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News
Study Finds At-Risk Medicare Advantage Plans Lead in Quality and Efficiency
02/11/2025
A recent study published in JAMA Network Open provides evidence that at-risk Medicare Advantage (MA) payment arrangements lead to superior quality and efficiency in health care delivery compared with fee-for-service (FFS) MA models.
A recent study published in JAMA Network Open provides evidence that at-risk Medicare Advantage (MA) payment arrangements lead to superior quality and efficiency in health care delivery compared with fee-for-service (FFS) MA models.
A recent study published in JAMA...
02/11/2025
First Report Managed Care
News
90% ROI on Mental Health Benefits
02/07/2025
A recent study published in JAMA Network Open highlights the financial benefits of employer-sponsored behavioral health programs, demonstrating that these programs can result in significant net medical costs savings.
A recent study published in JAMA Network Open highlights the financial benefits of employer-sponsored behavioral health programs, demonstrating that these programs can result in significant net medical costs savings.
A recent study published in JAMA...
02/07/2025
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News
Biosimilar Competition Reduces Adalimumab Spending but Faces Challenges in Uptake
01/20/2025
In the first year of biosimilar competition for adalimumab, spending on the drug decreased by nearly 50%, yet biosimilars accounted for less than 2% of prescriptions in the US.
In the first year of biosimilar competition for adalimumab, spending on the drug decreased by nearly 50%, yet biosimilars accounted for less than 2% of prescriptions in the US.
In the first year of biosimilar...
01/20/2025
First Report Managed Care
News
Study Highlights the Substantial Economic and Health Care Burden of Vitiligo
01/13/2025
Patients with vitiligo in the US face significantly higher health care costs and resource utilization compared with the general population, according to a study published in the Journal of Investigative Dermatology.
Patients with vitiligo in the US face significantly higher health care costs and resource utilization compared with the general population, according to a study published in the Journal of Investigative Dermatology.
Patients with vitiligo in the US...
01/13/2025
First Report Managed Care
News
Biosimilars Expand Access and Cut Costs in HER2-Positive Cancer Treatment
01/10/2025
Biosimilar versions of trastuzumab have rapidly gained market share in treating HER2-positive breast cancer since their introduction to the US markets.
Biosimilar versions of trastuzumab have rapidly gained market share in treating HER2-positive breast cancer since their introduction to the US markets.
Biosimilar versions of...
01/10/2025
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News
Evaluating Long-Term Cost Benefits of Etranacogene Dezaparvovec in Hemophilia B Management
12/19/2024
A study published in Journal of Managed Care and Specialty Pharmacy evaluated the budgetary implications of introducing etranacogene dezaparvovec, a novel gene therapy for hemophilia B, into a US commercial health plan.
A study published in Journal of Managed Care and Specialty Pharmacy evaluated the budgetary implications of introducing etranacogene dezaparvovec, a novel gene therapy for hemophilia B, into a US commercial health plan.
A study published in Journal of...
12/19/2024
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News
Financial Hardships Associated With Long COVID Across Income and Education Levels
12/19/2024
A study published in Health Services Research analyzing data from the 2022 Behavioral Risk Factor Surveillance System (BRFSS) has revealed a significant association between long COVID and financial hardships.
A study published in Health Services Research analyzing data from the 2022 Behavioral Risk Factor Surveillance System (BRFSS) has revealed a significant association between long COVID and financial hardships.
A study published in Health...
12/19/2024
First Report Managed Care
News
Oncology Biosimilars Offer Cost-Efficient Solutions for Sustainable Health Care
12/19/2024
Oncology biosimilars have emerged as a cost-effective and affordable alternative to their reference biologics.
Oncology biosimilars have emerged as a cost-effective and affordable alternative to their reference biologics.
Oncology biosimilars have...
12/19/2024
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News
Global Oncology Biosimilars Market to Surge to $35.79 Billion by 2034
12/19/2024
The global oncology biosimilars market is set to experience remarkable growth, with its value projected to soar from $6.50 billion in 2024 to $35.79 billion by 2034, at an impressive CAGR of 18.6%.
The global oncology biosimilars market is set to experience remarkable growth, with its value projected to soar from $6.50 billion in 2024 to $35.79 billion by 2034, at an impressive CAGR of 18.6%.
The global oncology biosimilars...
12/19/2024
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News
Biosimilar Competition May Fail to Lower Out-of-Pocket Costs for Patients
12/13/2024
Despite the promise of cost savings with biosimilar competition, a study published in JAMA Network found that patient spending on biologic drugs remained the same, indicating the need for policy interventions to ensure affordability.
Despite the promise of cost savings with biosimilar competition, a study published in JAMA Network found that patient spending on biologic drugs remained the same, indicating the need for policy interventions to ensure affordability.
Despite the promise of cost...
12/13/2024
First Report Managed Care

Behind the Bill

Behind the Bill
SCOTUS Takes on the Nondelegation Doctrine: Surprising Reactions and What They Mean for Agency Power
04/02/2025
The Supreme Court recently heard arguments in Federal Communication Commission (FCC) v Consumers’ Research, a case that I covered in February and one that could dramatically reshape federal agency authority through the nondelegation...
The Supreme Court recently heard arguments in Federal Communication Commission (FCC) v Consumers’ Research, a case that I covered in February and one that could dramatically reshape federal agency authority through the nondelegation...
The Supreme Court recently heard...
04/02/2025
First Report Managed Care
Behind the Bill
Dr Oz’s Prescription for Making Medicaid “Viable at Every Level”
03/26/2025
On Tuesday, March 25, 2025, the Senate Finance Committee voted to advance Dr Mehmet Oz in his confirmation as the next head of the Centers for Medicare and Medicaid Services (CMS).1 The full Senate vote is expected “soon” (whatever that...
On Tuesday, March 25, 2025, the Senate Finance Committee voted to advance Dr Mehmet Oz in his confirmation as the next head of the Centers for Medicare and Medicaid Services (CMS).1 The full Senate vote is expected “soon” (whatever that...
On Tuesday, March 25, 2025, the...
03/26/2025
First Report Managed Care
Behind the Bill
The $880 Billion Question Continues: Dr Oz's Confirmation and the Future of Medicaid
03/19/2025
Last week, I explored the $880 billion question facing Congress—whether lawmakers could achieve their budget goals without cutting Medicaid. This week, that question took center stage as Dr Mehmet Oz, President Trump's nominee to lead the...
Last week, I explored the $880 billion question facing Congress—whether lawmakers could achieve their budget goals without cutting Medicaid. This week, that question took center stage as Dr Mehmet Oz, President Trump's nominee to lead the...
Last week, I explored the $880...
03/19/2025
First Report Managed Care
Behind the Bill
The $880 Billion Question: Can Congress Cut Spending Without Touching Medicaid?
03/12/2025
I’d like to step away from administrative law for a moment to provide a quick update on Medicaid. With news coming from all sides, what does the future of Medicaid actually look like? The House of Representatives narrowly passed a budget...
I’d like to step away from administrative law for a moment to provide a quick update on Medicaid. With news coming from all sides, what does the future of Medicaid actually look like? The House of Representatives narrowly passed a budget...
I’d like to step away from...
03/12/2025
First Report Managed Care
Behind the Bill
RFK Jr’s Public Comment Ban: The Silent Shift in Health Care Rulemaking
03/05/2025
The erosion of administrative law continues, and with it, the dismantling of decades-long precedent. In June, the Supreme Court overturned a 40-year-old doctrine that allowed federal agencies to interpret their own ambiguous statutes. Later...
The erosion of administrative law continues, and with it, the dismantling of decades-long precedent. In June, the Supreme Court overturned a 40-year-old doctrine that allowed federal agencies to interpret their own ambiguous statutes. Later...
The erosion of administrative...
03/05/2025
First Report Managed Care
Behind the Bill
Prevention Over Pills? The First 2 Weeks of Health Care’s New Direction
02/26/2025
The dust has barely settled from Robert F Kennedy Jr’s confirmation as Secretary of Health and Human Services (HHS), but the changes are already coming fast and furious—a key theme of the Trump Administration’s actions within the last several...
The dust has barely settled from Robert F Kennedy Jr’s confirmation as Secretary of Health and Human Services (HHS), but the changes are already coming fast and furious—a key theme of the Trump Administration’s actions within the last several...
The dust has barely settled from...
02/26/2025
First Report Managed Care
Behind the Bill
The Nondelegation Doctrine: The Next Constitutional Showdown (Part 2)
02/19/2025
Last week, I explored the potential revival of the nondelegation doctrine through Federal Communication Commission v Consumers’ Research. Today, I want to examine what this could mean for health care regulation by considering the parallels...
Last week, I explored the potential revival of the nondelegation doctrine through Federal Communication Commission v Consumers’ Research. Today, I want to examine what this could mean for health care regulation by considering the parallels...
Last week, I explored the...
02/19/2025
First Report Managed Care
Behind the Bill
The Nondelegation Doctrine: The Next Constitutional Showdown (Part 1)
02/12/2025
Just when you thought the dust had settled from the Chevron decision, the Supreme Court is gearing up to hear arguments in Federal Communications Commission v Consumers' Research next month, potentially reviving the long-dormant nondelegation...
Just when you thought the dust had settled from the Chevron decision, the Supreme Court is gearing up to hear arguments in Federal Communications Commission v Consumers' Research next month, potentially reviving the long-dormant nondelegation...
Just when you thought the dust...
02/12/2025
First Report Managed Care
Behind the Bill
No, President Trump Did Not Actually Sign an Executive Order That Would Increase Drug Costs for Beneficiaries
02/05/2025
On inauguration day, President Trump issued an executive order rescinding several Biden-era health care initiatives, including 3 experimental drug pricing models developed by the Center for Medicare and Medicaid Innovation (CMMI). Oh boy did...
On inauguration day, President Trump issued an executive order rescinding several Biden-era health care initiatives, including 3 experimental drug pricing models developed by the Center for Medicare and Medicaid Innovation (CMMI). Oh boy did...
On inauguration day, President...
02/05/2025
First Report Managed Care
Behind the Bill
Robert F. Kennedy Jr’s Confirmation and the Unexpected Turn in the Drug Pricing Debate
01/29/2025
The Plot Thickens in Drug Pricing Drama Just when you thought the drug pricing debate couldn't get more interesting, Robert F. Kennedy Jr adds an unexpected twist. During closed-door Senate meetings, President Trump’s US Department of...
The Plot Thickens in Drug Pricing Drama Just when you thought the drug pricing debate couldn't get more interesting, Robert F. Kennedy Jr adds an unexpected twist. During closed-door Senate meetings, President Trump’s US Department of...
The Plot Thickens in Drug...
01/29/2025
First Report Managed Care

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Trending Articles

News
Initiating Prophylaxis at Younger Age May Preserve Joint Status in Severe Hemophilia A
04/19/2023
Researchers found an association between long-term joint preservation status and patient age at the time of initiating primary prophylaxis for severe hemophilia A.
Researchers found an association between long-term joint preservation status and patient age at the time of initiating primary prophylaxis for severe hemophilia A.
Researchers found an association...
04/19/2023
First Report Managed Care
Icario logo.
Commentary
Advancing Health Equity With Personalized Member Experiences
05/16/2023
Icario Team
In this commentary, the Icario team explores the topic of advancing health equity and how recent updates to the CMS Framework for Health Equity can help health plans close gaps in care.
In this commentary, the Icario team explores the topic of advancing health equity and how recent updates to the CMS Framework for Health Equity can help health plans close gaps in care.
In this commentary, the Icario...
05/16/2023
First Report Managed Care
Conference Coverage
FDA Oncology Approvals Commonly Involve Surrogate Endpoints, Analysis Shows
06/02/2023
In an updated analysis presented at the 2023 ASCO Annual Meeting, researchers examined the frequency with which surrogate endpoints were used to support oncology approvals from 2006 to 2022.
In an updated analysis presented at the 2023 ASCO Annual Meeting, researchers examined the frequency with which surrogate endpoints were used to support oncology approvals from 2006 to 2022.
In an updated analysis presented...
06/02/2023
First Report Managed Care
Headshot of Anthony Watson on a blue background underneath the PopHealth Perspectives logo.
Podcasts
Payer Reimbursement and Prescription Digital Therapeutics: Understanding FDA Regulations
06/29/2023
Anthony Watson, former vice president of Regulatory and Quality at Pear Therapeutics, discusses his recent perspective article explaining FDA regulations as they relate to prescription digital therapeutics (PDTs) and highlights why he...
Anthony Watson, former vice president of Regulatory and Quality at Pear Therapeutics, discusses his recent perspective article explaining FDA regulations as they relate to prescription digital therapeutics (PDTs) and highlights why he...
Anthony Watson, former vice...
06/29/2023
First Report Managed Care
News
Fear of Movement in Patients With Ankylosing Spondylitis Linked With Lower Life Quality
07/27/2023
Research findings indicate a link between kinesiophobia, a fear of movement and injury, and decreased quality of life in patients with ankylosing spondylitis.
Research findings indicate a link between kinesiophobia, a fear of movement and injury, and decreased quality of life in patients with ankylosing spondylitis.
Research findings indicate a...
07/27/2023
First Report Managed Care

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