The American journal of managed care
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Alzheimer disease (AD) is the most common cause of dementia and the sixth leading cause of death in the United States. Today, more than 6 million Americans are living with AD and that number is expected to increase to 13.8 million by 2060. The progressive debilitating nature of this illness and the absence of disease-modifying treatments contributes to a substantial economic and societal burden on the healthcare system. ⋯ Indirect costs such as loss in productivity, diminished quality of life, and an increasing dependence on informal unpaid care provided by family caregivers augments the economic and societal burden of this disease. As drug development continues to evolve, the emergence of disease-modifying therapy may help to offset the burden associated with AD-related dementia. Managed care organizations are uniquely positioned to mitigate costs and positively impact outcomes through the promotion of disease awareness, early diagnosis, and treatment and disease management programs focused on multidisciplinary care coordination and caregiver support.
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In the health spending debate, what policy makers need most is an honest, realistic, and evidence-based discussion. Unfortunately, many studies in the public arena fall far short.
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Severe asthma accounts for 5% to 10% of asthma cases. Despite this, patients with uncontrolled severe asthma consume significant healthcare resources. Approximately 40% of patients with severe asthma have uncontrolled disease. ⋯ Healthcare professionals need to consider phenotype and endotype to individualize patient treatment. As medications and hospitalizations are the largest drivers of asthma-related costs to health systems, choosing optimal therapies to reduce uncontrolled symptoms and exacerbations curbs cost. Successful disease management strategies are employed by managed care organizations that have a collaborative team to ensure patient access to biologics.
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To learn how preferences and practices regarding telehealth have evolved during the COVID-19 pandemic for physicians who provide opioid use disorder (OUD) treatment. ⋯ Physicians were asked about their OUD telehealth policy preferences. Findings suggest that the COVID-19 pandemic increased physician respondent use of telehealth technology, and this has positively shifted their perceptions of effectiveness. Respondents overwhelmingly report interest in post-COVID-19 pandemic telehealth use and support for proposed legislation to loosen telehealth restrictions.
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Cardiovascular disease (CVD) remains the leading cause of death globally. Hypercholesterolemia is a major modifiable risk factor for developing atherosclerotic CVD (ASCVD). Although statins are the foundational evidence-based treatment option, significant gaps in care exist as approximately 5% to 30% of patients do not tolerate statin therapy. ⋯ Alirocumab and evolocumab were approved in 2015 and have been shown to reduce ASCVD risk in secondary prevention patients; however, the cost of therapy has been a barrier to uptake despite significant price reductions. Inclisiran is unique in that it requires administration by a healthcare professional, thus creating challenges and unknowns when it comes to implementing this drug in clinical practice. Managed care professionals have considerable experience with developing approaches to providing access to novel injectable lipid-lowering therapies, such as alirocumab and evolocumab, and with the approval of inclisiran, they now have an expanding list of such therapies to incorporate into their care plans.