- 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.
AI in Health Care: Balancing Governance, Innovation, and Trust
September 2nd 2025In this conversation with Reuben Daniel, associate vice president of artificial intelligence at UPMC Health Plan, we dive into how UPMC Health Plan builds trust with providers and members, discuss challenges of scaling AI effectively, and hear about concrete examples of AI's positive impact.
Listen
Infertility Coverage Boosts ART Use and Pregnancy Success: Richard A. Brook, MS, MBA
August 26th 2025In this episode, Richard A. Brook, MS, MBA, discusses his study showing that infertility treatment coverage increases assisted reproductive technology (ART) use and improves pregnancy outcomes.
Listen
Health Care Utilization and Cost of Diagnostic Testing for Respiratory Infections
September 17th 2025Syndromic reverse transcriptase–polymerase chain reaction tests for respiratory infections were associated with lower health care resource utilization and costs, implicating potential for improved value in patient care.
Read More
