As a progressive disease diabetes presents an ongoing challenge for physicians to provide adequate control of patients’ diabetes, and new agents with novel mechanisms of action help reduce the burden in the management of diabetes.

In a recent Peer Exchange discussion, Dr Peter Salgo, of Columbia University College of Physicians and Surgeons and NewYork-Presbyterian Hospital, led a discussion on novel agents and their role in treating patients with and with cardiovascular disease. On the panel was Dr. Om Ganda of Joslin Diabetes Center; Jim Kenney of JTKenney, a managed care consulting practice; and Dr Helena Rodbard, past president of the American College of Endocrinology and past president of the American Association of Clinical Endocrinologists.

Listen to the full discussion: https://www.ajmc.com/peer-exchange/new-classes-for-treatment-of-type-2-diabetes/

Every week, The American Journal of Managed Care® recaps the top managed care news of the week, and you can now listen to it on our podcast, Managed Care Cast.

This week, the top managed care news included HHS laying out a plan for importing certain prescription drugs from other countries; a potential new standard of care for chronic lymphocytic leukemia; 3 insulin makers get subpoenaed over their pricing practices.

Read more about the stories in this podcast:

HHS, FDA Outline Foundation for Importing Certain Drugs From Other Countries: https://www.ajmc.com/newsroom/hhs-fda-outline-foundation-for-importing-certain-drugs-from-other-countries

CMS Testing Pilot to Give FFS Medicare Providers Historical Claims Data on Patients: https://www.ajmc.com/newsroom/cms-testing-pilot-to-give-ffs-medicare-providers-historical-claims-data-on-patients

Ibrutinib–Rituximab Improves Survival Compared With Current Treatment for Chronic Lymphocytic Leukemia: https://www.ajmc.com/newsroom/ibrutinibndashrituximab-improves-survival-compared-with-current-treatment-for-chronic-lymphocytic-leukemia

What We're Reading: Democrats Debate Medicare for All; Insulin Makers Questioned; Best Hospital Rankings: https://www.ajmc.com/newsroom/what-were-reading-democrats-debate-medicare-for-all-insulin-makers-questioned-best-hospital-rankings

Bipartisan Senate Bill Seeks to Roll Back a Decade's Worth of Insulin Price Hikes: https://www.ajmc.com/focus-of-the-week/bipartisan-senate-bill-seeks-to-roll-back-a-decades-worth-of-insulin-price-hikes

Lilly to Launch Half-Price Version of Humalog: https://www.ajmc.com/newsroom/lilly-to-launch-halfprice-version-of-humalog

Sanofi Offer Sets Monthly Price of $99 for Insulin Supply: https://www.ajmc.com/newsroom/sanofi-offers-set-monthly-price-of-99-for-insulin-supply

IVBM: Advancing Oncologu Quality Through Value-Based Care: https://www.ajmc.com/meetings/ivbm-philadelphia-2019-09-19

While precision medicine has started to inch its way to becoming a norm in healthcare, there are still barriers holding back widespread implementation amomg providers and organizations. From reimbursement challenges to primary use in oncology to proving the return on investment of implementing a precision medicine program, addressing these barriers could open the door to more providers and oragnizations embracing precision medicine in their practice. 

To discuss these challenges and ways to mitigate them, we sat down with Joel Diamond, MD, a practicing physician, adjunct associate professor of Biomedical Informatics at the University of Pittsburgh, and cofounder and chief medical officer of 2bPrecise.

Every week, The American Journal of Managed Care® recaps the top managed care news of the week, and you can now listen to it on our podcast, Managed Care Cast.

This week, the top managed care news included bipartisan Senate bills taking aim at drug prices, especially insulin; a study linking payer refusal to pay for proprotein convertase subtilisin/kexin type 9 inhibitors with heart attacks and deaths; and a former FDA commissioner visiting The American Journal of Managed Care®.

Read more about the stories in this podcast:

Senate Finance Committee Unveils Bipartisan Bill to Lower Drug Costs: https://www.ajmc.com/newsroom/senate-committee-unveils-bipartisan-bill-to-lower-drug-costs

Bipartisan Senate Bill Seeks to Roll Back a Decade's Worth of Insulin Price Hikes: https://www.ajmc.com/focus-of-the-week/bipartisan-senate-bill-seeks-to-roll-back-a-decades-worth-of-insulin-price-hikes

Rejected, Unfilled PCSK9 Inhibitor Prescriptions Linked to Higher Risk of Cardiovascular Events: https://www.ajmc.com/focus-of-the-week/rejected-unfilled-pcsk9-inhibitor-prescriptions-linked-to-higher-risk-of-cardiovascular-events

Impact of a Co-pay Accumulator Adjustment Program on Specialty Drug Adherence: https://www.ajmc.com/journals/issue/2019/2019-vol25-n7/impact-of-a-copay-accumulator-adjustment-program-on-specialty-drug-adherence

Consuming Riboflavin Through Diet May Reduce Migraine Occurrence: https://www.ajmc.com/newsroom/consuming-riboflavin-through-diet-may-reduce-migraine-occurrence

Addressing the Complexities of Value-Based Payment Models by Managed Care Cast

Every week, The American Journal of Managed Care® recaps the top managed care news of the week, and you can now listen to it on our podcast, Managed Care Cast.

This week, the top managed care news included CMS pushing for bundled payments in radiation oncology; reports detailing deficiencies in hospice care; a study finding widening disparities in life expectancy among white Americans.

Read more about the stories in this podcast:

CMS Proposes Bundled Payments for Radiation Oncology: https://www.ajmc.com/newsroom/cms-proposes-bundled-payments-for-radiation-oncology

OIG Reports Find Deficiencies in Hospice Care and Resulting Harms to Patients: https://www.ajmc.com/focus-of-the-week/oig-reports-find-deficiencies-in-hospice-care-and-resulting-harms-to-patients

Study Reveals Declining Life Expectancy Among White Americans That Defies Easy Answers: https://www.ajmc.com/focus-of-the-week/study-reveals-declining-life-expectancy-among-white-americans-that-defies-easy-answers

Systolic, Diastolic BP Both Predict Cardiovascular Events, Kaiser Permanente Study Finds: https://www.ajmc.com/newsroom/systolic-diastolic-bp-both-predict-cardiovascular-events-kaiser-permanente-study-finds

Number of Manufacturers and Generic Drug Pricing From 2005 to 2017: https://www.ajmc.com/journals/issue/2019/2019-vol25-n7/number-of-manufacturers-and-generic-drug-pricing-from-2005-to-2017

Pharmaceutical manufacturers sought to improve patient access to treatments through the use of co-payment assistance cards. But, while these cards reduce the out-of-pocket cost for enrollees, employers worry that they could result in increased medication use and associated expenditures, thus negating efforts made with benefit designs. To mitigate the issue, pharmacy benefit managers have introduced co-pay accumulator adjustment programs, which prevent pharmaceutical manufacturer subsidies put toward a patient’s out-of-pocket costs from counting toward the deductible. As a result, high-deductible health plan enrollees could face a sharp spike in out-of-pocket costs when the manufacturer subsidy limits are reached, but the patient has not reached their deductible.

Despite the lack of data around how these programs affect patient outcomes, they have become popular among employers.

Bruce Sherman, MD, FCCP, chief medical officer of the National Alliance of Healthcare Purchasers Coalition, discusses the findings of a paper in the July issue of The American Journal of Managed Care® on the impact of co-pay accumulator adjustment programs on specialty drug use.

Read the paper: https://www.ajmc.com/journals/issue/2019/2019-vol25-n7/impact-of-a-copay-accumulator-adjustment-program-on-specialty-drug-adherence

Just halfway through the year, and 2019 has been busy for biosimilars with new guidance and approvals, but the loss of a big advocate of biosimilars from the FDA. In this episode of Managed Care Cast, Kelly Davio, senior editor of The Center for Biosimilars®, a sister site of The American Journal of Managed Care®, discusses new approvals, what the loss of Scott Gottlieb, MD, as FDA commissioner means, the reality of pay-for-delay deals, and more.

Learn more about biosimilars at centerforbiosimilars.com.

Every week, The American Journal of Managed Care® recaps the top managed care news of the week, and you can now listen to it on our podcast, Managed Care Cast.

This week, the top managed care news included uncertainty surrounding the fate of the Affordable Care Act's individual mandate; a study finding Medicare beneficiaries may be paying more for some generics than brand-name drugs; the Trump administration proposing 5 new payment models to transform kidney disease care.

Read more about the stories in this podcast:

Appeals Court Shows Uncertainty Over Constitutionality of ACA's Individual Mandate: https://www.ajmc.com/focus-of-the-week/appeals-court-shows-uncertainty-over-constitutionality-of-acas-individual-mandate

Medicare Beneficiaries May Pay More for Some Generics Than Brand-Name Drugs: https://www.ajmc.com/focus-of-the-week/medicare-beneficiaries-may-pay-more-for-some-generics-than-brandname-drugs

Despite Growth, Uptake of Downside Risk in ACO Contracts Remains Low: https://www.ajmc.com/focus-of-the-week/despite-growth-uptake-of-downside-risk-in-aco-contracts-remains-low

HHS Unveils 5 New Payment Models to Transform Kidney Disease Care: https://www.ajmc.com/newsroom/hhs-unveils-5-new-payment-models-to-transform-kidney-disease-care

Evidence-Based Diabetes Management—June 2019: https://www.ajmc.com/journals/evidence-based-diabetes-management/2019/june-2019

While many women in healthcare report experiencing subtle or not-so-subtle bias and microaggressions at work, a recently published study sought to determine how healthcare professionals associate men and women with career and family, and also how surgeons associate men and women with surgery and family medicine. In this podcast, we speak with the lead author, Arghavan Salles, MD, PhD, about the findings, as well as other issues affecting women in healthcare.