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MMIT Reality Check on Immune Globulin (PID) (Mar 2021)

Posted by Matt Breese on Mar 19, 2021

According to our recent payer coverage analysis for immune globulin (PID) treatments, combined with news from key healthcare influencers, market access is shifting in this drug landscape.

To help make sense of this new research, MMIT's team of experts analyzes the data and summarizes the key findings for you. The following are brief highlights. To read the full piece, including payer coverage, drug competition and prescriber trends, click here.

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Topics: Specialty, Market Access, Payer, Branding & Marketing

Perspectives on Stock Selloff Following CVS 4Q Earnings Report

Posted by Leslie Small on Mar 18, 2021

Although CVS Health Corp.'s stock price dropped about 5% after the company reported its fourth-quarter and full-year 2020 financial results on Feb. 16, equities analysts seemed to be unshaken in their view that the firm — which owns health insurer Aetna — has strong fundamentals, AIS Health reported.

For the fourth quarter of 2020, CVS's net income of $975 million was down 44% compared with the prior-year period, a result the company partially attributed to lower operating income driven by the impact of the COVID-19 pandemic on its Health Care Benefits and Retail/Long-Term Care segments. For the full year 2020, CVS's operating income and net income increased relative to 2019.
 
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Topics: Data & Analytics, Payer

Radar On Market Access: Ohio Names New Medicaid PBM, Sues One of Current Vendors

Posted by Leslie Small on Mar 16, 2021

Ohio recently cleared a key hurdle in its plan to revamp how Medicaid enrollees' pharmacy benefits are managed, choosing Gainwell Technologies as the single PBM that will replace big-name firms including Cigna Corp.'s Express Scripts, CVS Heath Corp.'s Caremark, UnitedHealth Group's OptumRx and Centene Corp.'s Envolve Pharmacy Solutions, AIS Health reported.

Although PBMs and insurers generally oppose state moves to carve out pharmacy benefits from their Medicaid managed care contracts, Ohio says it expects the new single-PBM approach will "drive transparency, reduce pharmacy costs and simplify provider administration."

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Topics: Industry Trends, Market Access, Payer

MMIT Reality Check on Non-Small Cell Lung Cancer EGFR Mutated (Mar 2021)

Posted by Matt Breese on Mar 12, 2021

According to our recent payer coverage analysis for non-small cell lung cancer EGFR mutated treatments, combined with news from key healthcare influencers, market access is shifting in this drug landscape.

To help make sense of this new research, MMIT's team of experts analyzes the data and summarizes the key findings for you. The following are brief highlights. To read the full piece, including payer coverage, drug competition and prescriber trends, click here.

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Topics: Specialty, Market Access, Payer, Branding & Marketing

Radar On Market Access: Cigna's Evernorth to Acquire MDLive in Telehealth Expansion

Posted by Peter Johnson on Mar 11, 2021

Health insurers have begun to consolidate their position in the telehealth market, as indicated by a recent move by Cigna Corp. to acquire MDLive Inc. Meanwhile, lawmakers are beginning to consider the future of telehealth regulation and payment, AIS Health reported.

Cigna's Evernorth health services arm announced on Feb. 26 that it had reached an agreement with MDLive to acquire the virtual care provider, according to MDLive's website. MDLive has been available in-network as a primary care option to all members of Cigna's commercial plans since January 2020.

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Topics: Industry Trends, Data & Analytics, Payer

MMIT Reality Check on Crohn's Disease (Mar 2021)

Posted by Matt Breese on Mar 5, 2021

According to our recent payer coverage analysis for Crohn's disease treatments, combined with news from key healthcare influencers, market access is shifting in this drug landscape.

To help make sense of this new research, MMIT's team of experts analyzes the data and summarizes the key findings for you. The following are brief highlights. To read the full piece, including payer coverage, drug competition and prescriber trends, click here.

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Topics: Specialty, Market Access, Payer, Branding & Marketing

Radar On Market Access: 2020 Was 'Breakout Year' for Digital Engagement in Health Care

Posted by Jane Anderson on Mar 4, 2021

Health care organizations, eager for innovative ways to engage members in the midst of the pandemic, ramped up their use of email and texts in 2020 and found they were highly effective at prompting consumer action, a recent survey on health care consumer engagement found.

The survey, conducted annually for the past five years by consulting and research firm Engagys, found when it polled around 100 health care entities in November that 2020 had been a "breakout year" for use of more efficient digital channels and personalized messages, Kathleen Ellmore, the firm's co-founder and managing director, tells AIS Health.

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Topics: Industry Trends, Data & Analytics, Payer

MMIT Reality Check on HIV (Feb 2021)

Posted by Matt Breese on Feb 26, 2021

According to our recent payer coverage analysis for HIV treatments, combined with news from key healthcare influencers, market access is shifting in this drug landscape.

To help make sense of this new research, MMIT's team of experts analyzes the data and summarizes the key findings for you. The following are brief highlights. To read the full piece, including payer coverage, drug competition and prescriber trends, click here.

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Topics: Specialty, Market Access, Payer, Branding & Marketing

Trends That Matter for Rx Benefits in Medicaid

Posted by Leslie Small on Feb 25, 2021

Beginning in April, California and New York will join a growing list of states that have opted to carve out prescription drug benefits from their Medicaid contracts with insurers, wagering that the state can do a better job at negotiating drug prices with manufacturers than managed care organizations and their contracted PBMs, AIS Health reported.

"I think the pharmacy benefit overall will be something that states are looking at in order to find savings in some way — whether through carveouts or through another policy — just because there are limited levers that the state is going to be able to pull to save money," says Rachel Dolan, a senior policy analyst with the Kaiser Family Foundation’s Program on Medicaid and the Uninsured.
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Topics: Industry Trends, Market Access, Data & Analytics, Payer

Radar On Market Access: Analysts Downplay Stock Selloff Following CVS 4Q Earnings Report

Posted by Leslie Small on Feb 25, 2021

Although CVS Health Corp.'s stock price dropped about 5% after the company reported its fourth-quarter and full-year 2020 financial results on Feb. 16, equities analysts seemed to be unshaken in their view that the firm — which owns health insurer Aetna — has strong fundamentals, AIS Health reported.

For the fourth quarter of 2020, CVS's net income of $975 million was down 44% compared with the prior-year period, a result the company partially attributed to lower operating income driven by the impact of the COVID-19 pandemic on its Health Care Benefits and Retail/Long-Term Care segments. For the full year 2020, CVS's operating income and net income increased relative to 2019.

Read More

Topics: Industry Trends, Data & Analytics, Payer