- Center on Health Equity & Access
- Clinical
- Health Care Cost
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- Insurance
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- Value-Based Care
Episode 9 - The Payer Approach to Immunotherapy
In this segment, the panelists explain how coverage policies vary by payer, and explore the factors that affect the costs associated with different immunotherapy agents.
Michael Kolodziej, MD, discusses how Aetna reviews evidence and takes several factors into account when making payer decisions about supporting cancer research, and explains that different organizations have different processes. Jeffrey Weber, MD, PhD, continues the conversation with an explanation of how different immunotherapy agents have different dosage and administration requirements, which affect overall costs.
Addressing cost differentials and coverage policy inconsistencies is important because what is covered by payers directly impacts the types of treatments that are recommended to patients. As concluded by Daniel J. George, MD, providers want to be able to recommend a clinical trial or other treatment modality in situations where standard therapy is not likely to be effective for the patient.
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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NCCN Data Find Racial, Socioeconomic Disparities in Quality of Care for Metastatic Pancreatic Cancer
April 9th 2025New data from the National Comprehensive Cancer Network (NCCN) reveal that socially vulnerable and minority patients with metastatic pancreatic cancer are less likely to receive recommended treatments and achieve longer survival.
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