January 29, 2023
Chicago 12, Melborne City, USA

Major Insurer Restricts Coverage Of Aduhelm


United Healthcare says the drug is “unproven and not medically necessary.” In other news from the healthcare industry, large nonprofit healthcare systems are recording losses from their investments that are offsetting significant operating losses.

STATISTICS: United Healthcare limits coverage of Aduhelm following Medicare

United Healthcare is limiting Aduhelm’s insurance coverage across all of its health plans, saying the drug is “unproven and not clinically necessary for the treatment of Alzheimer’s disease due to insufficient evidence of efficacy,” according to the company’s new policy. Physicians planning to give adduhelm to United Healthcare patients must obtain prior approval from the insurance company, effective June 1. Patients must also be in an approved clinical trial. (Herman, 5/2)

Modern Healthcare: To limit access to United Healthcare Aduhelum

United Healthcare will limit coverage of Biogen’s Aduhelm, the country’s largest health insurance company, on Sunday. The subsidiary of United Health Group will only cover the treatment of expensive Alzheimer’s disease known as adukanumab for patients enrolled in clinical trials and will require prior approval. The drug is “not clinically necessary for the treatment of Alzheimer’s disease due to unproven and insufficient evidence of efficacy,” the insurer wrote in bulletins. The rules apply to the insurer’s commercial, personal and Medicare members and will be effective June 1. (Tapper, 5/2)


Wall Street Journal: Cerebral’s preferred pharmacy Trupil discontinues adrenal prescription for all customers

Online pharmacy company Trupil Inc. It said it was temporarily discontinuing prescriptions for adrenaline and other controlled substances used to treat attention deficit hyperactivity disorder, and partner Cerebral Inc. had asked its physicians to direct patients to local pharmacies. Cerebral, a San Francisco-based online mental-health organization that describes Trupil as its preferred pharmacy, informed its doctors of Trupil’s decision in a Friday email seen by the Wall Street Journal. The email states that Trouble and Mailing will not support Schedule 2 controlled substances, including Adral and Vivans, “to any of their customers.” (Winkler, 5/2)

Modern healthcare: Stanford health nurses approve contracts, end week-long strike

Stanford Healthcare and Stanford Children’s Health nurses have agreed to a three-year contract following the strike, which began a week ago, the union said Monday. The nurses will return to work on Tuesday. The members of the committee, or CRONA, for the recognition of the Nursing Achievement, voted 83% in favor of the agreement on Sunday, the union said. The union represents the 5,000 nurses employed by Southern California Hospitals. The union announced a temporary agreement on Saturday. (Christ, 5/2)

Industry Finances –

Modern Healthcare: Nonprofit Hospital Investment Covers Covers Operating Losses

Large nonprofit healthcare systems are recording investment loss losses that are offsetting significant operating losses. The St. Louis-based Ascension recorded an operating loss of $ 640.1 million over $ 19 billion in revenue in the first nine months of its 2022 fiscal year, according to a 142-hospital system revenue statement released Friday. About $ 900 million in non-operating income, $ 736.4 million of which was responsible for return on investment, is more than offsetting the losses. It was down from about $ 4.5 billion in operating profit in the same period last year. (Kachik, 5/2)

AP: WVU is getting M 11M for research on visual impairment

The University of West Virginia is receiving $ 11 million in federal dollars for research into the treatment and progression of chronic eye disease. West Virginia has the second highest rate of visual impairment in the United States, according to a university news release. A visual disability is a disability that cannot be treated with corrective glasses. “The idea is to think collectively,” said Bishwanathan Ramamurthy, chair of biochemistry at West Virginia University. “How can we change? How can we translate our basic science results into clinical practice that helps people?” (5/3)

Bloomberg: Astrag agrees to IC 2.6 billion acquisition of ICIG’s CordenPharmer

Astorg Partners Agreement will be acquired by drug development and manufacturing company CordenPharma, one of the largest private equity deals of the year in European healthcare. The French private equity firm is buying the business from an international chemical investor group, according to a statement Monday, confirming an earlier Bloomberg News report. Under the terms of the agreement, the founders of CordenPharma will reinvest as partners with Asturg. (Forster, Henning & Nair, 5/2)

Modern Healthcare: Optam’s $ 236 Million Atria Health Deal Score Final Regulatory Approval

The Massachusetts Supreme Court has approved the proposed acquisition of িয় 236 million Atrius Health, a subsidiary of United Health Group, one of the largest nonprofit medical groups in the state. Massachusetts Supreme Judicial Court Judge Dalila Arges Wendland ruled that the proposed transaction was in the public interest and was disobedient to Atrius, who continued to operate as a nonprofit. Atrius Health has struggled financially. The state’s attorney general approved the decision in late April, and with Friday’s judicial review, the companies have completed all the legal steps necessary to move the deal forward. (Tapper, 5/2)

This is part of the KHN Morning Briefing, a summary of the health policy coverage of major news organizations. Sign up for an email subscription.


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