Optum Rx's new cost-based program uses an internal algorithm that leverages multiple available industry data sources, such as NADAC and PAC, to inform reimbursement.

Historically, RSV has been studied mainly in infants and older adults, but recent research shows that it also poses a significant threat to adults with asthma and COPD. However, research on the virus within these groups has been limited.

Avidity Biosciences Inc. says will submit an application for accelerated approval to the FDA for del-zota before the end of this year.

Optum Rx has eliminated reauthorization for almost 70 drugs for chronic diseases, about 10% of its overall pharmacy prior authorizations.

Research 'marries' traditional pathology with genomics.

Trust remains a sensitive subject amongst employees as the shortage of mental health resources makes it even harder for them to build that trust with employers.

Researchers found that adherence to the first and second annual screenings was 61% and 51%, respectively, with higher lung cancer detection rates observed in those who followed through on these screenings.

In a February 2025 Time magazine cover story, Jamie Ducharme reports on this atypical and disquieting trend. Ducharme cites a 79% increase in early-onset cancer diagnoses and a 28% increase in cancer-related deaths in this age group from 1990 to 2019.

EsoBiotec’s platform has the potential to eliminate the complex and time-consuming process for manufacturing, helping to make CAR-T cell therapies more accessible.

The Acute Dialysis and Pheresis Therapies (ADAPT) Program has grown from nine nurses to 12.

Regulators are expected to make a decision in the third quarter of 2025 on Kerendia to treat patients with heart failure with a left ventricular ejection fraction (LVEF) of ≥40%.

Here’s what you missed this week on Managed Healthcare Executive.

RSV leads to approximately 1.4 million hospitalizations and over 13,000 in-hospital deaths worldwide among infants under six months old.

Patients with acute kidney injury requiring temporary hemodialysis often follow the protocol used for people on long-term dialysis, despite significant pathophysiological differences between the two.

At a Senate confirmation hearing for CMS administrator, Mehmet Oz, M.D., would not answer directly whether he would support budget cuts to the Medicaid program.

Lissy Hu, M.D., MBA, CEO of Ascend Learning, was one of Managed Healthcare Executive’s 2022 Emerging Leaders in Healthcare winners. The editors caught up with Hu as part of our new “Where Are They Now?” series spotlighting the career paths of past emerging leaders.

Early research shows a one-time gene therapy has potential for addressing both the liver and lung disease that patients with alpha-1 antitrypsin deficiency (AATD) face.

Data show people with pulmonary arterial hypertension tend to stay in the hospital longer and have higher medical bills.

David M. Cordani, chairman and CEO of The Cigna Group, expressed that these moves were made to “build upon our strengths for continued growth, enhance our customer focus, and deliver even greater value for those we serve."

The early results of trials for two injectable, investigational antiretroviral therapies, VH4524184 and VH4011499, have the potential for extended dosing intervals.

Steqeyma is one of seven Stelara biosimilars that have been approved by the FDA.

In a real-world study, researchers found this data by comparing treatment patterns, healthcare resource utilization, and costs between patients receiving CAR T-cell therapy and those treated with the non-CAR T standard of care.

Lumicera Health Services, Navitus’ specialty pharmacy, has made a deal with Teva to offer an unbranded biosimilar that they estimate will save $112,000 and $336,000 per patient per year. Navitus will remove Stelara from formulary on July 1, 2025.

Gilead has reported results for a once-yearly intramuscular injection that show blood concentrations of lenacapavir exceeded those from the twice-yearly dosing.