Drug Approvals for Important Disease States
11/14/2014
Kerri Fitzgerald
With an influx of blockbuster drugs coming off patent in the next few years, in 2015, a potential $20.9 billion revenue could be reached for first-time generics.
With an influx of blockbuster drugs coming off patent in the next few years, in 2015, a potential $20.9 billion revenue could be reached for first-time generics.
With an influx of blockbuster...
11/14/2014
First Report Managed Care
Biosimilars Coming to Market in 2015, Questions Ensue
11/14/2014
Kerri Fitzgerald
The first FDA-approved biosimilar agent is expected to hit the market in March 2015; however, there are still a number of questions and concerns.
The first FDA-approved biosimilar agent is expected to hit the market in March 2015; however, there are still a number of questions and concerns.
The first FDA-approved...
11/14/2014
First Report Managed Care
Conference Insider
ACC/AHA Guidelines Still Stirring Up Discussion, Questions
11/14/2014
Kerri Fitzgerald
Since the 2013 American College of Cardiology (ACC) and American Heart Association (AHA) joint guidelines were published, debate has ensued.
Since the 2013 American College of Cardiology (ACC) and American Heart Association (AHA) joint guidelines were published, debate has ensued.
Since the 2013 American College...
11/14/2014
First Report Managed Care
Drug Spending Reaches All-Time High for Specialty Pharmacy
11/14/2014
Kerri Fitzgerald
“[Specialty pharmacy] is front page news today,” said Jim Smeeding, RPh, MBA, executive director, NASP, as he opened a session on current trends and future outlooks on the specialty pharmacy industry.
“[Specialty pharmacy] is front page news today,” said Jim Smeeding, RPh, MBA, executive director, NASP, as he opened a session on current trends and future outlooks on the specialty pharmacy industry.
“[Specialty pharmacy] is front...
11/14/2014
First Report Managed Care
Conference Insider
Multiple Sclerosis Remains a Top Concern for Costly Disease Management
11/14/2014
Kerri Fitzgerald
Boston—Multiple sclerosis (MS) is the most common chronic disease affecting the central nervous system in young adults, and it continues to be a costly burden on the healthcare system in terms of treatment options. During a satellite...
Boston—Multiple sclerosis (MS) is the most common chronic disease affecting the central nervous system in young adults, and it continues to be a costly burden on the healthcare system in terms of treatment options. During a satellite...
Boston—Multiple sclerosis (MS)...
11/14/2014
First Report Managed Care
Another Costly Drug Approval Keeps Spotlight on Hepatitis C
11/14/2014
Kerri Fitzgerald
Once again, HCV is at the forefront of discussions as the FDA just recently approved the first once-daily oral combination of ledipasvir and sofosbuvir to treat HCV genotype 1 infection, which comes with an even larger pricetag: $94,500 for a...
Once again, HCV is at the forefront of discussions as the FDA just recently approved the first once-daily oral combination of ledipasvir and sofosbuvir to treat HCV genotype 1 infection, which comes with an even larger pricetag: $94,500 for a...
Once again, HCV is at the...
11/14/2014
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
Dairy, Gluten Show No Major Effect on MS Activity and Quality of Life
02/15/2024
Jolynn Tumolo
Dairy and gluten intake had no substantial effects on disease activity and quality of life in a retrospective study of 186 patients with multiple sclerosis (MS). Researchers published their findings online in Multiple Sclerosis Journal –...
Dairy and gluten intake had no substantial effects on disease activity and quality of life in a retrospective study of 186 patients with multiple sclerosis (MS). Researchers published their findings online in Multiple Sclerosis Journal –...
Dairy and gluten intake had no...
02/15/2024
First Report Managed Care
News
Health Care Administration Inefficiencies: Lessons from the 2024 Medallion Report
03/26/2024
Hannah Musick
Discover the impact of manual processes and staffing challenges on payer enrollment and credentialing workflows in the 2024 State of Payer Enrollment and Credentialing Report by Medallion.
Discover the impact of manual processes and staffing challenges on payer enrollment and credentialing workflows in the 2024 State of Payer Enrollment and Credentialing Report by Medallion.
Discover the impact of manual...
03/26/2024
First Report Managed Care
IPF letters
Formulary Frontlines®
New Therapies in Development for Idiopathic Pulmonary Fibrosis (IPF) Address Existing Challenges With Diagnosis and Management
05/13/2024

Reviewed by Elizabeth Volkmann, MD, MS

Reviewed by Elizabeth Volkmann, MD, M...
IPF is a chronic, progressive interstitial lung disease that presents a significant burden to ~3 million patients worldwide. Despite ongoing challenges with IPF diagnosis and management, new therapies in development are showing promise.
IPF is a chronic, progressive interstitial lung disease that presents a significant burden to ~3 million patients worldwide. Despite ongoing challenges with IPF diagnosis and management, new therapies in development are showing promise.
IPF is a chronic, progressive...
05/13/2024
First Report Managed Care
Conference Coverage
Immune Colitis Associated With Rituximab Therapy in Relapsing Multiple Sclerosis
05/24/2024
Hannah Musick
A case study highlighted rare immune colitis associated with rituximab therapy in a patient with relapsing multiple sclerosis (RMS) and emphasizes the need for increased awareness and monitoring of this potential adverse effect in clinical...
A case study highlighted rare immune colitis associated with rituximab therapy in a patient with relapsing multiple sclerosis (RMS) and emphasizes the need for increased awareness and monitoring of this potential adverse effect in clinical...
A case study highlighted rare...
05/24/2024
First Report Managed Care
Katie Devlin
Interview
Strategies for Adjusting With Health Care Interoperability
07/01/2024
Katie Devlin, DHSc, MS, CPHIMS
In this interview, Katie Devlin, VP of Interoperability at Cotiviti, discusses the impact of major shifts like TEFCA and the CMS Interoperability Rule on health plans, emphasizing the importance of joining a QHIN to increase data...
In this interview, Katie Devlin, VP of Interoperability at Cotiviti, discusses the impact of major shifts like TEFCA and the CMS Interoperability Rule on health plans, emphasizing the importance of joining a QHIN to increase data...
In this interview, Katie Devlin,...
07/01/2024
First Report Managed Care

November 2014 Volume 11 Issue 11

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