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June 2017 - FRMC

Conference Insider
Novel Treatments and Strategies For Relapsing Multiple Sclerosis
07/06/2017
Gary Owens, MD, a managed health care consultant and a First Report Managed Care Editorial Advisory Board member, presented “Improving Patient Outcomes with Novel Treatments and Strategies in the Management of Relapsing Multiple Sclerosis,”...
Gary Owens, MD, a managed health care consultant and a First Report Managed Care Editorial Advisory Board member, presented “Improving Patient Outcomes with Novel Treatments and Strategies in the Management of Relapsing Multiple Sclerosis,”...
Gary Owens, MD, a managed health...
07/06/2017
First Report Managed Care
Conference Insider
Improving Management of Patients with Psoriasis to Reduce Costs
07/06/2017
Steven R Feldman, MD, PhD, professor of dermatology at the Psoriasis Treatment Center at Wake Forest University School of Medicine, discussed how to improve treatment adherence and outcomes in patients with psoriasis at the NAMCP 2017 Spring...
Steven R Feldman, MD, PhD, professor of dermatology at the Psoriasis Treatment Center at Wake Forest University School of Medicine, discussed how to improve treatment adherence and outcomes in patients with psoriasis at the NAMCP 2017 Spring...
Steven R Feldman, MD, PhD,...
07/06/2017
First Report Managed Care
Conference Insider
Targeted QI Initiative Improves CRC Screening Uptake
07/06/2017
A quality improvement initiative using fecal immunochemical testing (FIT) and colonoscopy was able to improve colorectal cancer (CRC) screening uptake in a managed care setting, according to a poster presented at Digestive Disease Week 2017.
A quality improvement initiative using fecal immunochemical testing (FIT) and colonoscopy was able to improve colorectal cancer (CRC) screening uptake in a managed care setting, according to a poster presented at Digestive Disease Week 2017.
A quality improvement initiative...
07/06/2017
First Report Managed Care
Conference Insider
Switching From Remicade to Biosimilar Inflectra Effective For IBD
07/06/2017
Research presented at Digestive Disease Week 2017 found that switching from Remicade (infliximab; Janssen) to Inflectra (infliximab-dyyb; Pfizer) did not cause inflammatory bowel disease (IBD) symptoms to evolve among a patient cohort in...
Research presented at Digestive Disease Week 2017 found that switching from Remicade (infliximab; Janssen) to Inflectra (infliximab-dyyb; Pfizer) did not cause inflammatory bowel disease (IBD) symptoms to evolve among a patient cohort in...
Research presented at Digestive...
07/06/2017
First Report Managed Care
Conference Insider
Integrated Care Model Improved Outcomes Patients With IBD
07/06/2017
A recent presentation at Digestive Disease Week 2017 showed that integrated models of care improve management and outcomes of inflammatory bowel diseases like Crohn disease and ulcerative colitis.
A recent presentation at Digestive Disease Week 2017 showed that integrated models of care improve management and outcomes of inflammatory bowel diseases like Crohn disease and ulcerative colitis.
A recent presentation at...
07/06/2017
First Report Managed Care
Conference Insider
Trulance Reduced Symptom Severity in Patients With Irritable Bowel Syndrome
07/06/2017
Recent research from two phase 3 clinical trials, presented at Digestive Disease Week 2017, showed that Trulance (plecanatide; Synergy) is safe and effective at reducing symptom severity in patients with irritable bowel syndrome (IBS) with...
Recent research from two phase 3 clinical trials, presented at Digestive Disease Week 2017, showed that Trulance (plecanatide; Synergy) is safe and effective at reducing symptom severity in patients with irritable bowel syndrome (IBS) with...
Recent research from two phase 3...
07/06/2017
First Report Managed Care
Conference Insider
Costs, Hospital Stay Reduced Through Nonsurgical Weight-Loss Treatment Option
07/06/2017
A study presented at Digestive Disease Week 2017 found that nonsurgical endoscopic sleeve gastroplasty may be an effective option for treating obesity in patients who are not candidates for surgery. 
A study presented at Digestive Disease Week 2017 found that nonsurgical endoscopic sleeve gastroplasty may be an effective option for treating obesity in patients who are not candidates for surgery. 
A study presented at Digestive...
07/06/2017
First Report Managed Care
Conference Insider
Financial Conflicts of Interest Common Among Clinical Pathway Vendors
07/06/2017
A majority of practitioners involved in clinical pathway development at three major oncology vendors received nonresearch general payments in 2015, according to research presented at the 2017 ASCO Annual Meeting.
A majority of practitioners involved in clinical pathway development at three major oncology vendors received nonresearch general payments in 2015, according to research presented at the 2017 ASCO Annual Meeting.
A majority of practitioners...
07/06/2017
First Report Managed Care
Conference Insider
Cancer Drug Costs Are Too High Relative to Clinical Value
07/06/2017
A recent poster presentation at the 2017 ASCO Annual Meeting found that the clinical value of new oncology drugs is not in line with high price increases over time. 
A recent poster presentation at the 2017 ASCO Annual Meeting found that the clinical value of new oncology drugs is not in line with high price increases over time. 
A recent poster presentation at...
07/06/2017
First Report Managed Care
Conference Insider
ACA Increased Cancer Screenings, Early Diagnosis
07/06/2017
Recent research presented at the 2017 ASCO Annual Meeting found that after implementation of the ACA, there was a slight increase in the percentage of cancers diagnosed at an earlier, more treatable stage.
Recent research presented at the 2017 ASCO Annual Meeting found that after implementation of the ACA, there was a slight increase in the percentage of cancers diagnosed at an earlier, more treatable stage.
Recent research presented at the...
07/06/2017
First Report Managed Care
Conference Insider
Burden on Treatment Costs Impact Quality of Life Among Melanoma Survivors
07/06/2017
Financial toxicity and excessive financial burden appeared common among melanoma survivors, frequently leading to disease-related distress, according to research presented at the 2017 ASCO Annual Meeting.
Financial toxicity and excessive financial burden appeared common among melanoma survivors, frequently leading to disease-related distress, according to research presented at the 2017 ASCO Annual Meeting.
Financial toxicity and excessive...
07/06/2017
First Report Managed Care
Conference Insider
HPV Vaccine Underutilized Despite Significant Oral HPV Infection Protection
07/06/2017
Research presented at the 2017 ASCO Annual Meeting showed that although human papillomavirus (HPV) vaccine reduces the rate of oral HPV infection, the vaccine is still underutilized among teens and young adults. 
Research presented at the 2017 ASCO Annual Meeting showed that although human papillomavirus (HPV) vaccine reduces the rate of oral HPV infection, the vaccine is still underutilized among teens and young adults. 
Research presented at the 2017...
07/06/2017
First Report Managed Care
News Connection
Pennsylvania Premiums Could Increase 20% in 2018 Without CSRs
07/06/2017
A double-digit rate increase could seriously affect a significant number of states if Congress and the Trump Administration fail to fund key ACA cost-sharing reductions to insurers, according to a press release from the Pennsylvania Insurance...
A double-digit rate increase could seriously affect a significant number of states if Congress and the Trump Administration fail to fund key ACA cost-sharing reductions to insurers, according to a press release from the Pennsylvania Insurance...
A double-digit rate increase...
07/06/2017
First Report Managed Care
News Connection
Senate Republicans Consider Taxing Employer-Sponsored Plans
07/06/2017
While they rework the AHCA into a more palatable bill, Republican Senators are reportedly mulling taxing employer-sponsored health insurance plans, according to The Wall Street Journal. 
While they rework the AHCA into a more palatable bill, Republican Senators are reportedly mulling taxing employer-sponsored health insurance plans, according to The Wall Street Journal. 
While they rework the AHCA into...
07/06/2017
First Report Managed Care
News Connection
UnitedHealth’s Experimental PCP-Integration Program, Harken Health, to Shut Down in 2017
07/06/2017
Harken Health, an experimental business model piloted by UnitedHealth, has announced it will shut down in 2017, according to a report in The Chicago Tribune.
Harken Health, an experimental business model piloted by UnitedHealth, has announced it will shut down in 2017, according to a report in The Chicago Tribune.
Harken Health, an experimental...
07/06/2017
First Report Managed Care
News Connection
ONC Poised to Shift Focus After Deep Budget Cuts
07/06/2017
Under President Donald Trump’s proposed budget plan, the Office of the National Coordinator for Health IT (ONC) would receive only $38 million in funding—$22 million less than the office received in 2016 and 2017. 
Under President Donald Trump’s proposed budget plan, the Office of the National Coordinator for Health IT (ONC) would receive only $38 million in funding—$22 million less than the office received in 2016 and 2017. 
Under President Donald Trump’s...
07/06/2017
First Report Managed Care
News Connection
Tymlos Reduces Fracture Risk Through 3.5 Therapy Years in Phase 3 Trial
07/06/2017
Tymlos, a recently FDA-approved human parathyroid hormone related peptide injection, showed a significant reduction in vertebral and nonvertebral bone fracture among postmenopausal women with osteoporosis after an extended 42-month trial,...
Tymlos, a recently FDA-approved human parathyroid hormone related peptide injection, showed a significant reduction in vertebral and nonvertebral bone fracture among postmenopausal women with osteoporosis after an extended 42-month trial,...
Tymlos, a recently FDA-approved...
07/06/2017
First Report Managed Care
News Connection
Galcanezumab Meets Migraine Reduction Goals in Three Phase 3 Trials
07/06/2017
The investigational treatment galcanezumab has met its primary endpoint of monthly migraine reduction in three separate phase 3 trials, according to a press release from the drug’s manufacturer. 
The investigational treatment galcanezumab has met its primary endpoint of monthly migraine reduction in three separate phase 3 trials, according to a press release from the drug’s manufacturer. 
The investigational treatment...
07/06/2017
First Report Managed Care
Payer Roundtable
Payer Roundtable: Are Drug Coupons a Burden for Payers?
06/15/2017
Dean Celia
As the shift to value-based care accelerates, experts discussed how coupons impact drug spending, explained when their use may make sense, and offered advice on addressing their impact.
As the shift to value-based care accelerates, experts discussed how coupons impact drug spending, explained when their use may make sense, and offered advice on addressing their impact.
As the shift to value-based care...
06/15/2017
First Report Managed Care
Managed Care Q&A
Connecting Payers With the Formulary Information They Need
06/13/2017
David Costill
Susan A Cantrell, RPh, CAE, CEO of the Academy of Managed Care Pharmacy (AMCP), discusses how AMCP's eDossier System can help health care and formulary decision makers easily review products as well as evaluate relevant, associated evidence.
Susan A Cantrell, RPh, CAE, CEO of the Academy of Managed Care Pharmacy (AMCP), discusses how AMCP's eDossier System can help health care and formulary decision makers easily review products as well as evaluate relevant, associated evidence.
Susan A Cantrell, RPh, CAE, CEO...
06/13/2017
First Report Managed Care
News
Biosimilars: Missing the Mark
06/12/2017
John Otrompke, BA, JD; David Costill
As pharmacy benefit managers negotiate deep discounts for reference biologics, biosimilar prices are not making the spending impact that payers had hoped for. 
As pharmacy benefit managers negotiate deep discounts for reference biologics, biosimilar prices are not making the spending impact that payers had hoped for. 
As pharmacy benefit managers...
06/12/2017
First Report Managed Care
Health Care Reform: What Can Payers Expect from Washington?
06/09/2017
Dean Celia
After an initial failed launch, the American Health Care Act will move to the Senate for consideration and further development. We spoke with managed care experts about the difficulties of passing a bill that improves health care coverage...
After an initial failed launch, the American Health Care Act will move to the Senate for consideration and further development. We spoke with managed care experts about the difficulties of passing a bill that improves health care coverage...
After an initial failed launch,...
06/09/2017
First Report Managed Care
News Connection
California Senate Passes Single-Payer Plan, Major Obstacles Remain
06/08/2017
The California Senate recently passed its plan to establish a single-payer health system in the State; however, a huge cost burden and logistical barriers will need solutions before the plan can become a reality. 
The California Senate recently passed its plan to establish a single-payer health system in the State; however, a huge cost burden and logistical barriers will need solutions before the plan can become a reality. 
The California Senate recently...
06/08/2017
First Report Managed Care
Formulary Frontlines®
Treatment Advances in Carcinoid Syndrome and Neuroendocrine Tumors
06/08/2017
Eileen Koutnik-Fotopoulos
Patients diagnosed with neuroendocrine tumors often experience different burdens associated with the disease resulting in costly treatments of thousands of dollars per year.
Patients diagnosed with neuroendocrine tumors often experience different burdens associated with the disease resulting in costly treatments of thousands of dollars per year.
Patients diagnosed with...
06/08/2017
First Report Managed Care
Pharmacy Insight
Runaway Drug Price Increases: Unsustainable Price Increases Burden Pharmacy Spending
06/08/2017
Russell J. Spjut, PharmD
Yearly incremental drug price increases are becoming an unsustainable burden on specialty pharmacy spending.
Yearly incremental drug price increases are becoming an unsustainable burden on specialty pharmacy spending.
Yearly incremental drug price...
06/08/2017
First Report Managed Care
Department
Oncology Spending Increases as New Treatments Emerge
06/08/2017
A recent report found that global spending on oncology therapeutics and supportive care drugs have increased by billions of dollars. 
A recent report found that global spending on oncology therapeutics and supportive care drugs have increased by billions of dollars. 
A recent report found that...
06/08/2017
First Report Managed Care
News Connection
Gilead’s Bictegravir Shows Equivalent Efficacy to Tivicay in Phase 3 Trials
06/08/2017
Multiple phase 3 HIV trials suggest fixed-dose combination treatment regimens containing Gilead's investigational agent bictegravir are noninferior to those containing GlaxoSmithKline’s Tivicay.
Multiple phase 3 HIV trials suggest fixed-dose combination treatment regimens containing Gilead's investigational agent bictegravir are noninferior to those containing GlaxoSmithKline’s Tivicay.
Multiple phase 3 HIV trials...
06/08/2017
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

June 2017 Volume 14 Issue 6

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