July/August 2012, Vol 5, No 5

The growing impact of specialty injectables and biologic agents on the budgets of health plan sponsors is undeniable.

Managing Medical Benefit Drugs Under Specialty Pharmacy: The Next Critical Challenge for Managed Care

Atrial fibrillation (AF) is the most common clinically significant cardiac arrhythmia, diagnosed in approximately 1% of the general population.1 It is estimated that AF currently affects more than 2 million people in the United States and more than 4 million across the European Union, with the number of US patients with AF estimated to increase 2.5-fold by the year 2050.1,2

The Enormous Impact of Atrial Fibrillation and Stroke on Patients, Payers, and Society

Specialty pharmaceuticals are quickly commanding a growing share of prescription market share dollars and consequently a greater amount of attention from payers. It is becoming increasingly important for payers to fully understand the nuances of cost control within the specialty pharmacy space before developing a contracting and formulary strategy for specialty pharmaceuticals.

Personalized medicine aims to assist healthcare providers to individualize a patient treatment based on the patient’s attributes, which may include biomarkers, genetics, demographic characteristics, and other covariates. Much progress has been made in recent years in the translational research areas of genomics, proteomics, and metabolomics, and several biomarkers have been identified for a number of important diseases, including atherosclerosis, cancer, and rheumatoid arthritis.

No Physician Treats an Average Patient: Bridging the Gap between Group-Based Data and Patient-Specific Treatment Outcomes

Well, they certainly surprised me.

The Supreme Court upheld most of the Affordable Care Act (ACA), giving the White House cause to breathe a sigh of relief. The Court ruled the individual mandate to buy insurance constitutional, requiring only that we call the penalty for noncompliance a tax. The only real setback was in Medicaid. The federal government’s threat to take away all Medicaid funding from a state that did not expand eligibility to everyone with incomes below 133% of the poverty level was declared coercive and unconstitutional.

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  •  Association for Value-Based Cancer Care
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  • Rheumatology Practice Management
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