These medications have revolutionized the treatment of conditions like rheumatoid arthritis. But they are budget busters and have a tricky side effect profile.
Katherine T. Adams
Insurers apply this management technique to medical pharmacy spending, which includes the costly treatments for rheumatoid arthritis.
A surge of new MS treatments have been for the relapsing-remitting form of the disease. A new drug that targets CD20-positive B cells may change that.
They are far less common than many chronic conditions. But by some measures, the financial and health toll from inflammatory bowel disease, rheumatoid arthritis, and psoriasis is comparable to stroke and lower back pain.
Hub programs are growing in popularity as a way for pharmaceutical companies to combat the clout of employers, health plans, and PBMs. But they spell trouble if they spark collusion, threaten patients, or waste federal dollars.
David A. Ganz
Heather E. McCreath
Legislation & Regulation: Campaign 2016
Adverse selection, other problems may hinder the presumptive Democratic candidate’s proposal to let people buy into Medicare in their 50s.
Richard Mark Kirkner
CMS’s data-liberation movement is helping to accelerate the transition to value- and risk-based payment systems. For payers and providers, the trick is knowing what to do with the data.
Michael D. Dalzell
Studies show Eli Lilly’s Taltz achieves higher remission rates than its main competitor but is also marked by slightly more infections.
Thomas Morrow, MD
Care targeting pain and symptoms has caught the eye of insurers.
Managed Care Outlook