Why Better Data and Awareness Matters for Medicaid Work Requirements
April 17th 2025With policymakers considering work requirements for Medicaid eligibility, Jennifer Haley, principal research associate in the Health Policy Division at the Urban Institute, said it’s more important than ever to understand how those changes could unintentionally cause harm, particularly when data systems fall short and public awareness is limited.
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It’s a Specialty Drug World, We’re Just Living in It, Expert Says
April 17th 2025The difference between specialty drugs and traditional drugs and how each have vied for market competition, according to Jeff Casberg, MS, RPh, senior vice president of clinical pharmacy services at IPD Analytics.
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Jennifer Haley Debunks the Belief That Medicaid Work Requirements Will Push Its Users to Work
April 16th 2025In this first part of a two-part video series, Jennifer Haley, principal research associate of the Health Policy Division at the Urban Institute, spoke with MHE about the impact the proposed Medicaid work requirements could have on millions and research that supports this belief.
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Insights Into Chronic Itch From Shawn Kwatra, M.D.
April 15th 2025A Q&A between Shawn Kwatra, M.D., professor and chair of dermatology at the University of Maryland School of Medicine, and Managed Healthcare Executive about new discoveries in chronic itch, how treatment options are improving and the challenges patients face in getting access to the right therapies.
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Medicaid Work Requirements Could Lead to Major Coverage Losses Across Expansion States in the U.S.
April 15th 2025The analysis from the Urban Institute breaks down projected coverage losses across the 40 Medicaid expansion states, where researchers based their estimates on previous work requirement rollouts in Arkansas and New Hampshire.
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Specialty Drugs Dominate Pharmaceutical Frontier in 2025
April 15th 2025In a Q&A with Jeff Casberg, MS, RPh, senior vice president of clinical pharmacy services at IPD Analytics, Casberg explains the evolution of specialty drugs, the future of GLP-1 competition and what to expect from the traditional drug pipeline.
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Chronic Itch Often Overlooked as New Treatments Face Coverage Hurdles
April 10th 2025In this second part of a video series, Shawn Kwatra, M.D., professor and chair of dermatology at the University of Maryland School of Medicine, described a common scenario where patients with severe atopic dermatitis must first try and fail multiple topical treatments, all while having widespread symptoms, before insurers will approve systemic therapies.
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United Health Foundation Awards $7M in Grants to Improve Maternal, Infant Health
April 9th 2025United Health Foundation, the charitable branch of UnitedHealth Group, awarded more than $7 million in grants to organizations in Georgia, Michigan, New Mexico and Wisconsin to improve maternal and infant healthcare, reduce disparities and strengthen the doula workforce in underserved communities.
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340B Program Is Driving Up Costs and Needs Urgent Reform | AMCP Annual 2025
April 7th 2025At the 2025 AMCP annual meeting in Houston from March 31 to April 3, John M. O'Brien, Pharm.D., MPH, president and CEO of the National Pharmaceutical Council (NPC), shared concerns and potential reforms in a conversation with Managed Healthcare Executive.
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GLP-1 and Biosimilars Trends, Impact on Payers and Costs | AMCP Annual 2025
April 4th 2025Doug Long, BA, MBA, vice president of Industry Relations at IQVIA, shares what's happening in the growing GLP-1 and biosimilars space. Long was a presenter at the annual AMCP 2025 meeting in Houston, where he discussed these topics and more earlier this week.
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The Future of Gene Therapies and Their Impact on Payers | AMCP Annual 2025
April 3rd 2025Maria Lowe, Ph.D., associate vice president of Pharmaceutical Intelligence at Institute for Clinical and Economic Review (ICER) addresses the possible gene therapies that we could see reach the market this year.
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Defining Specialty Drugs and Upcoming Approvals to Watch | AMCP Annual 2025
April 3rd 2025Maria Lowe, Pharm.D., BCPS, associate vice president of pharmaceutical intelligence at the Institute for Clinical and Economic Review, described specialty drugs as high-cost treatments requiring complex handling or disease management and highlighted key upcoming approvals, including a new PCSK9 inhibitor for lipid lowering and tolebrutinib, a Bruton's tyrosine kinase (BTK) inhibitor, which could become the first in its class approved for multiple sclerosis.
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Evidence Suggests IRA is a ‘Poorly Designed Policy’ | AMCP Annual 2025
April 3rd 2025Julie Patterson, Pharm.D., Ph.D., of the National Pharmaceutical Council, tells Managed Healthcare Executive at the annual AMCP meeting in Houston that the Inflation Reduction Act of 2022 is a policy that seems to be leading to more consequences than it is benefits.
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Impact of IRA Drug Negotiation on Part D Formularies and PBMs | AMCP Annual 2025
April 3rd 2025At the AMCP 2025 meeting, Julie Patterson, Pharm.D., Ph.D., of the National Pharmaceutical Council, explained that the impact of the IRA drug negotiation program on patient access is still unclear, but early research shows that coverage for selected drugs has been strong. However, as Medicare Part D undergoes changes, there are concerns about how plan incentives, formulary design and utilization management might affect future access.
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What's Ahead for Site-Neutral Payments in Medicare and State Policies | AMCP Annual 2025
April 2nd 2025Co-presenter, Sean Shirk, Pharm.D., director of specialty clinical solutions at Prime Therapeutics, discussed this topic during a presentation on legislative impacts on site of service at the AMCP 2025 annual meeting in Houston on Tuesday.
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Winrevair Shows Promise in Advancing PAH Treatment | ACC 2025
March 31st 2025Marc Humbert, M.D., Ph.D., professor of respiratory medicine at Université Paris-Saclay and Inserm, believes that recent clinical trials have reinforced the potential of Winrevair (sotatercept) as a breakthrough in pulmonary arterial hypertension (PAH) treatment.
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Medicaid Cuts Remain Center Stage as Experts Address Industry Challenges
March 28th 2025In a recent conversation with Jennifer McGuigan Babcock, senior vice president for Medicaid policy at the Association for Community Affiliated Plans (ACAP), and Gabe Scott, a partner at K&L Gates Health Care Group, the two discussed efforts to protect Medicaid’s role in the healthcare system and the consequences of the budget cuts announced in February.
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