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Formulary Frontlines®

Formulary Frontlines®
Comparative Review of Alzheimer Therapeutics Coverage Across 3 Major Health Plans
03/20/2026
Danielle Sposato
Alzheimer’s disease treatment is entering a new—and highly complex—era. With the rise of disease-modifying therapies, increasing scrutiny around cost and clinical value, and evolving payer policies, understanding real-world formulary access...
Alzheimer’s disease treatment is entering a new—and highly complex—era. With the rise of disease-modifying therapies, increasing scrutiny around cost and clinical value, and evolving payer policies, understanding real-world formulary access...
Alzheimer’s disease treatment is...
03/20/2026
First Report Managed Care
Formulary Frontlines®
Comparative Review of Atopic Dermatitis Therapeutics Coverage Across 3 Major Health Plans
02/17/2026
Juliet Gallagher
As atopic dermatitis treatment advances from traditional immunosuppressants and topical steroids to high-cost biologics and oral JAK inhibitors, payers are recalibrating how—and when—patients gain access to systemic therapy. Our latest...
As atopic dermatitis treatment advances from traditional immunosuppressants and topical steroids to high-cost biologics and oral JAK inhibitors, payers are recalibrating how—and when—patients gain access to systemic therapy. Our latest...
As atopic dermatitis treatment...
02/17/2026
First Report Managed Care
Formulary Frontlines®
Comparative Review of Migraine Therapeutics Coverage Across 3 Major Health Plans
11/20/2025
Juliet Gallagher
As migraine therapeutics evolve from legacy triptans to high-cost, targeted CGRP agents, payers face the challenge of balancing clinical innovation with cost containment. Our latest Formulary Frontlines analysis compares how Blue Cross Blue...
As migraine therapeutics evolve from legacy triptans to high-cost, targeted CGRP agents, payers face the challenge of balancing clinical innovation with cost containment. Our latest Formulary Frontlines analysis compares how Blue Cross Blue...
As migraine therapeutics evolve...
11/20/2025
First Report Managed Care
Formulary Frontlines®
Comparative Review of Asthma Biologics and Anti-Inflammatories Coverage Across 3 Major Health Plans
09/26/2025
Juliet Gallagher
As the asthma treatment landscape evolves, payers must navigate the balance between broad access to foundational therapies and tight controls on high-cost biologics. Our latest Formulary Frontlines analysis compares how Blue Cross Blue...
As the asthma treatment landscape evolves, payers must navigate the balance between broad access to foundational therapies and tight controls on high-cost biologics. Our latest Formulary Frontlines analysis compares how Blue Cross Blue...
As the asthma treatment...
09/26/2025
First Report Managed Care
Formulary Frontlines®
Comparative Review of DMARDs Coverage Across 3 Major Health Plans
07/25/2025
Danielle Sposato; Juliet Gallagher
Our latest Formulary Frontlines report compares how Blue Cross Blue Shield, Cigna, and UnitedHealthcare manage coverage across key MS drug classes—revealing major differences in tier placement, access restrictions, and class inclusion. Gain...
Our latest Formulary Frontlines report compares how Blue Cross Blue Shield, Cigna, and UnitedHealthcare manage coverage across key MS drug classes—revealing major differences in tier placement, access restrictions, and class inclusion. Gain...
Our latest Formulary Frontlines...
07/25/2025
First Report Managed Care
Formulary Frontlines®
Comparative Review of RA Biologics and DMARDs Coverage Across 3 Major Health Plans
05/23/2025
Danielle Sposato; Juliet Gallagher
Our latest Formulary Frontlines report analyzes how Blue Cross Blue Shield, Cigna, and UnitedHealthcare structure coverage for RA biologics and DMARDs, revealing key differences in tiering, utilization management, and biosimilar strategy....
Our latest Formulary Frontlines report analyzes how Blue Cross Blue Shield, Cigna, and UnitedHealthcare structure coverage for RA biologics and DMARDs, revealing key differences in tiering, utilization management, and biosimilar strategy....
Our latest Formulary Frontlines...
05/23/2025
First Report Managed Care
Formulary Frontlines®
Comparative Review of Anticoagulant Coverage Across 3 Major Health Plans
11/14/2024
Danielle Sposato; David J. Sand, MD, MBA
When thinking of anticoagulants as a drug class, their treatment and usage across therapeutic areas is vast and growing. Anticoagulants can treat patients across these therapeutic areas, from blood clotting disorders to thromboembolic...
When thinking of anticoagulants as a drug class, their treatment and usage across therapeutic areas is vast and growing. Anticoagulants can treat patients across these therapeutic areas, from blood clotting disorders to thromboembolic...
When thinking of anticoagulants...
11/14/2024
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
Formulary Frontlines®
Challenges, Treatment Options, and Costs Linked With Upper Tract Urothelial Carcinoma
06/20/2023
Julie Gould
Bladder cancer was the sixth most common cancer type in the United States in 2020, behind breast, lung, prostate, colon, and skin cancers.
Bladder cancer was the sixth most common cancer type in the United States in 2020, behind breast, lung, prostate, colon, and skin cancers.
Bladder cancer was the sixth...
06/20/2023
First Report Managed Care
Formulary Frontlines®
Lurbinectedin Proves Effective as Second-line Therapy Option for Patients With Metastatic SCLC
04/07/2021
Edan Stanley
"Seeing first-hand the aggressive nature of SCLC and knowing that the large majority of those diagnosed will experience relapse, I am excited to see an effective new treatment demonstrating durable responses," said William Jeffrey Petty, MD,...
"Seeing first-hand the aggressive nature of SCLC and knowing that the large majority of those diagnosed will experience relapse, I am excited to see an effective new treatment demonstrating durable responses," said William Jeffrey Petty, MD,...
"Seeing first-hand the...
04/07/2021
First Report Managed Care

Pipeline Projections

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
Pipeline Projections
Examining Newly FDA-Approved Anticoagulants and Upcoming Drugs in the Approval Pipeline
02/12/2025
Roy Moore
In this episode of Pipeline Projections, Roy Moore—Senior Healthcare Research & Data Analyst at Clarivate and Editorial Board Member of First Report Managed Care—explores newly approved and existing anticoagulant therapies. He analyzes...
In this episode of Pipeline Projections, Roy Moore—Senior Healthcare Research & Data Analyst at Clarivate and Editorial Board Member of First Report Managed Care—explores newly approved and existing anticoagulant therapies. He analyzes...
In this episode of Pipeline...
02/12/2025
First Report Managed Care

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

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