The FDA granted approval for Spinraza in late December for use on children and adults with spinal muscular atrophy. Insurance coverage is mostly focused on infants and children.
Kaiser Health News examines the role of PBMs in the prescription drug-pricing pipeline.
The high cost of Spinraza, a new and promising treatment for spinal muscular atrophy, highlights how the cost-benefit analysis insurers use to make drug coverage decisions plays out in human terms.
Republican senators are warming to the idea of a scaled-back plan that would delete the Affordable Care Act’s individual and employer mandates but leave the rest of law generally intact. But this approach has caused difficulties in the past.
During another day of fast-moving developments, Senate Republicans signaled their intent to attempt to bring an updated repeal-and-delay bill to the floor for a vote next week.
The failure this week of the U.S. Senate’s ACA repeal effort was one more twist in the ongoing political drama that has complicated routine rate setting for insurers and state officials.
A key bill provision would likely lower premiums, but coverage would be skimpier with consumers left to figure out the trade-offs.
A little-noticed provision of the Senate GOP health plan would unwind an Affordable Care Act provision limiting insurer profits, administrative costs.
The latest Republican plan to revamp the health law reshapes how age and income affect what help consumers get for paying premiums.
The study also found that the largest percentage of medical coverage claims related to opioid abuse and dependence nationally come from older patients — those ages 51 to 60.