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Pharmacist-Led Outreach Boosts SGLT2 Inhibitor Initiation in Veterans With CKD and Diabetes
06/05/2026
Grace Taylor, MS, MA
Clinical pharmacists nearly doubled SGLT2 inhibitor initiation among veterans with chronic kidney disease (CKD) and type 2 diabetes in a large US Department of Veterans Affairs quality improvement study.
Clinical pharmacists nearly doubled SGLT2 inhibitor initiation among veterans with chronic kidney disease (CKD) and type 2 diabetes in a large US Department of Veterans Affairs quality improvement study.
Clinical pharmacists nearly...
06/05/2026
First Report Managed Care
News
Reducing Reliance on Epidural Steroid Injections Through Evidence-Based De-Implementation
06/05/2026
Rebecca Amrick
Researchers examined epidural spinal injections as a candidate for de-implementation, specifically for patients with chronic low back pain, and provided suggestions for successfully redirecting care toward more effective and sustainable...
Researchers examined epidural spinal injections as a candidate for de-implementation, specifically for patients with chronic low back pain, and provided suggestions for successfully redirecting care toward more effective and sustainable...
Researchers examined epidural...
06/05/2026
First Report Managed Care
News
CT-P39 Shows Promise as a Cost-Saving Alternative to Omalizumab for CSU
06/04/2026
Rebecca Amrick
A clinical trial comparing CT-P39 with reference omalizumab found both drugs to be comparable both in efficacy and safety, indicating CT-P39 as a suitable alternative to omalizumab for patients with chronic spontaneous urticaria (CSU).
A clinical trial comparing CT-P39 with reference omalizumab found both drugs to be comparable both in efficacy and safety, indicating CT-P39 as a suitable alternative to omalizumab for patients with chronic spontaneous urticaria (CSU).
A clinical trial comparing...
06/04/2026
First Report Managed Care
Behind the Bill
CMS Finalizes Federal IDR Rule to Streamline No Surprises Act Dispute Resolution
05/29/2026
Grace Taylor, MS, MA
The Centers for Medicare & Medicaid Services (CMS) has finalized updates to the federal Independent Dispute Resolution (IDR) process under the No Surprises Act, lowering administrative fees, creating a centralized dispute portal, and...
The Centers for Medicare & Medicaid Services (CMS) has finalized updates to the federal Independent Dispute Resolution (IDR) process under the No Surprises Act, lowering administrative fees, creating a centralized dispute portal, and...
The Centers for Medicare &...
05/29/2026
First Report Managed Care
News
Differences in OUD Treatment Coverage Across Medicaid Managed Care Plans From 2015 to 2019
05/26/2026
Rebecca Amrick
From 2015 to 2019, Medicaid coverage of opioid use disorder (OUD) increased while plans covering treatment services decreased, raising concerns about substance use care plans and treating patients with addiction.
From 2015 to 2019, Medicaid coverage of opioid use disorder (OUD) increased while plans covering treatment services decreased, raising concerns about substance use care plans and treating patients with addiction.
From 2015 to 2019, Medicaid...
05/26/2026
First Report Managed Care
News
Linvoseltamab Demonstrates Lower Care Costs than Teclistamab and Elranatamab for TCE RRMM
05/26/2026
Rebecca Amrick
Linvoseltamab demonstrates lower and comparable care costs compared to teclistamab and elranatamab, appearing as a possible lower-cost alternative for treating patients with triple-class exposed (TCE) relapsed or refractory multiple myeloma...
Linvoseltamab demonstrates lower and comparable care costs compared to teclistamab and elranatamab, appearing as a possible lower-cost alternative for treating patients with triple-class exposed (TCE) relapsed or refractory multiple myeloma...
Linvoseltamab demonstrates lower...
05/26/2026
First Report Managed Care
News
Comorbidities Increase Clinical and Economic Burden for Patients With Chronic Kidney Disease
05/22/2026
Rebecca Amrick
The clinical and economic burden of chronic kidney disease (CKD) is increased when combined with comorbidities such as type 2 diabetes and heart failure, highlighting the need for improved policies and procedures to optimize disease...
The clinical and economic burden of chronic kidney disease (CKD) is increased when combined with comorbidities such as type 2 diabetes and heart failure, highlighting the need for improved policies and procedures to optimize disease...
The clinical and economic burden...
05/22/2026
First Report Managed Care
News
Pembrolizumab Plus Chemotherapy Improves Survival in mNSCLC at Higher Cost
05/22/2026
Rebecca Amrick
Pembrolizumab plus chemotherapy demonstrates more clinical efficiency in treating patients with metastatic non–small cell lung cancer (mNSCLC), but prolonged survival leads to higher overall health care costs.
Pembrolizumab plus chemotherapy demonstrates more clinical efficiency in treating patients with metastatic non–small cell lung cancer (mNSCLC), but prolonged survival leads to higher overall health care costs.
Pembrolizumab plus chemotherapy...
05/22/2026
First Report Managed Care
Behind the Bill
Congress Targets Enforcement Gaps in the No Surprises Act
05/22/2026
Hannah Musick
A bipartisan bill aims to strengthen enforcement of the No Surprises Act amid growing concerns that some health plans are failing to comply with binding payment decisions in the federal dispute resolution process.
A bipartisan bill aims to strengthen enforcement of the No Surprises Act amid growing concerns that some health plans are failing to comply with binding payment decisions in the federal dispute resolution process.
A bipartisan bill aims to...
05/22/2026
First Report Managed Care
News
Asciminib Shows Durable Frontline Benefit in Newly Diagnosed CML
05/20/2026
Hannah Musick
At 96 weeks, asciminib demonstrated higher major molecular response rates and fewer treatment discontinuations due to adverse events compared with imatinib and second-generation tyrosine kinase inhibitors in newly diagnosed chronic myeloid...
At 96 weeks, asciminib demonstrated higher major molecular response rates and fewer treatment discontinuations due to adverse events compared with imatinib and second-generation tyrosine kinase inhibitors in newly diagnosed chronic myeloid...
At 96 weeks, asciminib...
05/20/2026
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

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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