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RADAR on Medicare Advantage
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Although PBM reform measures wound up being cut from Republicans’ newly passed budget reconciliation legislation, 11 bipartisan Congress members on July 10 introduced a package containing PBM restrictions that some industry stakeholders hope can finally get across the finish line....
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From its Medicare Part D partnership with Humana Inc. to the recent launch of the Everyday Health Signals program, Walmart Inc. has a long history of supporting health care consumers, including Medicare Advantage and managed Medicaid members. AIS Health, a division of MMIT, culled its archives...
HEALTH PLAN WEEKLY
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Two Wall Street analysts recently downgraded Oscar Health, Inc.’s stock, citing concerns about the Affordable Care Act exchange market. Ari Gottlieb, principal of health care consulting form A2 Strategies, tells AIS Health that the worries are warranted considering Oscar’s exposure to the exchanges.
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Donald Trump's administration has kept most of the Biden-era health care antitrust rules in place, according to speakers at a July 9 Manatt webinar. Still, they suggested that this administration may be slightly more open to the idea of divestitures as a remedy for antitrust concerns than the previous administration.
Radar On Speciality Pharmacy
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In a first, the FDA recently approved a drug administered every six months as pre-exposure prophylaxis (PrEP) to reduce the risk of sexually acquired HIV. While some potential speed bumps to uptake exist, the therapy’s efficacy and less onerous dosing schedule compared with other similar medications could spur its use, making a tremendous difference in the fight against the infectious disease.
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Many ultra-high-cost cell and gene therapies come with the promise of a cure — but it’s not that simple. It’s unclear with many of the agents exactly how long that “cure” will last. And the process a person must go through both before and after treatment is an extensive one, necessitating coordination among various components. So while many employers may not have had a claim for one of these products, they still need to prepare for that possibility.
RADAR ON DRUG BENEFITS
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Although high-cost prescription drugs are increasingly busting U.S. employers’ budgets, companies face significant barriers when trying to upend the pharmacy benefits management status quo, panelists said during a recent conference in Washington, D.C.
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Billionaire investor Mark Cuban, speaking at a Washington, D.C., conference on June 24, said the Mark Cuban Cost Plus Drug Co. can’t fully disrupt the pharmacy benefits space because the country’s three biggest PBMs have too much leverage over drug manufacturers.
About AIS Health
AIS Health is a publishing and information company that has served the health care industry for more than 30 years. Our mission is to provide our readers with an actionable understanding of the business of health care and pharmaceuticals. Our in-depth writing covers the companies, people, catalysts and trends that create the richly textured contours of the health care and drug industry. AIS Health maintains journalistic independence from our parent company, MMIT. We are committed to integrity in reporting and bringing transparency to health industry data.
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