Bundled payment models can push Medicare and health system costs down considerably without sacrificing quality of care, according to new research from the Perelman School of Medicine at the University of Pennsylvania.

Researchers at the University Health Network (UHN) in Toronto, Canada, have found that when treating patients with recurrent Clostridium difficile infection (RCDI), a single fecal transplantation (FT) delivered by enema is no more effective than the existing standard of care (the administration of oral vancomycin taper).

A Vermont law that seeks to shed light about why the price of medications rise seems to have misplaced its flashlight.

“Tis better to have loved and lost than never to have loved at all,” the poet Alfred Lord Tennyson wrote.

A pivotal phase 3 trial of trabodenoson ophthalmic suspension (Inotek Pharmaceuticals) for the treatment of patients with primary open-angle glaucoma (POAG) or ocular hypertension (OHT) has failed to achieve its primary endpoint of superiority in the reduction of intraocular pressure (IOP) compared with placebo at all 12 time points.

The new Republican-controlled Congress, which convened on January 2, is eager to get started on repealing major portions of President Obama’s Patient Protection and Affordable Care Act (PPACA), according to a Reuters report. Leading Democrats have warned of a fierce fight over the controversial health care law.

In 2016, hospitals began to spin off specialty lines designed to serve certain niches of patients, with the aim of cutting the overhead expenses of hospital operators, according to an article on the FierceHealthcare website.

Seventy years after the Centers for Disease Control and Prevention (CDC) was founded to fight mosquitoes that carried malaria, the agency has found itself in combat with another mosquito-borne illness, Zika virus.

Innocoll, a specialty pharmaceutical company based in Ireland, has received a Refusal to File letter from the FDA for Xaracoll (bupivacaine HCl collagen-matrix implants) for the treatment of postsurgical pain.

A Medicare bundled payment program for hip and knee replacement seems to be saving money, according to a study in JAMA. But that might not impress President-elect Trump’s nominee to head Health and Human Services. Rep.

Cybersecurity in the health insurance industry isn’t getting the kind of attention it deserves.

The medical profession is like the airline industry: Anything less than perfect performance and lives are endangered.

Cempra, Inc., has received a complete response letter (CRL) from the FDA regarding the company’s new drug applications (NDAs) for oral and intravenous solithromycin for the treatment of community-acquired bacterial pneumonia (CABP) in adults.

City of Hope researchers in Duarte, California, have successfully treated a patient with recurrent multifocal glioblastoma using MB-101 (Fortress Biotech), a chimeric antigen receptor T-cell (CAR-T) therapy, to attack cells with the interleukin-13 receptor α2 (IL13Rα2) antigen, which is common in brain cancer.

The FDA has accepted a new drug application (NDA) granting priority review for betrixaban (Portola Pharmaceuticals), an oral, once-daily factor Xa inhibitor anticoagulant, for extended-duration prophylaxis of venous thromboembolism (VTE) in acute medically ill patients with risk factors for VTE.


Managed Care’s Top Ten Articles of 2016

There’s a lot more going on in health care than mergers (Aetna-Humana, Anthem-Cigna) creating huge players. Hundreds of insurers operate in 50 different states. Self-insured employers, ACA public exchanges, Medicare Advantage, and Medicaid managed care plans crowd an increasingly complex market.

Major health care players are determined to make health information exchanges (HIEs) work. The push toward value-based payment alone almost guarantees that HIEs will be tweaked, poked, prodded, and overhauled until they deliver on their promise. The goal: straight talk from and among tech systems.

They bring a different mindset. They’re willing to work in teams and focus on the sort of evidence-based medicine that can guide health care’s transformation into a system based on value. One question: How well will this new generation of data-driven MDs deal with patients?

The surge of new MS treatments have been for the relapsing-remitting form of the disease. There’s hope for sufferers of a different form of MS. By homing in on CD20-positive B cells, ocrelizumab is able to knock them out and other aberrant B cells circulating in the bloodstream.

A flood of tests have insurers ramping up prior authorization and utilization review. Information overload is a problem. As doctors struggle to keep up, health plans need to get ahead of the development of the technology in order to successfully manage genetic testing appropriately.

Having the data is one thing. Knowing how to use it is another. Applying its computational power to the data, a company called RowdMap puts providers into high-, medium-, and low-value buckets compared with peers in their markets, using specific benchmarks to show why outliers differ from the norm.
Competition among manufacturers, industry consolidation, and capitalization on me-too drugs are cranking up generic and branded drug prices. This increase has compelled PBMs, health plan sponsors, and retail pharmacies to find novel ways to turn a profit, often at the expense of the consumer.
The development of recombinant DNA and other technologies has added a new dimension to care. These medications have revolutionized the treatment of rheumatoid arthritis and many of the other 80 or so autoimmune diseases. But they can be budget busters and have a tricky side effect profile.

Shelley Slade
Vogel, Slade & Goldstein

Hub programs have emerged as a profitable new line of business in the sales and distribution side of the pharmaceutical industry that has got more than its fair share of wheeling and dealing. But they spell trouble if they spark collusion, threaten patients, or waste federal dollars.

More companies are self-insuring—and it’s not just large employers that are striking out on their own. The percentage of employers who fully self-insure increased by 44% in 1999 to 63% in 2015. Self-insurance may give employers more control over benefit packages, and stop-loss protects them against uncapped liability.