CER Daily Newsfeed

NPC at #AMCP2025: Recap & Highlights

(4/14, National Pharmaceutical Council: E.V.I.dently Today) comments “...During a session titled, ‘Understanding 340B Stakeholder Perspectives, Litigation Trends, and Reform Prospects,’ John O’Brien shared NPC research showing higher 340B profit margins for facilities serving wealthier communities and research conducted by IQVIA showing lost rebates for employers and increased cost to states and local governments...NPC Chief Strategy Officer Kimberly Westrich moderated a dynamic session on ‘Patient Engagement in Managed Care Pharmacy: Putting Policy Into Practice.’ Panelists Kimberly Lenz of MassHealth, Emily Tsiao of Premera Blue Cross, and Joe Vandigo of Applied Patient Experience discussed practical patient engagement methods related to managed care formulary reviews, PDABs, and the IRA.” Full

Zanubrutinib May Lead to Cost Savings vs Ibrutinib in R/R CLL

(4/15, Jared Kaltwasser, The American Journal of Managed Care) reports “Zanubrutinib offers significant progression-free survival benefits over ibrutinib in R/R CLL, as shown in the ALPINE trial. Economic analysis indicates zanubrutinib can prevent disease progression or death more effectively and at a lower cost.” Full

Still Out of Reach: Why Effective Opioid Treatment Isn’t Getting to Patients

(4/15, Jeffrey A. Singer, CATO Institute) comments “...Studies show some people have better responses to methadone than to buprenorphine. Buprenorphine is a partial agonist, whereas methadone is a full agonist...A 2024 retrospective cohort study of the comparative effectiveness between buprenorphine and methadone published in the Journal of the American Medical Association concluded: Receipt of methadone was associated with a lower risk of treatment discontinuation compared with buprenorphine/naloxone. The risk of mortality while receiving treatment was similar for buprenorphine/naloxone and methadone, although the CI estimate for the hazard ratio was wide.” Full

“All I Do Is Win”: Why Beating Benchmarks Doesn’t Mean That ACOs Are Reducing Costs

(4/15, Andrew M. Ryan, Adam A. Markovitz, Hayden Rooke-Ley, Health Affairs Forefront) comments “Even as most value-based payment (VBP) models fail to generate savings, public officials and industry leaders tout the ostensible success of Medicare’s accountable care organizations...Yet, independent and peer-reviewed analyses tell a very different story. These studies find that ‘gross’ savings (which do not account for incentive payments to ACOs) are modest to non-existent, while ‘net’ savings (which account for incentive payments) are vanishingly small or actually represent losses to the Centers for Medicare and Medicare Services.” Full

Market Access and HTA – a Snapshot of Recent Developments with Sreeram Ramagopalan: January–March 2025

(4/15, Sreeram Ramagopalan, The Evidence Base) comments “...The finding that US commercial health plans do reference HTAs in their coverage decisions – particularly international ones – creates an opportunity for manufacturers to influence payer decision-making through robust economic evidence. Manufacturers should consider employing generalized cost-effectiveness analysis (GCEA) approaches to demonstrate the holistic societal value of their medicines, which can inform both Medicare negotiations and commercial coverage determinations.” Full