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April 2018 - FRMC

Conference Insider
Study Examines Multiple PARP Inhibitors
05/07/2018
A featured poster session at the Society of Gynecologic Oncology’s (SGO) 2018 Annual Meeting detailed the results of a study comparing the efficacy and tolerability of PARP inhibitors as maintenance treatment in BRCA-mutated...
A featured poster session at the Society of Gynecologic Oncology’s (SGO) 2018 Annual Meeting detailed the results of a study comparing the efficacy and tolerability of PARP inhibitors as maintenance treatment in BRCA-mutated...
A featured poster session at the...
05/07/2018
First Report Managed Care
Conference Insider
The Current and Future Role of PARP Inhibitors
05/07/2018
Joyce F Liu, MD, MPH, recently discussed the current and future role of PARP inhibitors for the treatment of ovarian cancer at the Society of Gynecologic Oncology’s 2018 Annual Meeting.
Joyce F Liu, MD, MPH, recently discussed the current and future role of PARP inhibitors for the treatment of ovarian cancer at the Society of Gynecologic Oncology’s 2018 Annual Meeting.
Joyce F Liu, MD, MPH, recently...
05/07/2018
First Report Managed Care
Conference Insider
ASCO Alternative Payment Model Yields Savings in Ovarian Cancer
05/07/2018
The American Society of Clinical Oncology’s (ASCO) Patient-Centered Oncology Payment (PCOP) model helps achieve costs savings in ovarian cancer when hospitalizations are reduced during the active treatment period, according to a study...
The American Society of Clinical Oncology’s (ASCO) Patient-Centered Oncology Payment (PCOP) model helps achieve costs savings in ovarian cancer when hospitalizations are reduced during the active treatment period, according to a study...
The American Society of Clinical...
05/07/2018
First Report Managed Care
Conference Insider
Urgent TAVR Has Beneficial Outcomes Compared With Elective TAVR
05/07/2018
Recent research presented at the ACC 2018 Scientific Session found that urgent or emergent transcatheter aortic valve replacement (TAVR) has acceptable outcomes when compared with elective TAVR. 
Recent research presented at the ACC 2018 Scientific Session found that urgent or emergent transcatheter aortic valve replacement (TAVR) has acceptable outcomes when compared with elective TAVR. 
Recent research presented at the...
05/07/2018
First Report Managed Care
Conference Insider
P2Y12 Inhibitor Copayment Program Did Not Improve Outcomes for MI Patients
05/07/2018
A recent clinical trial found that while reducing copayments for myocardial infarction (MI) patients taking P2Y12 receptor inhibitors improved adherence, it did not impact clinical outcomes after 1 year.
A recent clinical trial found that while reducing copayments for myocardial infarction (MI) patients taking P2Y12 receptor inhibitors improved adherence, it did not impact clinical outcomes after 1 year.
A recent clinical trial found...
05/07/2018
First Report Managed Care
Conference Insider
SGLT-2 Inhibitors Significantly Reduced Risk for CVD in Diabetes Patients
05/07/2018
New data released at the 2018 ACC Scientific Session confirmed that use of SGLT-2 inhibitors among patients with type-2 diabetes significantly decreases risk for cardiovascular death.
New data released at the 2018 ACC Scientific Session confirmed that use of SGLT-2 inhibitors among patients with type-2 diabetes significantly decreases risk for cardiovascular death.
New data released at the 2018...
05/07/2018
First Report Managed Care
Conference Insider
Opioid Misuse Risk Management Strategies For Payers and PBMs
05/07/2018
David Calabrese, RPh, MHP, Chief Pharmacy Officer at OptumRx, discussed how payers and PBMs can mitigate the risk and impact of the current opioid crisis in the United States, during his session at the PBMI 2018 National Conference.
David Calabrese, RPh, MHP, Chief Pharmacy Officer at OptumRx, discussed how payers and PBMs can mitigate the risk and impact of the current opioid crisis in the United States, during his session at the PBMI 2018 National Conference.
David Calabrese, RPh, MHP, Chief...
05/07/2018
First Report Managed Care
Conference Insider
An Investor’s Perspective on Shifting PBM Landscape
05/07/2018
Recently at the PBMI 2018 Annual Meeting, George Hill, managing director at RBC Capital Markets, recapped some recent marketplace changes and gave his outlook on how the PBM landscape is trending.
Recently at the PBMI 2018 Annual Meeting, George Hill, managing director at RBC Capital Markets, recapped some recent marketplace changes and gave his outlook on how the PBM landscape is trending.
Recently at the PBMI 2018 Annual...
05/07/2018
First Report Managed Care
Conference Insider
General Session: Is the PBM Industry Evolving or Disrupting?
05/07/2018
During the keynote presentation at PBMI, Adam Fein, PhD, discussed the current place of PBMs in the market and how he sees this changing in the near future.
During the keynote presentation at PBMI, Adam Fein, PhD, discussed the current place of PBMs in the market and how he sees this changing in the near future.
During the keynote presentation...
05/07/2018
First Report Managed Care
Conference Insider
ICER’s President Discusses The Future of Formulary Design
05/07/2018
During PBMI 2018, Steve Pearson, MD, explained how payers can improve access to high cost drugs without sacrificing affordability.
During PBMI 2018, Steve Pearson, MD, explained how payers can improve access to high cost drugs without sacrificing affordability.
During PBMI 2018, Steve Pearson,...
05/07/2018
First Report Managed Care
Viewpoint
Understanding Changes to the Medicare Advantage 2019 Risk Adjustment Model
05/07/2018
Jay Baker
In this Viewpoint, Jay Baker, Senior Vice President, Quality and Risk Adjustment Solutions, Advantmed, LLC, discusses the significant and complex proposed changes to the Medicare Advantage model which will require health plans to make...
In this Viewpoint, Jay Baker, Senior Vice President, Quality and Risk Adjustment Solutions, Advantmed, LLC, discusses the significant and complex proposed changes to the Medicare Advantage model which will require health plans to make...
In this Viewpoint, Jay Baker,...
05/07/2018
First Report Managed Care
News Connection
Ex-VA Secretary Shulkin Leaves With Scathing Comments on Privatization
05/07/2018
After David Shulkin, MD, was abruptly fired by President Donald Trump, he claimed he was pushed out of the Department of Veterans Affairs (VA) by political opponents who saw him as a obstacle to expanding privatization of care at the Agency.
After David Shulkin, MD, was abruptly fired by President Donald Trump, he claimed he was pushed out of the Department of Veterans Affairs (VA) by political opponents who saw him as a obstacle to expanding privatization of care at the Agency.
After David Shulkin, MD, was...
05/07/2018
First Report Managed Care
News Connection
CVS, Aetna Deal Could Cause Antitrust Issues
05/07/2018
A recent report released by the American Antitrust Institute (AAI) alerted the Department of Justice (DOJ) that the proposed merger of CVS and Aetna would hurt consumers and the health care industry.
A recent report released by the American Antitrust Institute (AAI) alerted the Department of Justice (DOJ) that the proposed merger of CVS and Aetna would hurt consumers and the health care industry.
A recent report released by the...
05/07/2018
First Report Managed Care
News Connection
Jardiance Trials Expand With New Exercise Capacity and Heart Failure Trials
05/07/2018
Boehringer Ingelheim and Eli Lilly recently announced that they plan to expand trials of Jardiance (empagliflozin; Boehringer Ingelheim/Eli Lilly) to study impact on exercise ability and heart failure symptoms. 
Boehringer Ingelheim and Eli Lilly recently announced that they plan to expand trials of Jardiance (empagliflozin; Boehringer Ingelheim/Eli Lilly) to study impact on exercise ability and heart failure symptoms. 
Boehringer Ingelheim and Eli...
05/07/2018
First Report Managed Care
Department
Outcomes-Based Pricing for PCSK9 Inhibitors Does Not Reduce Costs
05/07/2018
Recent research in the Annals of Internal Medicine found that outcomes-based contracting for expensive PCSK9 inhibitors did not reduce drug costs or improve cost-effectiveness of the drug.
Recent research in the Annals of Internal Medicine found that outcomes-based contracting for expensive PCSK9 inhibitors did not reduce drug costs or improve cost-effectiveness of the drug.
Recent research in the Annals of...
05/07/2018
First Report Managed Care
News Connection
Genome Sequencing Does Not Increase Downstream Health Care Costs
05/07/2018
A recent study in Genetics in Medicine found that genome sequencing in healthy patients and cardiology patients did not increase downstream health care costs.
A recent study in Genetics in Medicine found that genome sequencing in healthy patients and cardiology patients did not increase downstream health care costs.
A recent study in Genetics in...
05/07/2018
First Report Managed Care
An Inside Look at the Prior Authorization Process
05/07/2018
Dean Celia
A case in California involving an Aetna medical director who denied treatment without looking at patient records recently caused a stir in the media. We spoke with our experts to review best practices, how to involve nurses and specialists in...
A case in California involving an Aetna medical director who denied treatment without looking at patient records recently caused a stir in the media. We spoke with our experts to review best practices, how to involve nurses and specialists in...
A case in California involving...
05/07/2018
First Report Managed Care
Newsfeed
NCQA Weighs In On Prior Authorization
04/21/2018
The National Committee for Quality Assurance (NCQA) president Margaret O’Kane recently discussed Aetna's prior authorization denials process which is currently being investigated by at least four states.
The National Committee for Quality Assurance (NCQA) president Margaret O’Kane recently discussed Aetna's prior authorization denials process which is currently being investigated by at least four states.
The National Committee for...
04/21/2018
First Report Managed Care
News
How New HHS Policies Could Exacerbate Social Determinants of Health
04/11/2018
Paul Nicolaus
As the Trump Administration takes measures to broaden the moral and religious rights of health care professionals, critics say these moves may exacerbate existing social determinants of health among LGBT patients.
As the Trump Administration takes measures to broaden the moral and religious rights of health care professionals, critics say these moves may exacerbate existing social determinants of health among LGBT patients.
As the Trump Administration...
04/11/2018
First Report Managed Care
News
Law of the Land? States Attempt At Circumventing the ACA
04/02/2018
Mary Beth Nierengarten
A number of states have recently launched a range of attacks on the ACA, from offering plans that don’t meet its requirements to challenging its constitutionality.
A number of states have recently launched a range of attacks on the ACA, from offering plans that don’t meet its requirements to challenging its constitutionality.
A number of states have recently...
04/02/2018
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

April 2018 Volume 15 Issue 4

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