STAT

MAY 1, 2025

Novo Nordisk secured a major win on insurance coverage of its obesity drug , STAT notes. But the CVS news is a significant step for Novo, as both companies have been trying to broaden insurance coverage, a key hurdle for wider usage. CVS Caremark, the largest pharmacy benefit manager in the U.S.,

Insurance Coverage 121

Insurance Coverage Insurance 121

STAT

MARCH 2, 2023

Janice Morales-Ferrer is a planner. It’s helped her get ahead in her career and in raising three young kids. But it’s hard to plan when you’ve got a rare disease, especially one with no standard treatment regimen or predictable outcome. “I’m a data-driven person,” said the 46-year-old Boston area resident.

Insurance Coverage 127

Insurance Coverage Insurance 127

Fierce Healthcare

AUGUST 12, 2024

A recent rule by the Centers for Medicare & Medicaid Services (CMS) extending health insurance to children of undocumented immigrants under the Deferred Action for Childhood Arrivals (DACA) pro | A coalition of right-leaning states are calling foul on a recent CMS rule that would expand health insurance for DACA recipients under the Affordable (..)

Insurance Coverage 124

Insurance Coverage Insurance 124

STAT

JANUARY 18, 2024

Pear received Food and Drug Administration clearance for its app treating substance use disorders and insomnia but insurers mostly refused to cover the novel treatments. For years, the playbook for many companies that wanted to market digital therapeutics was stupid simple: Sell it like a prescription drug.

Insurance Coverage 139

Insurance Coverage Insurance FDA 139

STAT

MARCH 29, 2024

And so, another working week will soon draw to a close. Not a moment too soon, yes? This is, you may recall, our treasured signal to daydream about weekend plans. Our agenda is still being formulated, but we do hope to promenade with the official mascots, catch up on our reading, and maybe stare at the telly now and then.

Insurance Coverage 129

Insurance Coverage Insurance 129

Fierce Healthcare

AUGUST 30, 2023

GoodRx has launched a new feature to allow healthcare professionals to see the cost of a patient’s prescription with their insurance. | The feature, embedded in GoodRx's provider solution, surfaces a patient’s coverage and benefits at the point of care with the goal of increasing price transparency and access to drugs.

Insurance Coverage 129

Insurance Coverage Insurance 129

Fierce Healthcare

DECEMBER 18, 2024

Healthcare spending reached nearly $5 trillion in 2023, growing by 7.5% from the prior year, according to new data from the federal government. Healthcare spending reached nearly $5 trillion in 2023, growing by 7.5% from the prior year, according to new data from the federal government.

Insurance Coverage 121

Insurance Coverage Insurance 121

STAT

AUGUST 2, 2023

… So many people have turned to drugs used for weight loss that some employers are cutting off insurance coverage to head off climbing bills , The Wall Street Journal reports. We continue to accept postcards and telegrams. Have a smashing day.

Insurance Coverage 98

Insurance Coverage Insurance 98

The Checkup by Singlecare

APRIL 9, 2025

That means patients insured under those plans will likely have their Ozempic prescription covered by insurance for Ozempic s FDA -approved purpose: blood sugar management for Type 2 diabetes. Ultimately, some Aetna members may get insurance coverage for Ozempic ; some may not. Here are just a few: Change insurance plans.

Insurance Coverage 76

Insurance Coverage Insurance Pharmacy Program Director Labelling 76

Pharmacy Times

JUNE 6, 2024

By improving health insurance coverage and cost of inhalers, such as out-of-pocket caps, access to care can be increased. Some companies are aiming to improve access by implementing price caps.

Insurance Coverage 139

Insurance Coverage Insurance 139

Pharmacy Times

JULY 19, 2024

More cost effectiveness data is crucial in advocating for better insurance coverage in the United States.

Insurance Coverage 123

Insurance Coverage Insurance 123

Fierce Healthcare

OCTOBER 26, 2023

Insurance coverage often fails to help Americans avoid medical debt, a new survey from the Commonwealth Fund revealed. Even with health insurance, people are feeling the effects of high medical costs, often cutting back on necessities or delaying care. A new survey shows half of Americans struggle to avoid their healthcare.

Insurance Coverage 137

Insurance Coverage Insurance 137

Fierce Healthcare

JUNE 7, 2023

Measurable differences in patient safety across race, ethnicities and insurance coverage persist even among hospitals rated at the top of their class, according to a new analysis of Leapfrog Hospit | New findings from a Leapfrog Group and Urban Institute analysis suggest that patient safety disparities are not driven by individual hospitals, but are (..)

Insurance Coverage 58

Insurance Coverage Insurance Hospitals 58

Fierce Healthcare

JUNE 12, 2024

trillion, according to newly published calculat | Record-high insurance coverage rates from pandemic policies alongside other trends like high utilization pushed health spending past the nominal GDP growth rate in 2023, according to new projections from government actuaries. with projected expenditures of $4.8

Insurance Coverage 126

Insurance Coverage Insurance 126

PharmExec

OCTOBER 2, 2023

Kirsch discusses the complexity of the drugs and the verification process, along with EVERSANA’s new platform, ACTICS eAccess.

Insurance Coverage 115

Insurance Coverage Insurance 115

STAT

FEBRUARY 15, 2023

has access to its Covid-19 shot, regardless of whether they have health insurance coverage. For those lacking sufficient insurance, the company will tap a patient assistance program. The vaccine maker released a brief statement that it “remains committed” to ensuring everyone in the U.S.

Vaccines 145

Vaccines Insurance Coverage Insurance 145

STAT

JUNE 26, 2024

Makers of RSV vaccines for older adults saw their plans to try to expand usage hit a significant hurdle on Wednesday, when an expert committee that advises the Centers for Disease Control and Prevention on vaccines recommended changes that will likely see fewer older adults qualify for insurance coverage for these products.

Vaccines 137

Vaccines Insurance Coverage Insurance Immunization 137

STAT

SEPTEMBER 17, 2024

   The 51-44 vote on the Right to IVF Act, which would bar state restrictions on the procedure and require insurance coverage, fell short of the 60 votes needed to pass, just as it did in June — and as Democrats expected it would.

Insurance Coverage 124

Insurance Coverage Insurance 124

STAT

MARCH 14, 2024

Damian here with a reminder that my colleague Ed Silverman is hosting a discussion today about the long-awaited arrival of Humira biosimilars and all they portend for drug costs, insurance coverage, and pharma revenues.    Sign up to tune in here. Read the rest…

Insurance Coverage 121

Insurance Coverage Insurance 121

STAT

NOVEMBER 28, 2023

Continue to STAT+ to read the full story…

Insurance Coverage 142

Insurance Coverage Insurance 142

Fierce Healthcare

MARCH 7, 2024

Healthcare policy wins and promises of further action on prescription drug prices, insurance coverage and reproductive care access are primed for the spotlight when President Joe Biden takes the ro | Speech previews from the White House celebrate and call for expansions to the Inflation Reduction Act.

Insurance Coverage 110

Insurance Coverage Insurance 110

STAT

MARCH 14, 2024

What has that meant for insurance coverage and the way drugmakers are marketing these medicines? Several biosimilar versions of Humira, which for years has been the world’s best-selling medicine, entered the U.S. market over the past year. Join leading experts to discuss the impact on the industry and patients.

Insurance Coverage 112

Insurance Coverage Insurance 112

STAT

APRIL 1, 2024

Over the past year, nine biosimilar versions of the medicine were launched by other companies seeking favorable placement on formularies, the lists of drugs for which health insurance coverage is available.

Insurance Coverage 141

Insurance Coverage Insurance 141

STAT

OCTOBER 6, 2022

Some experts and employers have been concerned that the drug pricing policy reforms that will save money in Medicare could incentivize drugmakers to try to charge more to patients with other forms of insurance coverage.    Continue to STAT+ to read the full story…

Insurance 112

Insurance Insurance Coverage 112

STAT

SEPTEMBER 17, 2024

We’ve been here before: Schumer called a vote in June on the legislation, which would bar state restrictions on the fertility procedure and require insurance coverage. That failed the 60-vote threshold to pass, with Sens. Lisa Murkowksi (R-Alaska) and Susan Collins (R-Maine) the only GOP members who supported the bill.

Insurance Coverage 107

Insurance Coverage Insurance 107

STAT

DECEMBER 28, 2022

The Food and Drug Administration is on track to top its previous records, offering expedited regulatory consideration — and if medical device companies have their way, a streamlined path to insurance coverage — to dozens of novel tools. Continue to STAT+ to read the full story…

Insurance Coverage 98

Insurance Coverage Insurance 98

Fierce Healthcare

JANUARY 29, 2025

Using personalized data and predictive algorithms, the platform generates a custom care plan, which can be analyzed against personal financial data, insurance coverage and healthcare trends to preserve family savings throughout the care journey.

Insurance Coverage 82

Insurance Coverage Insurance 82

STAT

OCTOBER 30, 2024

Novo Nordisk, the maker of Wegovy, may have funded the latest trial to see if knee osteoarthritis might be added to that growing list of non-obesity indications — and help the drug get broader insurance coverage. Continue to STAT+ to read the full story…

Insurance Coverage 104

Insurance Coverage Insurance FDA 104

Pharmacy Times

FEBRUARY 26, 2025

Intravenous immunoglobulin therapy for patients with CIDP requires navigating insurance coverage and prolonged therapy.

Insurance Coverage 73

Insurance Coverage Insurance 73

STAT

FEBRUARY 6, 2023

sales of Leqembi, its treatment for Alzheimer’s disease, although exact numbers were not provided and people taking the drug appear to be paying out of pocket because insurance coverage has not yet been established. Japanese drugmaker Eisai reported Monday the first U.S. The first U.S. sales of Leqembi were recorded on Jan.

Insurance Coverage 98

Insurance Coverage Insurance 98

Fierce Healthcare

APRIL 30, 2025

A significant upside to the acquisition is the new-found ability for BetterHelp customers to use insurance coverage for mental health services, a barrier that has kept some customers from signing up with the cash-pay mental health provider.

Insurance Coverage 69

Insurance Coverage Insurance 69

STAT

JUNE 1, 2023

Having insurance coverage alone doesn’t guarantee that people can afford or would be willing to pay continuously for chronic disease medications like Ozempic, a new, large-scale study finds.

Insurance 98

Insurance Insurance Coverage 98

Fierce Pharma

SEPTEMBER 24, 2024

drug prices, the role of insurers and pharmacy benefit managers (PBMs) often commands at least some of the attention. | At the Senate committee hearing on Novo Nordisk's prices for Ozempic and Wegovy, debate around insurance coverage and pharmacy benefit managers took up much of the conversation.

Insurance 80

Insurance Insurance Coverage 80

Fierce Healthcare

MAY 13, 2024

While more states have moved towards payment parity for telehealth, remote monitoring lacks coverage requirements in half of states. Popular digital health law firm Foley & Lardner releas | Law firm Foley & Lardner released a new 50-state survey that compares telehealth laws from 2019 to 2024.

Insurance Coverage 63

Insurance Coverage Insurance 63

STAT

JANUARY 31, 2023

The maneuver reflects the behind-the-scenes negotiations that occur between pharmaceutical companies and the pharmacy benefit managers, or PBMs, that create formularies, or lists of medicines for which insurance coverage is provided. Continue to STAT+ to read the full story…

Insurance 98

Insurance Insurance Coverage Pharmaceutical Companies Pharmaceutical Companies 98

The Checkup by Singlecare

MARCH 10, 2025

says that 90% of people with commercial insurance or Medicare Part D have preferred coverage with the lowest copay or coinsurance. However, insurance coverage doesnt necessarily mean Creon will be free. The out-of-pocket cost depends on the insurance planspecifically which drug tier they place it in.

Insurance Coverage 52

Insurance Coverage Insurance 52

STAT

JULY 6, 2023

At some point this summer, the drugmaker Novo Nordisk will release results from a closely watched study that, if successful, could further uncork demand for new obesity medications, streamline insurance coverage for the therapies, and demonstrate long-lasting health benefits.

Insurance Coverage 98

Insurance Coverage Insurance 98