News

Medicaid is the main healthcare coverage for people living with HIV in the United States, according to data compiled by KFF.

The 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.

The insurer’s healthcare expenses, especially physician and outpatient services, within the Medicare Advantage businesses were above what company leaders had expected.

In 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.

A 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.

The 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.

In 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.

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

Qfitlia (fitusiran) is the first therapy for both hemophilia A or B, with or without inhibitors, available in the United States.

The CEOs of CVS Health and UnitedHealth Group praised pharmacy benefit managers and promised transparency during investor calls. A critic of the “big 3” dismissed the statements as posturing.

Several drugs in development would block neonatal fragment crystallizable receptor (FcRn) as a way of reducing the autoantibodies that cause myasthenia gravis.

Current observations and foresight into the world of biosimilars, GLP-1s, PBM and payer trends, according to Jeff Casberg, MS, RPh, senior vice president of clinical pharmacy services at IPD Analytics, and Doug Long, MBA, vice president of industry relations at IQVIA.

In United States veterans, antiretroviral resistance was associated with higher healthcare resource utilization, despite lower pharmacy-related costs, according to an abstract submitted to the Academy of Managed Care Pharmacy (AMCP) held last week in Houston.

United 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.

The Xpert MTB/Ultra molecular diagnostic test may become a viable option for detecting tuberculosis (TB) in the stool of adults with HIV, according to the results of a recent study.

At 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.

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

Originally developed to treat Type 2 diabetes, glucagon-like peptide 1 (GLP-1s) are now being studied to explore their effects on various other conditions, such as sleep apnea, substance use disorder and Alzheimer’s disease, according to panelists participating in a keynote session of the Academy of Managed Care Pharmacy annual meeting today in Houston.

Maria 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.

Maria 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.

Julie 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.

At 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.

Juan Carlos Scott, president and CEO of the Pharmaceutical Care Management Association (PCMA), and Marissa Schlaifer, RPh, M.S., vice president of policy at Optum.

Scott Biggs and Douglas M. Long of IQVIA delivered a keynote on 2024-2025 healthcare and pharmaceutical trends, highlighting drug shortages, pharmacy closures, and the United States dependence on imported pharmaceuticals.

Co-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.

Connie Estep, Pharm.D., BCGP, director of specialty clinical solutions at Prime Therapeutics, presented on legislative impacts on site of service at this year's AMCP meeting in Houston.

Researchers say payers should take the added costs of drugs prescribed to deal with GLP-1 side effects into account when considering the financial impact of the popular class of drugs.

Balancing the cost, access to and risk management of CAR-T cell therapies is critical, according to a panel of experts who presented at the annual meeting of the Academy of Managed Care Pharmacy in Houston.

Originally approved by the FDA in September 2023, Biogen's Tofidence became the first tocilizumab biosimilar available in the U.S. market, launching in May 2024.

Digital solutions are needed in healthcare now so that more patients can get the access that they need, according to Vin Gupta, M.D., MPA, former chief medical officer of Amazon Pharmacy and a leading health policy expert.