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This is Jacob Emerson with Becker payer issues

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podcast.

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Here's your bi weekly industry news briefing for

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May 20 second.

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Well, a new study from the Blue Cross

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Blue Shield

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Association published May 20 first is found that

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a majority of patient taking weight loss drugs,

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discontinue use of their medication before reaching a

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clinically meaningful health benefit it. That study was

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conducted by the data arm of the association,

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Blue Health Intelligence,

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and it's based on national pharmacy and medical

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claims data from nearly a hundred and 70000

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commercial insurance members, the largest study of its

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kind to date. Members included in that study

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were prescribed Go or Sa between July 20

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14 and December 20 23,

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and they had at least 6 months of

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continuous enrollment before and after they began taking

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Gl ones. High Patients taking those drugs should

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complete at least 12 weeks of continuous treatment

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and to achieve weight loss that will positively

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impact their health.

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Bc sa, Vp of clinical affairs said that

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when patients take medication, they wanted to be

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safe and effective. The study shows, most people

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are unlike to see lasting benefits and that

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unfortunately, weight loss isn't as simple as filling

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a prescription.

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Now, in that study, it really found that

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58 percent of patients discontinued Gl 1 use

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before reaching a clinically meaningful health benefit.

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30 percent of patients

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continued use of weight loss drugs within the

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first month of treatment.

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A majority of Gl 1 prescriptions came from

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a primary care provider,

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patients who received a prescription from an endo

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or obesity medicine specialist or more likely to

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stick with treatment.

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Patients who saw their physician more often, regardless

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of specialty. We're more likely to continue with

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treatment.

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Patients ages 18 to 34 were more likely

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to drop out of treatment. Sooner.

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Gender had no effect on dropout rates in

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the first 12 weeks and patients with coexist

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conditions such as peripheral vascular disease or diabetes,

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Particularly those with 3 or more similar conditions

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were more likely to continue traits

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Well, 2 states have recently signed prior

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authorization reform bills into law In Oklahoma, a

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bill signed, will require prior authorization procedures to

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be published on websites available to patients and

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provider.

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This bill goes into a effect on January

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first.

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Those with chronic conditions must be notified no

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less than 60 days prior to changes that

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will affect them. If a prior authorization is

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denied, appeals must be reviewed by providers of

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the same or similar specialties.

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Payers must respond to urgent requests within 72

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hours and within 7 days for non urgent

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request.

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And in Vermont, the governor Phil Scott has

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signed a bill to reform the prior authorization

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process in the state. That legislation aligns prior

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auth with Medicaid and claim edits With Medicare.

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It also allows patients and providers to ask

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for exemptions to step therapy, and requires payers

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to decide prior authorization hospitalizations within 24 hours

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for urgent situations and 2 business days for

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non urgent care. It also directs the state's

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Department of Financial Regulation to prohibit prior author

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requirements for certain medications and services

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and require insurers to collect cost sharing amounts

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from patients.

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Bc of Vermont had raised concerns that the

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legislation would cause insurance rates to rise between

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5 and 7 percent. The governor said that

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to alleviate to pay concerns, he is directing

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the State's Department of Financial Regulation, and the

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agency of human services to jointly study the

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effects of the bill on health outcomes, costs,

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and insurance rates They are to report back

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to him on the findings.

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That study will also include a cost impact

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analysis of prior authorization laws in other states.

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To evaluate whether they have been successful in

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improving outcomes or reducing health care costs by

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reducing burdens for providers

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The governor's also requesting that the Green Mountain

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care board uses its authority to identify cost

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savings associated with reduced administrative burdens and to

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which ensure those savings pass all the way

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through to state residents in the form of

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lower costs,

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that legislation goes into effect in January 20

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25.

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Well Opt rx has unveiled a new pricing

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trend on May twentieth, following an industry wide

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trend of increasing transparency on medication costs.

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The pharmacy benefits pricing offering called Opt

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clear trend guarantee

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combines guarantees into a single per member cost

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and will offer drug benefit plan sponsors greater

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predictability of pharmacy spend. It's to help manage

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total lowest net cost. The company said the

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new pricing model, which will be available in

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January 20 25.

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Builds upon its cost made clear payment solutions

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that feature cost plus pricing with lower ingredient

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cost. Clear trident and guarantee is an alternative

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that combines resale, home delivery,

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specialty drug and rebate components into 1 per

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member value based model.

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Opt, the third largest Pb with its handling

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of 22 percent of Us

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prescription claims in 20 23

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is jumping into a popular trend.

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Following the increasing disruption status of Mark Cuban

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cost plus drugs pricing model. The nation's largest

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Pb are now offering similar services,

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as consumers demand more transparency and federal investigators

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probe the industry.

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And finally, employer adoption of Ic is up

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29 percent since 20 23. That's according to

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a may report from the Hr council.

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Or individual coverage health reimbursement arrangements

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allowing employers to offer a defined tax advantage

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contribution used to reimburse premiums

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for an individual health plan purchase by employee

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on their state's Aca exchange.

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Now

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Adoption grew 29 percent year over year between

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20 23 and 24.

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Ic 84 percent among employers with 50 or

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more employer employees.

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Among employers surveyed, 83 percent were not able

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to offer health benefits until they offered an

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ic or qualifying small employer Hr. 17 percent

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of employers switched from traditional group coverage.

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The number of employees offered to defined contribution

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health benefits now exceeds 200000 people, and that

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figure does not include dependence. So some estimates

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have said that more than 500000

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people may Nationwide

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enrolled. 25 percent of employees choose silver plans,

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34 percent choose bronze and 35 percent choose

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gold,

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The top metro areas for Ic adoption in

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ranking order are New York City, Atlanta, Los

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Angeles,

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the San Francisco Bay Area and the twin

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cities in Minute. Soda. If you like the

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latest health insurance industry news delivered straight to

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your inbox every morning, subscribe to the Becker

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payer issues e newsletter on our website at

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becker payer dot com. So