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Formulary Frontlines®

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
Formulary Frontlines®
New Options Available for Treatment-Resistant Depression
11/20/2020
Jeff Craven
Over the past 30 years, few new pharmacologic therapies have been developed for mood disorders, including depression. However, for patients who do not respond to conventional pharmacologic treatments for MDD, new answers for...
Over the past 30 years, few new pharmacologic therapies have been developed for mood disorders, including depression. However, for patients who do not respond to conventional pharmacologic treatments for MDD, new answers for...
Over the past 30 years, few new...
11/20/2020
First Report Managed Care
Formulary Frontlines®
Reducing Disease Progression, Burden for Patients With Multiple Myeloma
10/15/2020
Edan Stanley
Although it is rarer than most, multiple myeloma is the second most common blood cancer after non-Hodgkin lymphoma—effecting more than 130,000 adults in the United States.
Although it is rarer than most, multiple myeloma is the second most common blood cancer after non-Hodgkin lymphoma—effecting more than 130,000 adults in the United States.
Although it is rarer than most,...
10/15/2020
First Report Managed Care
Formulary Frontlines®
Achieving Effective Motor Control for Patients With Parkinson Disease
09/25/2020
Edan Stanley
There is no definitive cure for PD but the main objective is reducing symptoms and achieving effective motor control through medication and surgical therapy. The cornerstone of symptomatic treatment for PD is dopamine replacement therapy.
There is no definitive cure for PD but the main objective is reducing symptoms and achieving effective motor control through medication and surgical therapy. The cornerstone of symptomatic treatment for PD is dopamine replacement therapy.
There is no definitive cure for...
09/25/2020
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

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Trending Articles

News
Addressing Duchenne Muscular Dystrophy Challenges: Potential Benefits of Gene Transfer Therapy
10/02/2023
Danielle Sposato
Duchenne muscular dystrophy (DMD) is a genetic disorder characterized by the absence or near absence of functional dystrophin protein, leading to severe muscle weakness and early mortality, often before age 30. Current treatments, such as...
Duchenne muscular dystrophy (DMD) is a genetic disorder characterized by the absence or near absence of functional dystrophin protein, leading to severe muscle weakness and early mortality, often before age 30. Current treatments, such as...
Duchenne muscular dystrophy...
10/02/2023
First Report Managed Care
Videos
AVAHO 2023: Andrew Brunner, MD, Discusses Updates in MDS
10/20/2023
Andrew Brunner, MD
In this video, Dr Brunner reviews his recent discussion he held at the 2023 AVAHO Annual Meeting, and provides treatment updates in the treatment of MDS.
In this video, Dr Brunner reviews his recent discussion he held at the 2023 AVAHO Annual Meeting, and provides treatment updates in the treatment of MDS.
In this video, Dr Brunner...
10/20/2023
First Report Managed Care
News
Patients With MS Switching to Teriflunomide: Characteristics, Utilization, and Relapses
11/09/2023
Hannah Musick
“Switching to teriflunomide from existing DMTs in patients with relapsing MS resulted in a reduction in outpatient HCRU in this analysis of US claims data,” said researchers.
“Switching to teriflunomide from existing DMTs in patients with relapsing MS resulted in a reduction in outpatient HCRU in this analysis of US claims data,” said researchers.
“Switching to teriflunomide from...
11/09/2023
First Report Managed Care
Commentary
The Role of JAK Inhibitors in the Treatment of Autoimmune and Autoinflammatory Diseases
12/14/2023
Yvette C. Terrie, BS Pharm, RPh
While the majority of Janus kinase inhibitors (JAKs) are available in oral formulations, in July 2022, the FDA approved ruxolitinib cream 1.5% as the only topical formulation of a selective JAK (JAK1/JAK2) inhibitor approved in the US,...
While the majority of Janus kinase inhibitors (JAKs) are available in oral formulations, in July 2022, the FDA approved ruxolitinib cream 1.5% as the only topical formulation of a selective JAK (JAK1/JAK2) inhibitor approved in the US,...
While the majority of Janus...
12/14/2023
First Report Managed Care
Commentary
Request for FDA Approval: Prescription Digital Therapeutic Targeting Liver Disease With Breakthrough Device Designation
01/24/2024
Lisa Kuhns, PhD, MD
In January 2024, Better Therapeutics, Inc submitted a request to the US Food and Drug Administration (FDA) for Breakthrough Device Designation for its new prescription digital therapeutic (PDT) designed to treat metabolic...
In January 2024, Better Therapeutics, Inc submitted a request to the US Food and Drug Administration (FDA) for Breakthrough Device Designation for its new prescription digital therapeutic (PDT) designed to treat metabolic...
In January 2024, Better...
01/24/2024
First Report Managed Care

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