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New Proposed Rules would Significantly Increase Hospital/Insurer Price Transparency for Employers

The U.S. Department of Health and Human Services recently released two sets of regulations that would make health care costs publicly available.  These regulations could significantly shake up the health care space making it easier for employers to design health benefits to steer employees toward hospitals with high value services. The first regulation (found HERE) […]

New Treatment to Prevent Sickle Cell Crisis

New Treatment to Prevent Sickle Cell Crisis

On November 15, 2020, the U.S. Food and Drug Administration approved Adakveo®, a treatment to reduce the frequency of vaso-occlusive crisis (VOC) in patients with sickle cell disease. These severe events are unpredictable and can cause life-threatening complications. Sickle cell disease is an inherited blood disorder in which the red blood cells are abnormally shaped […]

Employers, Payers Begin to Base Drug Coverage on ICER’s Value-Based Price Benchmark

A recent article by the Wall Street Journal explores the Institute for Clinical and Economic Review (ICER), and how payers are beginning to use this organization’s model to make medication coverage decisions. ICER has no political ties, which allows it to provide an independent examination on the price of drugs. ICER uses a model which […]

ACA Open Enrollment Begins

Coverage for the Affordable Care Act’s (ACA’s) insurance exchanges is now open and runs through December 15th. This year consumers are expected to see premiums decline about 4%. Currently, approximately 10.6 million Americans’s receive health insurance on federal and state-based exchanges. Consumers can make their selections here: HealthCare.gov Additional Information: WSJ ; FierceHealthCare ; CNBC

New Cystic Fibrosis Medication Treats 90% of Patients, Priced at $300,000/Annually

New Cystic Fibrosis Medication Treats 90% of Patients, Priced at $300,000/Annually

On Monday October 21st, the U.S. Food and Drug Administration (FDA) announced the approval of Trikafta®, the first triple combination therapy, for cystic fibrosis (CF). Trikafta® is approved for patients 12 years and older with cystic fibrosis who have at least one F508del mutation in the cystic fibrosis transmembrane conductance regulator (CFTR) gene, which is […]

Open Enrollment for Medicare Begins this Week

Starting October 15th, Medicare beneficiaries can enroll or make changes to their Medicare Advantage or Medicare prescription drug coverage for 2020. The enrollment will be available now through December 7th for individuals to make their selections. Over 60 million seniors are expected to switch plans or stay with their existing coverage. Medicare beneficiaries can make […]

Newly Approved Narcolepsy Product has a Price tag Exceeding $100K Annually

On August 15, 2019, the United States Food and Drug Administration (FDA) approved Harmony Biosciences’ Wakix® (pitolisant) for the treatment of excessive daytime sleepiness (EDS) in adult patients with narcolepsy. Harmony Biosciences has indicated they expect Wakix® to be commercially available in the U.S. in the fourth quarter  of 2019 with an annual price tag […]