From Specialty Pharmacy News - Pharmaceutical manufacturers are maintaining their research-and-development focus on oncology, with 771 therapies, including vaccines, in the pipeline, according to a new report from the Pharmaceutical Research and Manufacturers of America (PhRMA), released Oct. 7. And while many innovative products are coming onto the U.S. market, there are many more that fail during clinical trials. Read more
From Health Plan Week - With consumers increasingly being given more choice and new channels to pursue their health care needs, health insurers should be aware that their role could be under severe threat if non-traditional entrants like Amazon.com, Inc., Google Inc., Target Corp. and Wal-Mart Stores, Inc. eye part of their market sector and act as distribution channels for coverage. The finding came in a new survey released by Strategy&, a PwC unit, which… Read more
From Inside Health Insurance Exchanges - During the first seven months of 2014, nearly half of people who bought health coverage through a public exchange had at least one prescription filled, according to an analysis of 80 million prescription claims conducted by pharmacy benefit manager Express Scripts Holding Co. Read more
From Medicare Advantage News - It was largely more of the same in the new National Committee for Quality Assurance (NCQA) rankings of Medicare Advantage plans. Kaiser Permanente plans occupied the first three places, as they did a year ago (MAN 10/10/13, p. 3). And not a single PPO made it into the top 23 in the rankings, which were released last month and again were prepared in partnership with Consumer Reports magazine. But while… Read more
From Specialty Pharmacy News - After Gilead Sciences, Inc.’s hepatitis C therapy Sovaldi (sofosbuvir) launched in December, much of the attention on the drug has focused on its $1,000-per-day price. But in clinical trials, the drug had sustained virologic response rates of more than 90%, making it much more effective than any previous therapy. Read more
From Report on Medicare Compliance - While hospitals fend off claim denials in core compliance risk areas, they also face revenue losses from pay-for-performance programs and their sometimes counterintuitive consequences. At the same time, pay-for-performance programs may create compliance risks for hospitals under fraud and abuse laws, because of the temptation to reward physicians for improving quality of care and give free goodies to patients to improve their health. Read more
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