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Episode 13 - Healthcare Reform's Impact on Immunotherapy (Part 2)
As the panelists continue discussing how healthcare reform will affect cancer therapy, the experts believe that although cost of therapy is a concern when treating patients, it does not form the entire equation that should be used when considering a treatment plan. Cost is an additional factor that should be assessed when determining value.
Daniel J. George, MD, explains that when determining the value of a treatment option, such as immunotherapy, medical professionals need to use an equation of quality over cost.
Unfortunately, Dr George fears that practitioners may feel that utilizing more expensive therapies due to improved outlooks on quality for their patients may cause practitioners to feel as though they are being penalized. Under this new model, it is important that medical professionals understand that the lowest cost should not be a deciding factor when considering immunotherapy treatment.
Oncologists will need to become comfortable with this new model, explains Michael Kolodziej, MD. In addition to reviewing data, oncologists will need to practice transparency, fairness, shared decision making, and consumerism, which are all factors that will affect the results of the new healthcare system.
New Research Challenges Assumptions About Hospital-Physician Integration, Medicare Patient Mix
April 22nd 2025On this episode of Managed Care Cast, Brady Post, PhD, lead author of a study published in the April 2025 issue of The American Journal of Managed Care®, challenges the claim that hospital-employed physicians serve a more complex patient mix.
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Specialty Drug Users to Gain Relief Under Medicare Reforms
May 16th 2025A new analysis looked at estimated out-of-pocket costs for etanercept, ustekinumab, and ibrutinib, specialty drugs that often represent a significant cost burden for Medicare Part D beneficiaries and which were selected for 2026 drug price negotiation under the Inflation Reduction Act.
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Varied Access: The Pharmacogenetic Testing Coverage Divide
February 18th 2025On this episode of Managed Care Cast, we speak with the author of a study published in the February 2025 issue of The American Journal of Managed Care® to uncover significant differences in coverage decisions for pharmacogenetic tests across major US health insurers.
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Navigation and Clinician Payment Investments Enhance Colorectal Cancer Screening Benefits
May 15th 2025Investing in patient navigation and clinician incentives ensures colorectal cancer screening completion, improves early detection, reduces disparities, achieves cost savings, and advances population health for all stakeholders.
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