- Center on Health Equity & Access
- Clinical
- Health Care Cost
- Health Care Delivery
- Insurance
- Policy
- Technology
- Value-Based Care
Anti-PD-1 Agents as Frontline Therapy
Richard W. Joseph, MD, notes that current treatment guidelines for melanoma recommend anti-PD-1 agents as front line therapy and discusses payer coverage for first-line use of these agents.
Although neither pembrolizumab nor nivolumab have FDA approval for the front line therapy indication, guidelines from the National Comprehensive Cancer Network recommended an anti-PD-1 agent as a preferred initial regimen, says Dr Joseph.
Unfortunately, he remarks, healthcare professionals and patients need to worry about whether front line use of these agents will be covered by payers. Currently, coverage of first-line anti-PD-1 therapy is mixed, Dr Joseph adds. While some payers cover anti-PD-1 therapy as front line treatment, others do not.
Front line use of anti-PD-1 therapy has the potential to save payers money, notes Dr Joseph, as these agents are more effective and less toxic than other options.
From MSSP ACOs to Employer Value: Translating Value-Based Principles to Self-Insured Plans
December 12th 2025Value-based care adoption in employer insurance requires replacing fragmented point solutions with unified, at-risk performance contracts that align vendors, providers, and members around total cost and quality goals.
Read More
From Complexity to Clarity: A Path to Value in Employer Health Plans
December 12th 2025Employers struggle to define value from health care spending amid complexity and misaligned incentives. Achieving measurable outcomes requires transparency, incentive realignment, and gradual, employee-centered change.
Read More
