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March 2017 - FRMC

News Connection
Spiriva Respimat Approved for Children 6 and Up
03/20/2017
The FDA broadened the approval of Spiriva Respimat (tiotropium bromide; Boehringer Ingelheim) inhalation spray to include children 6 and older.
The FDA broadened the approval of Spiriva Respimat (tiotropium bromide; Boehringer Ingelheim) inhalation spray to include children 6 and older.
The FDA broadened the approval...
03/20/2017
First Report Managed Care
News Connection
Industry-Funded Postmarket Studies May Not Appropriately Measure Safety
03/20/2017
A study suggests that due to small sample sizes and potential conflicts of interest, manufacturer-funded studies of approved drugs may not be accurate.
A study suggests that due to small sample sizes and potential conflicts of interest, manufacturer-funded studies of approved drugs may not be accurate.
A study suggests that due to...
03/20/2017
First Report Managed Care
News Connection
ED Patients of Frequent Opioid Prescribers Often Become Long-Term Users
03/20/2017
Long-term opioid painkiller use appears more common among emergency department patients treated by physicians with higher opioid prescription rates.
Long-term opioid painkiller use appears more common among emergency department patients treated by physicians with higher opioid prescription rates.
Long-term opioid painkiller use...
03/20/2017
First Report Managed Care
News Connection
CMS Data Reveals Accelerating US Health Care Costs
03/20/2017
Nationwide health costs are expected to increase an average of 5.6% annually and will account for nearly 20% of the US economy by 2025.
Nationwide health costs are expected to increase an average of 5.6% annually and will account for nearly 20% of the US economy by 2025.
Nationwide health costs are...
03/20/2017
First Report Managed Care
News Connection
New Low Back Pain Guidelines Recommend Nonprescription Treatments First
03/20/2017
The American College of Physicians (ACP) recently issued new clinical guidelines recommending that physicians avoid prescribing pain management drugs when treating acute or subacute low back pain. 
The American College of Physicians (ACP) recently issued new clinical guidelines recommending that physicians avoid prescribing pain management drugs when treating acute or subacute low back pain. 
The American College of...
03/20/2017
First Report Managed Care
News Connection
“Chatbot” Tool Helps Improve Delivery of Care
03/20/2017
A team of hospitalists, radiation oncologists, and interventional radiologists at the University of California at Los Angeles (UCLA) is testing an artificial intelligence prototype that acts as a virtual consultant, providing timely,...
A team of hospitalists, radiation oncologists, and interventional radiologists at the University of California at Los Angeles (UCLA) is testing an artificial intelligence prototype that acts as a virtual consultant, providing timely,...
A team of hospitalists,...
03/20/2017
First Report Managed Care
News Connection
Low-Cost Medication Reminder Devices Fail to Improve Adherence
03/20/2017
Simple, low-cost medication reminder tools for long-term prescriptions have no significant effect on adherence rates of patients with various chronic illnesses.
Simple, low-cost medication reminder tools for long-term prescriptions have no significant effect on adherence rates of patients with various chronic illnesses.
Simple, low-cost medication...
03/20/2017
First Report Managed Care
News Connection
Shift to Same-Day Cardiac Procedure Could Cut $300 Million Annually
03/20/2017
US hospitals could save by shifting percutaneous coronary intervention procedures to transradial, same-day discharge procedures.
US hospitals could save by shifting percutaneous coronary intervention procedures to transradial, same-day discharge procedures.
US hospitals could save by...
03/20/2017
First Report Managed Care
News Connection
Ozanimod Prevents Multiple Sclerosis Relapse in Phase 3 Trial
03/20/2017
Multiple sclerosis patients treated with ozanimod, a selective S1P 1 and 5 receptor modulator, were less likely to relapse than those treated with weekly Avonex.
Multiple sclerosis patients treated with ozanimod, a selective S1P 1 and 5 receptor modulator, were less likely to relapse than those treated with weekly Avonex.
Multiple sclerosis patients...
03/20/2017
First Report Managed Care
News Connection
Lynparza Tablets Show Promise for BRCA-Mutated Metastatic Breast Cancer
03/20/2017
Compared with standard chemotherapy, Lynparza provided an improvement in progression-free survival of patients with HER2-negative metastatic breast cancer.
Compared with standard chemotherapy, Lynparza provided an improvement in progression-free survival of patients with HER2-negative metastatic breast cancer.
Compared with standard...
03/20/2017
First Report Managed Care
News Connection
Biosimilars Council Petitions Courts to Reject Adding Exclusivity Period
03/20/2017
The Association for Accessible Medicines’ Biosimilars Council filed a brief contesting a decision allowing biologic manufacturers market exclusivity beyond 12 years. 
The Association for Accessible Medicines’ Biosimilars Council filed a brief contesting a decision allowing biologic manufacturers market exclusivity beyond 12 years. 
The Association for Accessible...
03/20/2017
First Report Managed Care
News Connection
HHS: Launch of Medicare Bundled-Payment Models Remains on Track
03/20/2017
A final rule by the Department of Health and Human Services (HHS) that establishes several cardiac and orthopedic bundled-payment models under Medicare was recently delayed; however, recent reports clarified that the launch date of the...
A final rule by the Department of Health and Human Services (HHS) that establishes several cardiac and orthopedic bundled-payment models under Medicare was recently delayed; however, recent reports clarified that the launch date of the...
A final rule by the Department...
03/20/2017
First Report Managed Care
News Connection
CMS Proposes New Rule to Stabilize ACA Markets
03/20/2017
A recent rule proposed by the Centers for Medicare & Medicaid Services (CMS) intends to stabilize the Affordable Care Act (ACA) individual and small group insurance markets by expanding pre-enrollment verification, providing more flexibility...
A recent rule proposed by the Centers for Medicare & Medicaid Services (CMS) intends to stabilize the Affordable Care Act (ACA) individual and small group insurance markets by expanding pre-enrollment verification, providing more flexibility...
A recent rule proposed by the...
03/20/2017
First Report Managed Care
Aetna-Humana/Anthem-Cigna: Is This the End of Mega Mergers?
03/20/2017
Dean Celia
In the wake of the recently blocked health insurance mega-mergers, experts predict what the big payers might target next.
In the wake of the recently blocked health insurance mega-mergers, experts predict what the big payers might target next.
In the wake of the recently...
03/20/2017
First Report Managed Care
News
Challenges in Pain Management - Struggling to Treat Pain and Prevent Addiction
03/20/2017
Dean Celia
The opioid crisis has left payers struggling between effectively managing pain with prescription narcotics and withholding medication to prevent abuse and addiction.
The opioid crisis has left payers struggling between effectively managing pain with prescription narcotics and withholding medication to prevent abuse and addiction.
The opioid crisis has left...
03/20/2017
First Report Managed Care
Department
Xolair Reduced Urticarial Symptoms More Than Expected
03/20/2017
According to data, longer-term utilization of Xolair (omalizumab; Genentech) produced positive responses in a larger number of patients than expected.
According to data, longer-term utilization of Xolair (omalizumab; Genentech) produced positive responses in a larger number of patients than expected.
According to data, longer-term...
03/20/2017
First Report Managed Care
News
Asthma Adherence Pathway Improves Dulera Adherence
03/20/2017
Implementation of the Asthma Adherence Pathway among treatment physicians helped to improve adherence to Dulera and improved asthma control.
Implementation of the Asthma Adherence Pathway among treatment physicians helped to improve adherence to Dulera and improved asthma control.
Implementation of the Asthma...
03/20/2017
First Report Managed Care
Department
Allergy and Immunology Guidelines Lack Cost Considerations
03/20/2017
Recent research presented at the 2017 AAAAI Annual Meeting revealed that while the majority of specialty guidelines contain recommendations that take costs into account, no standard methodology exists for approaching cost concerns during...
Recent research presented at the 2017 AAAAI Annual Meeting revealed that while the majority of specialty guidelines contain recommendations that take costs into account, no standard methodology exists for approaching cost concerns during...
Recent research presented at the...
03/20/2017
First Report Managed Care
Department
Xolair Decreases Asthma Exacerbations and Hospitalizations
03/20/2017
According to real-world data, patients treated with Xolair (omalizumab; Genentech) experienced decreased asthma exacerbations and hospitalizations compared with baseline.
According to real-world data, patients treated with Xolair (omalizumab; Genentech) experienced decreased asthma exacerbations and hospitalizations compared with baseline.
According to real-world data,...
03/20/2017
First Report Managed Care
Department
Medication Adherence Does Not Equal Health Care Savings, Improved Productivity
03/20/2017
Uncontrolled asthma can have a significant impact on health care resource utilization and work productivity.
Uncontrolled asthma can have a significant impact on health care resource utilization and work productivity.
Uncontrolled asthma can have a...
03/20/2017
First Report Managed Care
Department
Researchers Examine Prescribing Trends for Epinephrine
03/20/2017
The significant cost increases of self-injectable epinephrine grabbed headlines recently, leading researchers to investigate prescription trends in a tertiary referral center in Los Angeles.
The significant cost increases of self-injectable epinephrine grabbed headlines recently, leading researchers to investigate prescription trends in a tertiary referral center in Los Angeles.
The significant cost increases...
03/20/2017
First Report Managed Care
Department
Engaging Medicaid Patients With Pharmacists Improves Adherence, Outcomes
03/20/2017
A presentation at the World Congress Medicaid Managed Care Summit addressed strategies for engaging members in face-to-face interactions with pharmacists.
A presentation at the World Congress Medicaid Managed Care Summit addressed strategies for engaging members in face-to-face interactions with pharmacists.
A presentation at the World...
03/20/2017
First Report Managed Care
Department
Tech Innovations Improve Care Coordination for Medicaid Patients
03/20/2017
At the World Congress Medicaid Managed Care Summit, Yousuf J Ahmad, DrPH, explained that care coordination can be optimized with innovative technology. 
At the World Congress Medicaid Managed Care Summit, Yousuf J Ahmad, DrPH, explained that care coordination can be optimized with innovative technology. 
At the World Congress Medicaid...
03/20/2017
First Report Managed Care
Department
Focusing on Behavioral Health Can Improve Medicaid Patient Population Health
03/20/2017
​A presentation at the World Congress 10th Annual Medicaid Managed Care Summit outlined how behavioral health analytics can be employed to improve health.
​A presentation at the World Congress 10th Annual Medicaid Managed Care Summit outlined how behavioral health analytics can be employed to improve health.
​A presentation at the World...
03/20/2017
First Report Managed Care
Formulary Frontlines®
Pay-For-Performance: Does it Really Work?
03/17/2017
Eileen Koutnik-Fotopoulos
The health care landscape is shifting from a fee-for-service to a pay-for-performance model.
The health care landscape is shifting from a fee-for-service to a pay-for-performance model.
The health care landscape is...
03/17/2017
First Report Managed Care
News
Managed Care Update: FDA Releases Guidelines on Biosimilar Interchangeability
03/17/2017
David Costill
New guidance from the FDA clarifies the expectations for drugmakers looking to demonstrate interchangeability between a biosimilar and its reference product.
New guidance from the FDA clarifies the expectations for drugmakers looking to demonstrate interchangeability between a biosimilar and its reference product.
New guidance from the FDA...
03/17/2017
First Report Managed Care
News
Deregulating The FDA to Cut Drug Prices
03/17/2017
Paul Nicolaus
The Trump Administration advocated for slashing the regulatory burden at the FDA in order to jumpstart competition on the pharmaceuticals market.
The Trump Administration advocated for slashing the regulatory burden at the FDA in order to jumpstart competition on the pharmaceuticals market.
The Trump...
03/17/2017
First Report Managed Care
Formulary Frontlines®
Opioid Dependence Treatment: Lessons for Reducing Diversion and Cost
03/06/2017
Richard G. Soper, MD, JD, MS
Richard G Soper, MD, JD, MS, discusses the financial impact on payers from prescription opioid abuse and offers cost reduction strategies.
Richard G Soper, MD, JD, MS, discusses the financial impact on payers from prescription opioid abuse and offers cost reduction strategies.
Richard G Soper, MD, JD,...
03/06/2017
First Report Managed Care
Managed Care Q&A
Applying Appropriate Use Criteria to Reduce Costs
03/03/2017
David Costill
Rami Doukky, MD, MSc, speaks about the development of appropriate use criteria for cardiac imaging and the implementation of laws mandating their use.
Rami Doukky, MD, MSc, speaks about the development of appropriate use criteria for cardiac imaging and the implementation of laws mandating their use.
Rami Doukky, MD, MSc,...
03/03/2017
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

March 2017 Volume 14 Issue 3

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