Payers

There are several pieces of legislation that could have an impact on drug rebates, explained Tracy Russell, senior director, government affairs, CoverMyMeds.

The approval of aducanumab (Aduhelm) was very controversial. There are 3 promising Alzheimer disease drugs in the pipeline with trials evaluating the efficacy, and there is a huge unmet need for these therapies, said Ray Tancredi, RPh, MBA, CSP, divisional vice president, specialty pharmacy development and brand Rx/vaccine purchasing, Walgreens.

Not only did a majority of each group say they hadn’t heard of biosimilars, but those who had heard of them had negative perceptions.

Patricia Deverka, MD, MS, senior researcher, deputy director at the Center for Translational and Policy Research and Precision Medicine, University of California San Francisco, explains what multicancer early detection tests currently exist and the research needed to understand their clinical utility.

The opening plenary of the Spring 2022 National Association of Accountable Care Organizations conference focused on addressing health equity and improving synergy between CMS and ACOs.

To achieve health equity, experts from CVS Health discuss why we must invest in programs that improve access to health care for historically marginalized communities, address social determinants, boost health education, increase representation in all levels of health care delivery, widen access to clinical trial research, and more.

Nathan H. Walcker, MBA, chief executive officer, Florida Cancer Specialists & Research Institute (FCSRI), discusses what guests can expect at the in-person Tampa meeting of The American Journal of Managed Care®'s Institute for Value-Based Medicine® (IVBM), co-hosted by FCSRI.

Increased uptake of biosimilars on par with the utilization rates of filgrastim biosimilars could have saved Medicare Part D $84 million in 2019.

Elaine Siegfried, MD, professor of pediatrics and dermatology, Saint Louis University Health Sciences Center, discusses several pediatric patient populations with atopic dermatitis who are candidates for the use of systemic therapies.

Key opinion leaders addressed cost, accessibility, and other barriers limiting use of comprehensive genomic profiling (CGP), and how employers can help drive preventive care and precision medicine through CGP.

Joseph Alvarnas, MD, vice president of government affairs at City of Hope and chief clinical adviser of AccessHope in Duarte, California, spoke March 4 at the closing session of the Association for Community Cancer Centers (ACCC) Annual Meeting & Cancer Business Summit in Washington, DC.

Predictive models can help find high-risk patients with asthma and manage them proactively, but prior models miss the highest-risk patients and may mislabel low-risk patients.

Alymsys from Amneal Pharmaceuticals and mAbxience is the third biosimilar referencing Avastin approved in the United States and the second of 3 biosimilar approvals Amneal expects in 2022.

Delayed diagnosis of wild-type transthyretin amyloid cardiomyopathy (ATTR-CM) results in inappropriate treatments prior to diagnosis and worse clinical outcomes after diagnosis.

News on 2 new CAR T-cell therapies and updates on PARP inhibitors, BTK inhibitors, and biosimilars.

Coverage from the Community Oncology Alliance 2022 Community Oncology Conference, held March 17-18 in Kissimmee, Florida.

Across OneOncology, says Edward Arrowsmith MD, MPH, clinical pathways offer a vehicle for physicians to agree on best practices and to implement them across the network. Early this year, Arrowsmith became medical director for Clinical Pathways, OneOncology.

In Medicaid, delivering care needs to address the lack of resources and other socioeconomic factors that impact patients, said Steve Evans, MD, chief medical officer of SilverSummit at Centene.

More than a quarter of patients experience disruptions and delays in treatment for chronic heart failure (CHF) after the initial prescription for sacubitril/valsartan was abandoned/rejected.

Review of CMS’ coverage with evidence development program exposes a need to improve program transparency and clarify requirements and timetables for reporting to improve access to novel therapies.

Without addressing rising costs, the problem of underinsurance in health care coverage will remain, said panelists at the 2022 V-BID Summit, discussing some of the smaller steps that are being proposed or are already in place to try to ease the financial burden.

Despite their intention to protect against coverage denial and/or premium increases, additional state-level Medigap regulations are correlated with lower Medigap enrollment and stronger moral hazard.

Patients who cardiologists see once every few months are getting handed over to pharmacists who can monitor them more frequently and get them to their goals, said Crystal Zhou, PharmD, assistant professor of Clinical Pharmacy at the University of California, San Francisco (UCSF).

Many of the accountable care organization (ACO) models are being tested to find changes to make to the Medicare Shared Savings Program, but there is a general problem with short-lived models ending and being replaced by new ones, said Michael Chernew, PhD.

With more people living with HIV now reaching advanced ages and qualifying for Medicare coverage, this new study investigated HIV-related influences on their health care spending, particularly antiretroviral therapy (ART), compared with a population who does not have HIV.

Many oncologists oppose white bagging because they prefer to be able to adjust doses during a visit based on lab reports taken that day.

Implementing changes in a health system to promote biosimilar adoption is not easy, but by implementing a program, there could be substantial savings.

The clinical effectiveness of chimeric antigen receptor (CAR) T-cell therapies adds a new weapon in the arsenal to treat patients with relapsed and refractory disease; however, they come with access, logistical, and reimbursement challenges that make it difficult to treat all the patients who could benefit.

Value-based contracts are growing as drugs get more expensive and effective, but it’s still an emerging area with a lot of unknown and uncertainty.