Medical Directors Forum
Mike Cantor, MD, JD

Mike Cantor, MD, JD
CareCentrix

And health plans can’t be caught flat-footed. They need to keep pace with the introduction of new treatments and be ready with strategies that address patient needs and manage costs. Using objective clinical data to guide dosing and working to redirect care to a patient’s home is a place to start.

Exondys 51 is being touted as a miracle drug for those suffering from the rare disease Duchenne muscular dystrophy. But, as the New York Times reports, insurers are balking at the exorbitant price for a medication whose long-term clinical benefits have yet to be measured.

News & Commentary
Frank Diamond
Eighty-seven percent of workers consider employer-sponsored health benefits to be important or extremely important when it comes to maintaining or looking for a job, according to a study by the Employee Benefit Research Institute. A retirement savings plan comes in second (77%), and a dental or vision plan third (72%).

Residents in Wisconsin and Indiana who buy insurance on the ACA exchanges will have fewer options next year as Anthem announced yesterday that it is pulling out of those states, the New York Times reports.

The situation is fluid, as it has been since the GOP took over the Senate in January partly because of a promise to repeal and replace Obamacare.

The Trump administration believes that reining in regulations on pharmaceutical companies is the best way to control the cost of drugs, the New York Times reports.

Major insurers have announced that they’ll not participate in the Obamacare market exchanges next year, and time’s running out for those health plans still on the fence since they must file their intentions and proposed premium rates today.

Original Research
Brooke Roeper, MSPH, MS
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Eric Beck, DO, MPH, FACEP
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Daniel Castillo, MD, MBA
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J. Brent Myers, MD, MPH
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Brandy Sparkman, RN, BSN
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Jonathan Cox, MHS
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Scott Bourn, PhD, RN, EMT-P
One in five elderly patients returns to the hospital within 30 days of leaving. These rehospitalizations are a common and costly occurrence. A program developed to address problems in post-acute transitional care seems to be effective in reducing 30-day readmission rates for some Medicare fee-for-service beneficiaries.
Tomorrow’s Medicine
Thomas Morrow, MD
Because it is given intravenously at the end of dialysis, Parsabiv could be the answer to the adherence problems posed by cinacalcet. Most patients are pretty adherent to dialysis. One study found that people missed only 7.1 episodes of dialysis per patient-year, which isn’t perfect but it’s certainly better than adherence to self-administered drugs.
MediMedia Poll
More than half (53%) of the 111 respondents to an online survey rated orphan drugs as having a major impact on rising drug costs, although there was also fairly wide (if mild) agreement that the 1983 Orphan Drug Act has been successful in creating incentives to develop remedies for rare diseases.