Description: The big event of 2023 is the launch of multiple Humira biosimilars, which began in January with the arrival of Amgen’s Amjevita on the market. The launch of Amjevita kicks off the process of changing the specialty drug marketplace in the United States. The expectation of the full impact of this big event is very hopeful, but there is still uncertainty several months after its beginning. Humira is the highest-selling drug in the world and has been since 2013 (Figure 1)—except for when COVID-19 projects temporarily surpassed it. The world is eagerly awaiting the launch of multiple biosimilar drugs to compete with Humira and hopefully bring more competitive pricing to the benefit of payers and patients everywhere.

Description: Explore the value and cost of prescription drugs, how they should be defined and measured and the effects various stakeholders in the pharmacy ecosystem can have on these factors in the latest webcast. You'll investigate the impact of coverage, formulary and rebate negotiations and related benefit design. Find out how actuaries can answer questions related to the prescription drug industry, in addition to improving the access, quality and affordability of prescription drugs in the United States. Join us for this webcast and come learn about value-based contract design, negotiations, implementation and administration for prescription drugs.

Description: While we are eight miles from Capitol Hill and a week away from the 2024 presidential election, actuaries and health policy experts will discuss the campaign platforms of the major parties and presidential candidates and the potential health policy implications in the next four years. Focus will be on the changing dynamics within ACA marketplaces with the knowledge benefit of both major party candidates having presidential administrative experience in the ACA environment. Session attendees will be well-equipped to discuss the post-ACA health policy implementation of Presidents Biden and Trump, recent policy proposals from both sides of the political aisle, and potential legislative/regulatory changes on the horizon.

Description: Join our exciting panel of health actuaries, ready for any challenge! Got an ACA puzzle? We've got the answers! Tackling a valuation dilemma? We're here to crack it! Facing a professionalism quandary? We'll navigate the complexities! Dealing with regulatory worries? We're your guiding light! Every question is welcome - there's no such thing as a silly question! Learning Outcomes: - Attendees will have the opportunity to get answers to their questions.

Description: The Inflation Reduction Act (IRA) introduced major changes to the Part D program. This session will unpack the impact of IRA's benefit redesign in 2025 premiums, costs, and beneficiary choices, and the implication of drug price negotiation in 2026. We will discuss how Part D plans are adapting to these changes, lessons learned from the 2025 bids, and what we can expect in 2026 after the price negotiation of the top ten Part D drugs.

Description: The U.S. health care system continues to have its problems. It costs too much and even with public policy developments we are not meeting the desired objectives. What's next? What else can we do? Discuss some of the emerging ideas that are being pursued and the likelihood of their success at solving our collective problem.

Description: The SOA is seeking researchers to explore considerations within the LGBTQ+ community impacting employer-based health benefit designs. Review details on the background, research objectives, proposal requirements, selection process, submission guidelines, and project conditions.

Description: While states face a wide variety of circumstances and have implemented diverse approaches to the MOE phase-out, we revisit the conversation to discuss emerging experience across stakeholders as we examine the operationalization of the PHE unwinding as it relates to this major disruptor in the distribution of the healthcare enrollment.

Description: Understand the role of food based interventions in health care. Learn the difference between produce prescription and medically tailored meals. Review new policies that will affect Medicare and Medicaid populations. Evaluate the possibility of health cost savings due to these interventions.

Description: This article is an update on the No Surprises Act, which is a U.S. Act aimed to reduce the risk that a person unexpectedly receives out of network charges for their health care visits. This is Part 2; Part 1 was featured in Health Watch's Sept 2024 issue.