Managed Care Cast

Today, we’re bringing you part 1 of a 2-part podcast series discussing multiple sclerosis, or MS. As part of the MS Stakeholder Summit, a panel of experts discusses tailoring treatments to patients with MS, payer considerations, and more.

Vizient recently released its Summer 2021 Pharmacy Market Outlook, which projects pharmaceutical spending for 2022 based on an analysis of its members' data, and on this episode of Managed Care Cast, we talk about some of their findings. The report, which delves into its members’ purchasing patterns, predicts a 3.1% increase in pharmaceutical spending next year, with oncology drugs accounting for about 25% of the increase. The report also discusses increasing competition from biosimilars, including the recent approval of insulin glargine as an interchangeable biosimilar for the treatment of diabetes; the practice of white bagging; and other issues.

On this episode of Managed Care Cast, we speak with Steven Lucio, PharmD, BCPS, senior principal, Pharmacy Solutions, about the report, which also discusses the continued impact of COVID-19 on health care.

August is National Psoriasis Awareness Month, and on this episode of Managed Care Cast, we bring you an excerpt of an interview conducted by Linda Stocum, assistant editor of Dermatology Times, for Medical World News, a new webcast from MJH Life Sciences.

In it, Jerry Bagel, MD, MS, Windsor Dermatology, East Windsor, New Jersey, discusses how psoriasis is now understood to be an inflammatory disease that, if left intreated, can have devastating cardiovascular effects, affecting lifespan and quality of life, especially for young people. He also discusses the many lifestyle changes that some patients will need to make after their skin becomes clear.

Huntington disease is an incurable, progressive neurodegenerative condition that is ultimately fatal, and the field of research into this rare disease saw a setback a few months ago with the end of 2 clinical trials for a type of possible therapy from Roche and Wave Life Sciences.

On this episode of Managed Care Cast, we bring you an excerpt of an interview, originally conducted by Matt Hoffman, senior editor of NeurologyLive, with Daniel Claassen, MD, MS, director, Huntington’s Disease Clinic, and division chief, of Behavioral and Cognitive Neurology, Vanderbilt University Medical Center. Claassen reviews the trial terminations and what that means for patients with this disease, but he also reviews some other candidates in the pharmaceutical pipeline, as well as the need for patient-reported outcomes and the possibility of wearable sensors.

In this episode of Managed Care Cast, the lead author of an article in the July issue of The American Journal of Managed Care® describes the latest research that looks at the power of self-insured employers to negotiate hospital prices and the relationship between employer market power and hospital prices.

Matthew Eisenberg, PhD, and coauthors used the US Census Bureau County Business Patterns data from 2010 to 2016 to estimate employer market power in metropolitan statistical areas (MSAs) and used Truven Health MarketScan commercial claims to estimate mean hospital prices and price ratios at the MSA level.

The paper, "Large Self-insured Employers Lack Power to Effectively Negotiate Hospital Prices," notes a few alternative ways that employers have tried to increase their ability to raise their purchasing power, but the success has been limited.

Eisenberg, an economist and assistant professor in the Department of Health Policy and Management at the Johns Hopkins Bloomberg School of Public Health, joined Managed Care Cast to discuss these findings.

In a recent paper published in JAMA Network Open, Charlie Wray, DO, MS, and colleagues examined experiences and opinions of nearly 150,000 Americans representing the 5 major forms of health insurance coverage.

Specifically, the researchers used survey data from the 2016-2018 Behavioral Risk Factor Surveillance System and compared access to care, cost of care, and reported satisfaction among those with public or private insurance.

Representing the experiences of over 61 million US adults, respondents included Medicaid and Medicare beneficiaries, those with Veterans Health Administration or military coverage, and those with individually purchased and employer-sponsored coverage.

On this episode of Managed Care Cast, Wray, an assistant professor of medicine at the University of California San Francisco, describes the surprising findings of the teams’ analyses, and offers some solutions to improving the quality of health insurance coverage in the United States.

Social distancing, vigilant sanitizing, and mask wearing required by COVID-19 did more than combat the pandemic—it cut down on flu cases as well as improved respiratory health for some patients. Some studies indicate that the measures also reduced Clostridium difficile, or C difficile, in hospitals and facilities.

A recent set of interviews on Medical World News®, the 24-hour online news program for health care professionals from MJH Life Sciences™, highlighted this development. The interviews, discussing the prospect of these mitigation efforts continuing post pandemic, were conducted by one of our sister sites, HCPLive®, which covered the Digestive Disease Week meeting this spring.

This episode of Managed Care Cast features a few of those interviews: Christie Teigland, PhD, vice president of Advanced Analytics for Avalere Health; Alpesh N. Amin, MD, University of California Irvine School of Medicine; and Brian E. Lacy, MD, PhD, Mayo Clinic.

Today, we’re bringing you part 2 of the MS Stakeholder Summit series. During part 1, which first ran 2 weeks ago, a panel of experts discussed tailoring treatments to patients with multiple sclerosis, payer considerations, and more. In this second part of the series, the same panel of experts continues their talk on MS. They will discuss newer therapies, switching therapies, and more.

Linda Schwimmer, JD, president and CEO of the New Jersey Health Care Quality Institute, discusses 2 reports on strengthening primary care after the COVID-19 pandemic: one from her own organization and the other from the National Academy of Medicine.

Diabetes care guidelines identify critical points in patients’ care when providers should refer them to diabetes self-management education, or DSME. However, it’s not known whether these clinical indicators of need actually increase the likelihood of receiving a referral.

On this episode of Managed Care Cast, we’re talking with an author of an Original Research article published in our June 2021 issue. The article, “Patient Need and Provider Referrals to Diabetes Self-management Education,” finds that although there is an association between patient need and DSME referral, many patients in need still aren’t being referred.

Joining us today is Brittany Brown-Podgorski, PhD, MPH, who is a postdoctoral fellow at the University of Texas at Austin and will soon be joining the faculty of the University of Pittsburgh.