Description: The coming wave of biosimilars could have a major impact on prescription drug spend in coming years. The big event of Humira biosimilar launches in 2023 will be significant in determining that ultimate impact. Payers are making coverage decisions. The more biosimilars are utilized, the greater the potential savings. How will biosimilar adoption be maximized?

Description: A brief review of the 2024 SOA Health Meeting in Baltimore

Description: The impact of Medicare on retiree medical. Issue No. 44.

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: The letter from the editor thanks all of the authors for their contributions and gives a very quick synopsis of what will be appearing in the June issue.

Description: This article summarizes what is new with the Academy health practice council. Issue No. 59

Description: Healthcare risk adjustment methodologies have become increasingly complex, largely due to the belief that complexity enhances accuracy. However, a disconnect exists between how healthcare risk is assessed and how payments are adjusted. This article explores the stark difference between measuring the accuracy of a risk assessment model at a member level, and that of a risk adjustment mechanism at the health plan level. I show that a highly simplified approach that does not use diagnosis codes can have similar accuracy on risk adjusted payments to models that do. These findings suggest that accuracy is not a barrier to developing simpler risk adjustment methodologies, which can improve payment accuracy and reduce the financial incentive for coding diagnoses.

Description: NAIC Health Update. Issue No. 44.

Description: This corner serves to update the membership of some of the section’s milestones for this year, set the trajectory for 2009, and thank the many dedicated individuals and teams who made it happen. Issue No. 59

Description: Read the August 2020 issue of Health Watch published by the Health Section. Newsletters provide practical information for the working actuary, articles on trends that impact sections and news about section activities.