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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.
Balancing Cost and Quality in Oncology: A Value-Based Care Perspective
January 30th 2025Travis Brewer, vice president of payer and public health strategy/relations at Texas Oncology, shared that value-based oncology care can achieve both cost efficiency and high-quality outcomes through integrated multidisciplinary teams, flexible payment models, and targeted treatment approaches.
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Unlocking Access: Exploring Mental Health Care Among Medicaid Managed Care Enrollees
January 23rd 2025On this episode of Managed Care Cast, we speak with the author of a study published in the January 2025 issue of The American Journal of Managed Care® to examine the association between quantitative network adequacy standards and mental health care access among adult Medicaid enrollees.
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