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Did you know : that healthcare fraud estimates in the United States exceed $68 billion annually? Did you know : the Federal Government won or negotiated over $2.5 billion in health care fraud judgments and settlements worth a total of over $1.9 billion in FY 2015? Did you know : that when differentiating fraud from waste and abuse, the […]

Myasthenia Gravis is a neuromuscular disorder that impacts over 50 thousand patients in the United States (U.S.). Of those patients that are diagnosed, approximately 95 percent are treated with immunosuppressants, intravenous immunoglobulin, and/or plasma exchange. The total number of treated patients is expected to grow at an annual rate of 1.7 percent.  Of those patients […]

Are you weighing the decision to enforce an NDC mandate on ALL Medical Pharmacy Claims? RJ Health’s Analytics team shares the pro’s & con’s of NDC mandates across Pricing, Formulary, and Network Quality Considerations. Here are some practical examples to help illustrate how, at the end-of-the-day, RJ Health believes the answer to the NDC vs. […]

On September 14, 2017, the Food and Drug Administration approved the first biosimilar for Genentech’s Avastin® (bevacizumab), which is the first oncological biosimilar product on the U.S. market. Avastin is approved for eight oncological indications, two of which have an orphan drug exclusivity through 2021. The approval of Amgen’s Mvasi™ (bevacizumab-awwb) includes 6 indications (Table […]

On August 3, 2017 the Food and Drug Administration approved a liposome-encapsulated combination of daunorubicin and cytarabine (VYXEOS™, Jazz Pharmaceuticals, Inc.) for the treatment of adults with newly-diagnosed therapy-related acute myeloid leukemia (t-AML) or AML with myelodysplasia-related changes (AML-MRC), which are two types of AML having a poor prognosis. VYXEOS is the first agent that […]

In an effort to contain growing healthcare costs, Congress enacted the Omnibus Budget Reconciliation Act of 1990 (OBRA’90) and created the Medicaid Drug Rebate Program. Pharmaceutical manufacturers’ participation in the program became a prerequisite for Medicaid coverage of outpatient prescription drugs. Since then, states have been required to collect associated drug rebates to receive federal […]

Biosimilars are intricate in their makeup and the process for FDA approval is even more multidimensional.  Todd Cooperman’s (PharmD, MBA, R.Ph.) recent whitepaper provides insight into biosimilars in the U.S. healthcare marketplace.  Below is a caption from the introduction of the whitepaper. Initial Food and Drug Administration (FDA) guidance on the biosimilar pathway was intentionally vague, […]

A running theme at the Asembia 2017 Specialty Pharmacy Summit was the explosive growth in attendance from several hundred a few years ago to greater than 6,000 in attendance in 2017.  Pharmaceutical and Biological (Pharma/Bio) manufacturers were the dominant presence at Asembia, which is no surprise given their pricing power in the specialty drug market, […]

RJ Health Systems will be exhibiting at several healthcare trade shows Spring 2017. We will be attending the following tradeshows: 14th Annual World Health Care Congress Convenes decision makers from all sectors of health care to catalyze meaningful partnerships and change. In 2017, faculty focus on policy and market forces impacting the health care business environment […]