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The Cigna Group reported today their total revenue of $247.1 billion for 2024, compared with $195.3 billion in 2023. This growth highlights the company’s strong financial results, supported by the success of Evernorth Health Services, new client acquisitions and growth in the specialty drug space.


Cigna's 27% Revenue Increase in 2024 and the Outlook on 2025

Peter Wehrwein has been the lead editor of Managed Healthcare Executive since February 2020.


After several days of worry that the global AIDS program might come to abrupt end, Secretary of State Marco Rubio issued a humanitarian waiver that appears to have restored funding.

RFK Jr. Voices Support for PEPFAR Amid Trump Foreign Aid Funding Freeze

At today's confirmation hearing, Democratic senators were skeptical of the HHS Secretary nominee Robert F. Kennedy Jr.'s claim that he is now pro-vaccine.

RFK Jr. Faces Scrutiny from Democrats on Vaccines and Medicare, Medicaid

Robert F. Kennedy Jr., the HHS secretary nominee, has said he is not antivaccine, but he has a track record of casting doubt on the safety and efficacy of vaccines.

RFK Jr. May Want to Talk MAHA. But His Views on Vaccines Are Likely To Be Topic A-1 at Senate Hearing Today 

Managed Healthcare Executive provides C-suite executives at health plans and provider organizations with news, analysis, insights, and strategies to pursue value-driven solutions.

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Here are certain facts that every executive responsible for managing populations at risk for prescription drug misuse should know as they make policy decisions affecting patient care and financial management.

Four Facts Healthcare Execs Should Know About the Drug Crisis 

Human metapneumovirus (HMPV) is a respiratory virus that may not be on most folk’s radars, but it’s more common than you think — and chances are, you’ve already had it.

A recent “outbreak” in northern China has brought HMPV into the spotlight, raising questions about its significance.

Frank Esper, M.D., a pediatric infectious disease specialist at Cleveland Clinic Children’s Hospital, provides his insights into this virus.

HMPV is similar to common respiratory illnesses such as colds, the flu and respiratory syncytial virus (RSV). Its symptoms include coughing, wheezing, a runny nose and a sore throat.

Although most cases are mild, certain groups — including young children, older adults and those with weak immune systems — face a higher risk of developing severe illness.

, children under five are especially vulnerable due to their developing immune systems.

First discovered in the Netherlands roughly 24 years ago, HMPV belongs to the same viral family as RSV.

Esper, who helped discover the virus during his fellowship at Yale-New Haven Hospital, noted that HMPV likely existed and infected humans for hundreds of years, however, the tools and technology to detect these viruses have only become available in the last few decades.

As “sister” viruses, HMPV and RSV share many characteristics.

Both cause upper and lower respiratory tract infections and can lead to conditions such as viral pneumonia and bronchiolitis.

In children, airway inflammation may result in wheezing and difficulty breathing. Adults with chronic lung conditions, such as asthma or COPD, are also at risk for complications.

Esper shared that while symptoms of the two viruses are similar, their seasonal occurrence differs. RSV typically surges in December and January, while HMPV is more common in March and April.

“They (HMPV and RSV) have a very sophisticated dance,” Esper said. “So, it's not just temperature, but it also has to do with immune priming — about when the susceptibility is.

“There's a lot that goes to when the seasonality of a virus (is). Temperature is one of those parts, but there's actually more than that. They work together somehow, we haven't figured out how.”

Accurate diagnosis requires molecular tests like PCR to detect the virus’s genetic material.

As far as spreading, HMPV travels through large respiratory droplets.

Close contact with an infected person, touching contaminated surfaces and then touching your face can lead to infection. The virus primarily affects the nasal passages but can spread to the lungs in severe cases, potentially causing pneumonia.

Preventive measures such as frequent handwashing, covering coughs and avoiding close contact with sick individuals are encouraged to limit its spread.

For mild cases, HMPV symptoms typically resolve within a few days to a week. More severe infections may take longer to improve and could leave lingering symptoms like a persistent cough.

There are no specific antibiotics to treat HMPV, so it’s encouraged to let the body fight it off on its own.

For mild cases, getting plenty of rest and drinking lots of fluids is usually enough. In more serious cases, people might need to go to the hospital for extra oxygen or help managing other health issues such as asthma or COPD.

Esper explained that the immune system is very important for getting better, and most people feel back to normal within three to five days.

“Your immune system, for the most part, is all you need,” he said. “You just need the time to weather the storm, and that's what we do from a treatment standpoint. A lot of the time, you don't need any medical treatment.”

The long-term effects of HMPV are still being studied, he mentioned.

While early-life RSV infections have been linked to asthma, there is currently no evidence of similar long-term complications from HMPV, Esper said. Most folks recover fully without lasting issues.

To reduce the risk of HMPV infection, it’s encouraged to follow these hygiene practices:

Wash your hands frequently with soap and water.

Cover your coughs and sneezes with a tissue or your elbow.

Avoid close contact with people who are sick.

Wear a mask during peak respiratory virus seasons, if needed.

When asked if other countries such as the U.S could experience an outbreak similar to that in China, Esper expressed that HMPV outbreaks happen annually worldwide, especially in the U.S., and are generally comparable in severity to other respiratory virus seasons.

He pointed out that, like other viruses during the COVID-19 pandemic, HMPV could potentially evolve into more aggressive forms. Scientists are continuing to study and monitor the virus to understand these risks better.

“We certainly have seen, over the previous years, that sometimes when viruses resurge after the pandemic, they have been a little more aggressive,” he said. “Maybe because we didn't see them for a whole year, and our immune systems weren't trying to see the response.”

Although HMPV isn’t as widely known as RSV or the flu, it’s still a significant respiratory virus. Being aware of its symptoms, understanding who is most at risk and taking preventive measures can help people stay healthy and protect those around them.

Esper stressed that maintaining good hygiene practices through regular handwashing, covering coughs and masking when necessary are the best defense against respiratory viruses like HMPV.

First discovered in the Netherlands roughly 24 years ago, HMPV belongs to the same viral family as RSV. 

Clinical

A Look at Human Metapneumovirus — a Respiratory Virus You've Likely Had Without Knowing

This webinar, “Your Guide to 2025: Pharma, Formularies, the Pipeline and More” featured Luke Greenwalt, MBA,vice president and lead of the Market Access Center of Excellence at IQVIA, an Jeff Casberg, RPh, M.S., senior vice president, clinical pharmacy at IPD Analytics. Greenwalt and Casberg, both of whom are on the

editorial advisory board, discussed the market trends for GLP-1s and biosimilars; the ’25 drug pipeline; and the prospects for PBM legislation.

Your Guide to 2025: Pharma, Formularies, the Pipeline and More

Ways workplaces and insurance companies have begun to support menopausal women, according to Jenifer Allbright, director of G&A Beneficial.

A New Era: Menopause Support and Workplace Change 

Thanks to lessening taboo, more women are becoming vocal about their struggles with menopause which includes disruptive symptoms like hot flashes, mood swings, memory lapses and anxiety.

In some cases, these symptoms can be so severe they can cause women to miss work. Missed workdays due to menopause symptoms costs the United States $1.8 billion annually according to 

. A similar study done in the UK showed that 

“Managing a well-rounded time off policy, that’s going to be huge,” Jenifer Allbright, Director of G&A Beneficial at G&A Partners, a national HR-outsourcing firm, said in an interview with 

. “And providing a safe, nurturing work environment, because we want to make sure they feel comfortable taking off the time they need.”

Some health insurance companies in the United States have also begun to offer menopause benefits. For example, Aetna has a list of 

 on their website to help their customers find specialized menopause care. They also offer 

 for hormone therapy, dependent on plan type, as well as menopause care through Gennev, a virtual clinic.

Blue Cross Blue Shield is also taking steps to support their customers. They have partnered with Maven, an app that offers virtual classes and personalized specialist recommendations. Coverage is dependent on state.

 Ways workplaces and insurance companies have begun to support menopausal women, according to Jenifer Allbright, Director of G&A Beneficial at G&A Partners.

The FDA has approved Tevimbra (tislelizumab-jsgr) for a second indication: in combination with platinum and fluoropyrimidine-based chemotherapy as a first-line treatment for metastatic HER2-negative gastric or gastroesophageal junction adenocarcinoma (G/GEJ) in adults whose tumors express the protein PD-L1.

Gastric cancer, commonly known as stomach cancer, is the fifth most common cancer globally and the fifth leading cause of cancer-related deaths, according to a release by BeiGene, the developer of Tevimbra.

In 2022 alone, nearly 1 million new cases were diagnosed worldwide, and the disease claimed 660,000 lives.

According to the American Cancer Society, there is an estimated 27,000 people in the United States who were diagnosed with gastric cancer in 2024, leading to approximately 11,000 deaths. The number of new cases of stomach cancer in the United States has been dropping by about 1.5% each year over the last 10 years.

This latest approval is the second for Tevimbra in 2024, as the drug was previously 

 in the United States as a monotherapy for unresectable or metastatic esophageal squamous cell carcinoma (ESCC) in adults following prior systemic chemotherapy that excluded the PD-L1 inhibitor. 

Temimbra launched in October 2024 at a price that company officials 

 was  10% lower than other anti-PD-1 therapies approved in this indication. At the time of launch, the average wholesale acquisition cost of Tevimbra was about $15,075 per month, 

 that updated pricing will be available in a few weeks.

The recent approval for Tevimbra’s use in gastric cancers is based on data from BeiGene’s 

 that was designed to evaluate the efficacy and safety of the drug in combination with chemotherapy.

Data revealed that the overall survival was 15 months for patients treated with Tevimbra and chemotherapy, compared with 12.9 months for those receiving placebo and chemotherapy. The hazard ratio was 0.80,  indicating a 20% reduction in the risk of death.

To better understand the drug’s safety, researchers analyzed data from 1,972 patients. Significant side effects that occurred when the treatment was combined with chemotherapy included issues with patient’s blood such as low white blood cells, low platelets and low red blood cells.

Other common side effects were fatigue, lung infections such as pneumonia, loss of appetite, skin rashes, liver problems, diarrhea and lung inflammation through pneumonitis.

Gastric cancer, commonly known as stomach cancer, is the fifth most common cancer globally and the fifth leading cause of cancer-related deaths.

Jeffrey Gudin, MD

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