- Center on Health Equity & Access
- Clinical
- Health Care Cost
- Health Care Delivery
- Insurance
- Policy
- Technology
- Value-Based Care
Challenges in the Management of Oral Oncolytics
During this segment, Bruce Feinberg; DO; Scott Gottlieb, MD; Brian Kiss, MD; and Michael Kolodziej, MD, highlight the issues that payers are encountering with the increased utilization of oral oncolytics and discuss how these issues are being addressed.
Dr Feinberg remarks that oral oncolytics are associated with high costs, which affects adherence, medication therapy management, and overall cost.
Payers are trying to manage these issues by splitting out “specialty pharmacy” medications and working with vendors to negotiate better prices, comments Dr Kiss. However, payment systems are becoming more complex and it is challenging to ensure that oncologists know to which types of pharmacies they should refer their patients for savings.
Professionals are recognizing an increased amount of drug wastage in the handling of these therapies, adds Dr Kiss. For example, many oral oncolytic prescriptions can be ordered via mail. Patients receive a large supply of their oral oncolytic; however, they may need to stop taking the medication due to tolerance issues.
Dr Kolodziej and Dr Gottlieb discuss the systems that pharmacy benefit managers have established in an attempt to resolve these issues.
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.
Read More
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.
Listen
How FcRn Blockade Targets Myasthenia Gravis Autoantibodies
January 29th 2025In part 2 of our interview with Katie Abouzahr, MD, Johnson & Johnson Innovative Medicine, we discuss the challenge inherent in treating adolescents who have the myasthenia gravis and how nipocalimab works via FcRn blockade to reduce the circulating autoantibodies that drive myasthenia gravis.
Read More
