Many people in the US qualify for both Medicare and Medicaid. Care concerns are often unique for these so-called “dual eligibles,” and significant policy efforts have been made to improve their health outcomes through new models of dual cove rage. Unfortunately, few data resources exist for dual […]
US Senate Report Finds Nine States Saw Spike in Medicare Advantage Advertising Complaints
The Medicare Advantage program allows patients to purchase a private insurance plan with their Medicare benefits. A report released by Senator Ron Wyden (D-OR) found that 9 of 10 states examined had an increase in complaints over private insurers engaging in unethical marketing practices targeting […]
Using Value-Based Payment to Support Health Equity Starts at Model Design
Although value-based payment (VBP) models offer the opportunity to advance health equity goals, doing so requires an intentional, carefully considered approach. Health equity must be centered in payment model design, according to newly published Health Affairs article in a recent series on VBPs. […]
Major US Healthcare Organizations Recommend Several Changes to Value-Based Care Programs
A group of US healthcare organizations has asked Congress for several changes to help boost engagement in value-based care payment models as laid out in the the Medicare Access and CHIP Reauthorization Act (MACRA). The groups included the National Association of ACOs (NAACOS), the American Medical […]
Teva Agrees to Pay New York $523 Million
Teva Pharmaceuticals has agreed to settle yet another case relating to its role in the US opioid crisis, this time with the state of New York. According to the state’s Attorney General Tish James, the pharma giant will pay an additional $313 million on top of the $210 million the state will receive […]
McKesson Reaches $141 Million Settlement with Shareholders in Generic Price Fixing Lawsuit
McKesson Corp. has indicated it reached a settlement with shareholders to the tune of $141 million in a lawsuit over price fixing claims regarding generic medications. The plaintiffs argued that the company lied when it said that it was raising prices due to supply disruptions, instead doing so for […]
Atropos and Syntegra Team Up to Bring Synthetic Data to Real-World Evidence Offerings
Atropos will work synthetic data into their offerings with their newly announced partnership with Syntegra. The pool of synthetic data, generated by Syntegra using real datasets and machine learning techniques, will supplement the real-world evidence (RWE) in Atropos Health’s Green Button […]
FDA Panel Discusses Real-World Evidence Confirming Pulse Oximeters Inaccurate for People with Darker Skin Tones
The US Food and Drug Administration held a panel this week discussing “mounting real-world evidence” (RWE) that pulse oximeters do not work as well on people with darker skin tones. The topic, long discussed and highlighted by communities of color and patient advocacy groups, came to a head during […]
US Could Save Nearly $4 Trillion by Addressing Health Equity
New data released by the Partnership to Fight Chronic Disease (PFCD) shows that the US could save $3.8 trillion by addressing health equity in people with chronic health issues. On a more granular level, the study found that the nation would cut healthcare costs by $2.7 trillion and recoup another […]
Verge Genomic’s AI-Designed ALS Drug Hits the Clinic for Testing
Verge Genomics has announced that the first patient in a phase I clinical trial has taken the company’s experimental small molecule drug VRG50635 for amyotrophic lateral sclerosis (ALS). The drug is the first for the company, as its early development was primarily performed using its ConVERGE […]
Alkermes Eyes Gains with Oncology Spinoff Thanks to Inflation Reduction Act
The Irish biotech Alkermes announced it will spin out its oncology division as it pivots to biologics development. The move is one made by several pharma and biotech giants in recent weeks due to rules surrounding price capping. While small molecule drugs can be negotiated by Medicare after 9 years […]
Indian Pharma Industry Fares Well Amid Inflation and Pricing Concerns
An ICRA analysis of 16 leading Indian pharma companies finds the industry doing well in spite of concerns regarding inflation and drug pricing. The selected companies reported an average revenue growth of 4.9%, driven in part by market growth in the US and abroad. However, the report also noted a […]
Advancing Disability Research via Harmonized Data
Recent efforts to advance disability research, healthcare, and policymaking have been held back by a lack of large, high-quality sources of real-world data (RWD) regarding disabled people. In a newly published article in Health Affairs, authors discuss how harmonizing disability-related RWD sources […]
ICER Publishes Revised Hemophilia Gene Therapy Evidence Report
A revised evidence report has been published by the Institute for Clinical and Economic Review (ICER) detailing the effectiveness and value of two gene therapies for hemophilia A and B. The gene therapies offer nearly complete remission of bleeds for a period of time without the need for […]
Supporting the Social Determinants of Health Infrastructure with Federal Funding
The growing public focus on social determinants of health (SDoH) spurred by the COVID-19 pandemic has outstripped the infrastructure in place to address issues of health equity. According to several stakeholders, increased federal funding is key to advancing these goals and developing a tech […]
Norstella and Citeline Announce Complete Merger
Norstella, a biotech that provides end-to-end services for therapeutic development has merged with Citeline, a leader in pharma intelligence. The acquisition brings the value of Norstella up to $5 billion, ranking among the largest in the industry. Norstella will use Citeline’s range of services and […]
Improving Cancer Outcomes with Value-Based Care and Reimbursement
At last month’s Community Oncology Alliance Payer Exchange Summit, a panel of speakers discussed how improving cancer outcomes and spending through value-based care and reimbursement requires a plethora of different strategies. The panel, entitled “New Strategies for Insurance Benefit Designs: From […]
Eli Lilly and US HHS at Odds Over 340B Program in Federal Court
The US Department of Health and Human Services (HHS) and Eli Lilly butted heads in a recent federal appeals court hearing over the agency’s 340B drug discount program, which requires that drugmakers give discounts on certain drugs to pharmacies that serve underprivileged communities. Lilly has […]
Epic’s Johnston Thayer Discusses New Real-World Data Platform
Epic’s director of clinical informatics and population health Johnston Thayer, MBA, RN, sat down with Healthcare Innovation to talk about the company’s new real-world data (RWD) tool. Best Care, as the platform is called, will pull data from Epic’s large electronic health record (EHR) database to […]
San Diego Non-Profit and Managed Care Company Brings Free Healthcare to Unhoused People
A non-profit team of clinicians is providing comprehensive care to San Diego’s unhoused population in a partnership with Medi-Cal, a medical provider for low-income people in California, and Molina Healthcare of California, a managed care company. The team, called Healthcare in Action, is comprised […]
OptumRX Settles Ohio Lawsuit for $15 Million
OptumRX has reached a settlement with the US state of Ohio to the tune of $15 million. The suit centered around claims the pharmacy benefit manager (PBM) giant was over-billing the state’s Bureau of Workers’ Compensation. Andrew Krejci, a spokesperson for OptumRX, initially argued that negotiations […]
UICC and WHO to Negotiate Prices for Cancer Generics and Biosimilars
Cancer drug price negotiations with the World Health Organization (WHO) and the Union for International Cancer Control (UICC) will center around biosimilars and generics. The goal is to increase access to life-saving medications for people living in low and low-middle income countries (LMICs). […]
Efficacy of Combination Therapy for Metastatic Breast Cancer Confirmed in Real-World Data Study
A new real-world data (RWD) study published in NPJ Breast Cancer has found that a combination therapy for a form of metastatic breast cancer (MBC) is more effective than monotherapy. The study investigated the use of palbociclib and an aromatase inhibitor (AI), comparing it to AI monotherapy. Data […]
Call for Nominations: STAT Madness 2023
STAT has opened nominations for its 2023 STAT Madness competition. Every year for the past seven years, STAT has invited readers to nominate research leaders who are advancing biomedical innovation. Select a research team who published novel research in 2022 and nominate them by January 17th, 2023. […]
Group Practices Rate Prior Authorization as Worst Regulatory Burden
The 2022 Annual Regulatory Burden Report by MGMA found that prior authorizations were the largest source of regulatory headaches for executives of group practices. Almost 82% of respondents stated that prior authorizations exacted a high burden on their practices and 89% said that their regulatory […]
Real-World Evidence-Based Regulatory Decision-Making Requires Collaboration
Advancing remote patient monitoring depends on the use of connected medical devices that generate large amounts of real-world data (RWD). To leverage these resources to generate usable real-world evidence (RWE), manufactures must work with firms specializing in digital health infrastructure, […]
ISPOR Releases Guidance on Reproducibility of Real-World Evidence Research
ISPOR has published a news guidance on using real-world evidence to determine efficacy and make healthcare decisions. The guidance puts forward a framework to address issues of data provenance, utilization, and analysis for researchers to follow in order to ensure reproducibility. This framework was […]
New Real-World Data Program for Personalized Oncology Care Revealed by Tempus
The artificial intelligence (AI) company Tempus has announced its new precision medicine oncology real-world data (RWD) platform Tempus+. The program is a collaboration between several cancer centers across the US. Over five million electronic health records (EHR) will be organized and made […]
Alnylam Blames New US Drug Pricing Laws for Shelving of Rare Eye Disease Therapeutic
Alnylam is setting aside a clinical trial of its therapeutic Vutrisiran for a rare eye disease due to the looming US drug pricing reforms, according to the company. The RNA-based treatment for Stargardt disease is currently used in another rare disease but would not face Medicare pricing […]
AJMC “What We’re Reading” – Uninsured Children, HIV and Monkeypox, and Health Outcomes by US State
In the latest edition of “What We’re Reading,” the AJMC staff cover several breaking stories. A recent study found that people living in conservative US states have lower life expectancies than more liberal ones. The researchers’ anaysis shows that over 170,000 lives could be saved if certain […]
