Congress Exempted the Medically Frail. The Coding System Cannot Find Them.
Fewer than 500 of 10,000 rare diseases have an ICD-10 code. The Medicaid frailty exemption is verified against codes most patients never had.
Access Read
Revtorpyk Got Its NCCN Category 1 Listing Two Months Before Celcuity Can Sell a Single Vial
The reimbursement case is being built before the product exists. Two gates remain, and a guideline solves neither.
NICE Backed Aficamten the Same Day the MHRA Authorised It, at a Price It Will Not Disclose
Concurrent MHRA and NICE decisions collapse the usual access gap to zero. Then read the conditions, because that is where the guidance lives.
The Biosimilar Was Too Cheap to Sell. So the Price Went Up Fourfold.
Byooviz relaunched in the US at an average sales price of $1,190, roughly four times its previous level and above the originator it references.
Washington Removed the Cushion Under Part D, and Handed the Auditors an Algorithm
Washington ended the subsidy holding Part D premiums down, charged a record number of Medicaid fraud defendants, and put prosecutors’ analytics inside CMS.
AbbVie Took Two EU Approvals in One Day, Both for Diseases Payers Have Called Cosmetic
The European Commission approved RINVOQ for non-segmental vitiligo and, the same day, for severe alopecia areata, both in adults and adolescents aged 12 and over.
The Alzheimer’s Blood Test Just Moved Into the GP’s Office, Which Is the Whole Point
GPs in North West London are running C2N’s Alzheimer’s blood test before referral, testing whether accurate amyloid detection works in primary care.
Brazil Approved Five Semaglutides in a Day. Sandoz Announced One of Them.
ANVISA approved five semaglutide products in a single day, including the one Sandoz will sell. Ozempic’s Brazilian patent expired in March.
NICE Said Yes to the Lung Machine, and Then Attached Four Years of Conditions
NICE conditionally recommended the XVIVO perfusion system for NHS use, with four years of evidence generation and a hub model to end the postcode divide.
Abbott Is Not Testing Whether TriClip Works. It Is Building the File That Gets It Paid.
Abbott began a 1,000-patient, five-year post-market study of TriClip across 100 sites, generating the durability evidence payers and guidelines require.