Managed Healthcare Week in Review March 7, 2020

Coverage of the recent annual meeting of the Pharmacy Benefit Management Institute (PBMI) in Orlando, Fla., proved popular with online readers of Managed Healthcare Executive, as this week’s top three most-read articles all came from conference coverage. Our top five of the week:

5. Assessing ACA Payment Reform at 10 Years. Five takeaways from the March issue of Health Affairs discuss how the Affordable Care Act has set the bar high for all coverage that has come after it, whether or not you like the law. The bottom line: payment reform has neither been a smashing success nor a complete failure-and the jury is very much still out.

4. Rheumatoid Arthritis (RA) Drug Pipeline at a Trickle. Disease-modifying antirheumatic drugs (DMARDs) have improved quality of life and symptoms for patients with RA, but the current pipeline doesn’t match the string of new approvals seen in recent years. The most notable is filgotinib, a highly selective oral Janus Kinas (JAK) inhibitor from Gilead and Galapagos NV. Much of the action in the RA space will be determined by how much providers and payers embrace biosimilars.

3. Steve Miller: Cigna Hasn't Seen Any Coronavirus-related Drug Shortages. The insurer Cigna, which now owns Express Scripts, hasn’t seen drug shortages due to the coronavirus epidemic, Steve Miller, MD, the company’s chief clinical officer, told attendees at PBMI 2020. Miller spoke Wednesday in a wide-ranging talk at the annual meeting, where he explained that supply chains for generics are shorter than for brand-name drugs.

2. PBMI 2020: Opioid Epidemic Update, Specialty Drugs Rule, and Amazonification of Healthcare. A roundup from the Orlando, Fla., meeting featured coverage from speaker Barry Meier, author of Pain Killer, and a discussion of why Amazon may take a different approach from PBMs-the retail disrupter is accustomed to saying, “yes.” 

1. ICER Launches Subscription-Model Tools. The Institute for Clinical and Economic Review (ICER), best-known for is reviews of whether new prescription drugs are cost-effective, will offer new interactive tools this year in a move away from its foundation funding model. Steven Pearson, ICER founder and president, said the offerings will be useful to drug developers, insurers and PBMs to arrive at drug prices. Pearson presented the new plan at the PBMI 2020 meeting.