The American journal of managed care
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The cost burden of patients with SMA is considerable, and is estimated to be approximately $4 million to $5 million over 10 years in patients with early-onset SMA. This cost is 54.2 times greater than an otherwise healthy population. The utilization of medication, resources, and cost differs between different types of SMA and is more intensive in infantile-onset SMA type 1. ⋯ With the approval of novel pharmacotherapy options for SMA, timely treatment initiation may help to decrease healthcare burden and costs associated with early-onset SMA. Current options are effective in improving mobility, but maximum benefit has yet to be seen as this population is still growing. Due to the cost of treatment, managed care pharmacists should consider appropriate utilization management and innovative outcomes-based payment models to decrease risk while maximizing outcomes.
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Alternative payment models (APMs) are part of a growing shift from volume-based, traditional fee-for-service payment models toward payment for value. To date, however, patients have been largely omitted from efforts to design new payment models. We sought to identify key characteristics of outcomes-based quality measures to inform future APMs that are more patient-centered. ⋯ The proposed framework offers a stepping stone on the path to clinically meaningful, patient-centered, high-value care. Next steps may include a broader review of gaps in APM quality measures across multiple therapeutic areas, additional vetting from a more diverse group of stakeholders, or a formal consensus.
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A 2020 federal court ruling requires clinical trial sponsors to report a decade's worth of previously exempted data to the National Institutes of Health (NIH) for publication on ClinicalTrials.gov. In Seife v HHS, the US District Court for the Southern District of New York invalidated NIH regulations that exempted certain clinical trials conducted between 2007 and 2017 from results reporting requirements mandated by the Food and Drug Administration Amendments Act. ⋯ These benefits make the recent decision in Seife particularly significant. However, its impact will be dampened if the government does not take steps to enforce it.
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This article argues that value-based health systems may contract with school districts engaged in capitated special education to achieve better patient outcomes and lower costs for the pediatric population.
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The fall season was accompanied by an urgent warning from the CDC of an impending "twindemic" of coronavirus disease 2019 and influenza. Despite the warnings, Black women are not lining up for vaccinations.