Hemlibra demonstrates how far antibody science has progressed. Genentech’s drug, approved late last year, connects two clotting factors to prevent the devastating bleeds in hemophilia patients with inhibitors. The high price may be offset by avoided costs in patients with factor VIII inhibitors.
Elisabeth Rosenthal has a unique perspective on what ails the American health care system. She is a physician turned journalist who has some firsthand knowledge about what takes place in American hospitals and doctor’s offices, although her Wikipedia entry makes a point of describing her as a “non-practicing physician.”
The 40-year-old has to guide one of the health insurer’s regional markets as the ACA continues to evolve. His course? Keep strengthening ties with providers.
Research has pointed to ways that falls can be prevented, but logistical and financial barriers get in the way.
When it comes to heart attacks, additional health care spending was only weakly associated with lower case-fatality rates, according to a study of Medicare patients. What did make a difference to researchers was coronary angioplasty on the first day of heart attack patients’ hospitalizations.
This professor of pharmaceutical economics in the University of Minnesota College of Pharmacy says that the rising level of health care spending is unsustainable. He argues that drug price increases should be reviewed and PBMs should be regulated. “We need [a] bona fide rate regulation review body that can meaningfully evaluate the information presented by drug companies.”
Once they have the right platforms in place, insurers can layer on predictive analytics, digital medical records, and other innovations that promise to make health care costs more manageable—and in the process make health insurers more competitive with the likes of CVS and maybe, eventually, Amazon.
The overall infant mortality rate in the U.S. declined 14% between 2005 and 2015, from 6.86 infant deaths per 1,000 live births in 2005 to 5.90 in 2015, according to the CDC. However, CDC researchers found wide variation among the states, ranging from 9.08 deaths per 1,000 live births in Mississippi (the highest rate), to 4.28 deaths per 1,000 live births in Massachusetts (the lowest).
Eliminating the cost-sharing payments (CSRs) to insurers to hold down out-of-pocket costs for low-income people who purchase individual health plans may wind up actually increasing overall federal spending by driving up premium subsidies to cover higher price plans.
Nonquantitative treatment limitations may be why care for mental health and substance abuse disorders isn’t keeping up with coverage gains.
Blame for the epidemic has focused on drugmakers, drug wholesalers, and physicians who prescribed opioids too liberally. This fall, fingers pointed at health insurers. Investigative reporting showed that coverage policies that restricted access to less addictive medications might have helped fueled the epidemic.
Women who were new patients waited an average of nearly 24 days to be seen by an ob/gyn, according to research by Athenahealth. In contrast, the new-patient wait to see for an orthopedist was 13 days. Waits for first appointments with primary care physicians, pediatricians, and cardiologists fell in between those two extremes.
The plaintiffs are now defendants and vice versa in the drawn-out dispute over ACA birth control coverage.