Casberg is Vice President of Clinical Pharmacy at IPD Analytics LLC and a member of the Managed Healthcare Executive editorial advisory board. He predicts that "payers will tighten" in 2024.
We asked our readers and some members of our editorial advisory board to make predictions for 2024. Here's what Jeffrey Casberg, M.S., RPh had to say:
“There will be increased trend toward transparency in the pharmacy benefit management industry, but the net result will
likely be little or no savings to employers or government payers. Negotiated Medicare drug prices under the Inflation Reduction Act don’t go into effect until 2026. Even so, the prospect of negotiated prices will start to affect Medicare and commercial payers’ formulary management in 2024. This will be the second year that Humira (adalimumab) biosimilars will be on the market. Compared to some high year two expectations, uptake will be lower than even modest prediction.
With Wegovy (semaglutide) and Zepbound (tirzepatide) approved by the FDA and on the market, payers will be working to tighten glucagon-like peptide 1 (GLP-1) inhibitor coverage criteria in 2024 as utilization continues to ramp up. We’re also going to see increased pressure on federal and state payers to cover weight loss drugs.
The drug shortages have been a problem for several years, especially in the hospital space, and they will continue next year. It is a problem with many different causes. None of them yield to easy answers and they won’t be solved in 2024.”
Breaking Down Health Plans, HSAs, AI With Paul Fronstin of EBRI
November 19th 2024Featured in this latest episode of Tuning In to the C-Suite podcast is Paul Fronstin, director of health benefits research at EBRI, who shed light on the evolving landscape of health benefits with editors of Managed Healthcare Executive.
Listen
A Motor Neuron Mystery Points to New Potential SMA Treatment Targets
December 20th 2024Some muscles are resistant to the loss of motor neurons seen in patients with spinal muscular atrophy, and new research has discovered that even in muscles that appeared resistant to SMA, subtle changes had occurred at the cellular level.
Read More
In this latest episode of Tuning In to the C-Suite podcast, Briana Contreras, an editor with MHE had the pleasure of meeting Loren McCaghy, director of consulting, health and consumer engagement and product insight at Accenture, to discuss the organization's latest report on U.S. consumers switching healthcare providers and insurance payers.
Listen