June 2017

Sales hit the billion-dollar mark as pharmaceutical companies have used the Orphan Drug Act to their advantage. Insurers are beginning to push back.
Joseph Burns
Krishna Rutvij Patel, PharmD
Projections show orphan drugs being a lucrative revenue stream for pharma for years to come, but payers are starting to scrutinize expenditures.
Ed Silverman
Despite some initially impressive results and good intentions, some wonder if this mix of altruism and capitalism can succeed.
Howard Wolinsky
They play a key role in the new payment models. But coordinators aren’t coordinated, and patients are getting annoyed—and worse.
Jan Greene
Brooke Roeper, MSPH, MS
Eric Beck, DO, MPH, FACEP
Daniel Castillo, MD, MBA
J. Brent Myers, MD, MPH
Brandy Sparkman, RN, BSN



Departments
Editor’s Memo
Peter Wehrwein
Legislation & Regulation
Now it’s the Senate’s turn. The key players include Republican senators from states that expanded Medicaid and the upper chamber’s parliamentarian.
Richard Mark Kirkner
Medication Management
The SGLT2 inhibitors and GLP-1 agonists may have a direct effect on heart failure and cardiovascular outcomes.
Thomas Reinke
Viewpoint
Michael Schlosser, MD
Tomorrow’s Medicine
The intravenous drug may help with adherence. The trouble: Health plans may pay a huge markup because it will be delivered as part of dialysis.
Thomas Morrow, MD