Payers will often look to disease analogs when making pricing and coverage decisions. These disease analogs can inform the level of rebates, need for prior authorization/utilization management, and the drug’s cost sharing tier. Traditionally, however, disease analogs are selected on an ad hoc basis. In a recent JMCP paper titled “A structured approach for identifying…
SACRAMENTO, Calif. — As smoke from Canadian wildfires drifted across North America, and western U.S. states girded for their annual fire siege, Neeta Thakur was well into her search for ways to offset the damage of such fumes on people’s health, especially among minority and low-income communities. For more than a decade, the University of…
When President Donald Trump signed a law adding work requirements for some Medicaid recipients, he may have undercut lawmakers in at least 14 states who were designing their own plans, according to health industry observers. Georgia is the only state with a work requirement in place for Medicaid, but several states have been pursuing such…
Cuando el presidente Donald Trump firmó una ley que agrega requisitos laborales para algunos beneficiarios de Medicaid, es posible que haya perjudicado a legisladores de al menos 14 estados que estaban diseñando sus propios planes, según observadores del sector de salud. Georgia es el único estado con un requisito laboral para Medicaid, pero varios estados…
By MICHAEL MILLENSON Shared decision-making between doctors and patients may be “the pinnacle of patient-centered care,” but three new medical journal articles suggest it’s encountering more problems than peaks. Yet counterintuitively, it may be artificial intelligence that rescues this intimately human interaction. “Shared decision-making is at a crossroads,” declares a Perspective in the Journal of General…
Today’s AI is not truly agentic because it’s not truly independent of you. The current crop of agents can’t set complex goals, or properly verify outputs. You have to spend a lot of effort on prompting, verifying, and system integrating. That just means the smarter you are, the smarter the AI is. It’s really amplified…
That is the title of my most recent paper published in Clinical Lung Cancer with co-authors Mark Danese, Melissa Laurie, Beata Korytowsky, Shane Jordan, Debbie Ryan and Sukhmani K. Padda. The study abstract is below. ObjectiveThis study examined brain metastases among patients with metastatic non-small cell lung cancer (mNSCLC), characterizing prevalence, use of brain imaging,…
Now that the Republicans’ big tax-and-spending bill has become law, new bureaucratic hurdles have emerged for millions of Americans who rely on Medicaid for health coverage. A provision in the new law dictates that, in most states, for the first time, low-income adults must start meeting work requirements to keep their coverage. Some states have…
If you want a covid-19 shot this fall, will your employer’s health insurance plan pay for it? There’s no clear answer. Health and Human Services Secretary Robert F. Kennedy Jr., a longtime anti-vaccine activist, has upended the way covid vaccines are approved and for whom they’re recommended, creating uncertainty where coverage was routine. Agencies within…
By MATTHEW HOLT I have been trying hard to suppress this line of thought but when I woke up in the middle of the night with this piece basically fully formed in my head I couldn’t not write it. Yes I might lose some friends, but someone in health tech has to say this. Last…