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Use of and Steering to Pharmacies Owned by Insurers and Pharmacy Benefit Managers in Medicare.
JAMA Health Forum
January 2025
Department of Population Health Sciences, Weill Cornell Medical College, New York, New York.
Importance: The prevalence of pharmacies owned by integrated insurers and pharmacy benefit managers (PBMs), or insurer-PBMs, is of growing regulatory concern. However, little is known about the role of these pharmacies in Medicare, in which pharmacy network protections may influence market dynamics.
Objective: To evaluate the prevalence of insurer-PBM-owned pharmacies and the extent to which insurer-PBMs steer patients to pharmacies they own in Medicare.
High-Cost Cancer Drug Use in Medicare Advantage and Traditional Medicare.
JAMA Health Forum
January 2025
Department of Health Systems, Management, and Policy, University of Colorado Cancer Center, Aurora.
Importance: Medicare Advantage (MA) plans are designed to incentivize the use of less expensive drugs through capitated payments, formulary control, and preauthorizations for certain drugs. These conditions may reduce spending on high-cost therapies for conditions such as cancer, a condition that is among the most expensive to treat.
Objective: To determine whether patients insured by MA plans receive less high-cost drugs than those insured by traditional Medicare (TM).
Estimating Visual Acuity With Spectacle Correction From Fundus Photos Using Artificial Intelligence.
JAMA Netw Open
January 2025
Department of Ophthalmology, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Importance: Determining spectacle-corrected visual acuity (VA) is essential when managing many ophthalmic diseases. If artificial intelligence (AI) evaluations of macular images estimated this VA from a fundus image, AI might provide spectacle-corrected VA without technician costs, reduce visit time, or facilitate home monitoring of VA from fundus images obtained outside of the clinic.
Objective: To estimate spectacle-corrected VA measured on a standard eye chart among patients with diabetic macular edema (DME) in clinical practice settings using previously validated AI algorithms evaluating best-corrected VA from fundus photographs in eyes with DME.
Multi-Stakeholder Call to Action for the Future of Vaccine Post-Marketing Monitoring: Proceedings from the First Beyond COVID-19 Monitoring Excellence (BeCOME) Conference.
Drug Saf
January 2025
Pfizer (Worldwide Medical & Safety), New York, NY, USA.
Cost-effectiveness of the addition of sintilimab as a first-line therapy for locally advanced or metastatic oesophageal squamous cell carcinoma: a Chinese healthcare system perspective.
Health Econ Rev
January 2025
Department of Pharmacy, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, 230001, China.
Background: The ORIENT-15 double-blind randomized controlled trial demonstrated that the addition of sintilimab to chemotherapy for locally advanced or metastatic oesophageal squamous cell carcinoma (OSCC) resulted in better clinical outcomes. In this analysis, we sought to evaluate the cost-effectiveness of sintilimab as a first-line treatment for locally advanced or metastatic OSCC from a healthcare system perspective in China.
Methods: A partitioned survival model was constructed to perform a cost-effectiveness analysis comparing chemotherapy alone with sintilimab for locally advanced or metastatic OSCC patients.
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