Creators of President Donald Trump’s blueprint to control drug prices, American Patients First, say it represents real reform. Critics see a pulled punch to the pharmaceutical industry.

Mary Caffrey, the managing editor of The American Journal of Managed Care’s Evidence-Based series, spoke with Harvard healthcare economist Michael E. Chernew, PhD, who is the co-editor in chief of AJMC, to discuss elements of the Trump administration proposal to control drug prices. Chernew is also a former vice chair of the Medicare Payment Advisory Commission.

Read more:

Trump Offers Blueprint to Drive Down Prescription Drug Prices; Targets Rebates, "Middlemen": www.ajmc.com/newsroom/-trump-offers-blueprint-to-drive-down-prescription-drug-prices-targets-rebates-middlemen

Azar Stumps for Plan to Hold Down Prescription Drug Costs: www.ajmc.com/focus-of-the-week/azar-stumps-for-plan-to-hold-down-prescription-drug-costs

Trump Targets Drug Prices, Right-to-Try in State of the Union: www.ajmc.com/newsroom/trump-targets-drug-prices-righttotry-in-state-of-the-union

​​​​​​​Will Trump Take Steps to Rein in Drug Prices?: www.ajmc.com/focus-of-the-week/will-trump-take-steps-to-rein-in-drug-prices

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 stories included President Donald Trump's plan to drive down drug prices; the FDA approved the first biosimilar of the year; a study found rapid uptake of PD-1 agents after FDA approval.

Read more about the stories in this podcast:

Trump Offers Blueprint to Drive Down Prescription Drug Prices; Targets Rebates, "Middlemen": www.ajmc.com/newsroom/-trump-offers-blueprint-to-drive-down-prescription-drug-prices-targets-rebates-middlemen

Azar Stumps for Plan to Hold Down Prescription Drug Costs: www.ajmc.com/focus-of-the-week/azar-stumps-for-plan-to-hold-down-prescription-drug-costs

FDA Approves Epoetin Alfa Biosimilar for Anemia: www.ajmc.com/newsroom/fda-approves-epoetin-alfa-biosimilar-for-anemia

Study Finds Rapid Uptake of Anti–PD-1 Agents Following FDA Approval: www.ajmc.com/newsroom/study-finds-rapid-uptake-of-anti8211pd1-agents-following-fda-approval

Researcher Details Microbiome Mysteries Connecting the Gut, Brain: www.ajmc.com/conferences/sobp-2018/researcher-details-microbiome-mysteries-connecting-the-gut-brain

Society of Biological Psychiatry 73rd Annual Scientific Convention: www.ajmc.com/conferences/sobp-2018

American Thoracic Society 2018 International Conference: www.ajmc.com/conferences/ats-2018

ISPOR Annual Conference: http://www.ajmc.com/conferences/ispor-2018

Newsletter Signup: www.ajmc.com/email-profile

The Scope of Physician Burnout: Symptoms, Impacts, and Efforts to Address It 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 stories included another report that shows uninsured rates are rising; FDA confirms shortages of the EpiPen, but the manufacturer insists the delay will be short; a Senate panel examines the need for transparency in insulin pricing.

Read more about the stories in this podcast:

No States Reported a Decline in the Uninsured Rate From 2016 to 2017: www.ajmc.com/focus-of-the-week/no-states-reported-a-decline-in-the-uninsured-rate-from-2016-to-2017

FDA Confirms Short-Term Shortages of EpiPen: www.ajmc.com/newsroom/fda-confirms-shortterm-shortages-of-epipen

ADA's Cefalu Calls for Transparency Across Supply Chain to Address Insulin Costs: www.ajmc.com/newsroom/adas-cefalu-calls-for-transparency-across-supply-chain-to-address-insulin-costs

Daratumumab Approved as Frontline Treatment in Newly Diagnosed Multiple Myeloma: www.ajmc.com/newsroom/daratumumab-approved-as-frontline-treatment-in-newly-diagnosed-multiple-myeloma

Single-Payer System Is the Solution for Mental Health Care, Panelists Say: www.ajmc.com/conferences/apa-2018/singlepayer-system-is-the-solution-for-mental-health-care-panelists-say

American Psychiatric Association 2018 Annual Meeting: www.ajmc.com/conferences/apa-2018

Accountable care organizations are incentivized to reduce spending and improve quality of care. One way they have tried to do achieve these goals is by establishing control over a patient’s full continuum of care by minimizing the care patients receive from other providers outside of the ACO, including specialists.

Michael Barnett, MD, and J. Michael McWilliams, MD, PhD, have a paper in the May issue of The American Journal of Managed Care® on leakage of specialty care among ACOs and the changes in specialty care leakage and use associated with the Medicare Shared Savings Program.

Read the paper: http://www.ajmc.com/journals/issue/2018/2018-vol24-n5/changes-in-specialty-care-use-and-leakage-in-medicare-accountable-care-organizations

Patients who get care at a hospital often receive bills that are bigger than they were expecting. In the case of Medicare, this can happen when a beneficiary receives care at a hospital for several days but was never formally admitted to the hospital. The result is higher out-of-pocket expenses and fewer Medicare benefits—the biggest being the qualification of a nursing home stay after being discharged from a hospital. While hospitals must now inform Medicare recipients when they are being held under observation status, the use of observation still places an undue burden on seniors.

Andria Jacobs, chief operating officer for PCG Software, discusses the impact of being held in observation, what CMS has done to try to alleviate the situation, and what else needs to be done.

Read Andria's past articles: http://www.ajmc.com/contributor/andria-jacobs-rn-ms-cen-cphq

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 stories included a report that insurance coverage gains are reversing; a deal to lower the cost of Praluent for Express Scripts members; findings that synthetic opioids are playing a bigger role in overdose deaths.

Increases in Insurance Coverage Rates From ACA Beginning to Reverse: www.ajmc.com/focus-of-the-week/increases-in-insurance-coverage-rates-from-aca-beginning-to-reverse

Sanofi, Regeneron to Cut Praluent Prices Under Exclusive Express Scripts Deal That Ends Prior Approval Delays: www.ajmc.com/newsroom/sanofi-regeneron-to-cut-praluent-prices-under-exclusive-express-scripts-deal-that-ends-prior-approval-delays

Dr Jay Edelberg on Safety, Efficacy of Praluent and Remaining Payment Challenges: www.ajmc.com/conferences/aha-2017/dr-jay-edelberg-on-safety-efficacy-of-praluent-and-remaining-payment-challenges

Synthetic Opioids Overtake Prescription Opioids as Driver of Overdose Deaths in 2016: www.ajmc.com/newsroom/synthetic-opioids-overtake-prescription-opioids-as-driver-of-overdose-deaths-in-2016

FDA Approves CAR T-Cell Treatment Kymriah for Adult B-Cell Lymphoma: www.ajmc.com/newsroom/fda-approves-cart-cell-treatment-kymriah-for-adult-bcell-lymphoma

Verma Highlights CMS Initiatives to Empower Patients and Promote Competition: www.ajmc.com/conferences/whcc-2018/verma-highlights-cms-initiatives-to-empower-patients-and-promote-competition

Former HHS Secretary Price Identifies a Path to Moving Forward in Healthcare Reform: www.ajmc.com/conferences/whcc-2018/former-hhs-secretary-price-identifies-a-path-to-moving-forward-in-healthcare-reform

15th Annual World Health Care Congress: www.ajmc.com/conferences/whcc-2018

Low-Value Services: Their Impact and Challenges With Addressing Them 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 stories included an announcement from CMS of creating direct provider contracting, plus a broad set of proposed rules for health information technology; new recommendations to improve postpartum care; a look at future competition among specialty drugs.

Read more about the stories in this podcast:

CMS: "Meaningful Use" Is Out, "Interoperability" Is In: www.ajmc.com/newsroom/cms-meaningful-use-is-out-interoperability-is-in

Humana Launches Bundled Payment Model to Improve Maternity Outcomes and Cost: www.ajmc.com/newsroom/humana-launches-bundled-payment-model-to-improve-maternity-outcomes-and-cost

What We're Reading: VA Pick's Hearing Delayed; Hospital Profits Fall; Re-Imagining Postpartum Care: www.ajmc.com/newsroom/what-were-reading-va-picks-hearing-delayed-hospital-profits-fall-reimagining-postpartum-care

ACOG Annual Clinical and Scientific Meeting: www.ajmc.com/conferences/acog-2018

Newsletter Sign-up: www.ajmc.com/email-profile

Specialty Drug Pipeline Review Focuses on Competition, Cancer Drugs: www.ajmc.com/conferences/amcp-2018/specialty-drug-pipeline-review-focuses-on-competition-cancer-drugs

Dr Aimee Tharaldson Discusses Key Market Trends in Specialty Pharmacy: www.ajmc.com/conferences/amcp-2018/dr-aimee-tharaldson-discusses-key-market-trends-in-specialty-pharmacy

The Academy of Managed Care Pharmacy (AMCP) 2018: www.ajmc.com/conferences/amcp-2018

At the beginning of the year, The American Journal of Managed Care® convened a panel of experts in infectious disease and managed care to discuss management of HIV, including the need for individualized care the role for newer treatments options. Here, we provide some of that conversation.

Watch the full discussion:

Special Considerations in HIV Management: www.ajmc.com/peer-exchange/special-considerations-in-hiv-management/