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Epsiode 11 - The Impact of Combination Therapies on Resource Allocations
Because combination therapy options are typically used to treat cancer, managed care professionals explore the high costs of newer treatment options for the treatment of cancer and raise questions about how the costs of drugs are determined. The discussion leads into a debate about whether high costs of combination therapies will underestimate their benefits and deter patients from receiving such necessary therapy.
Daniel J. George, MD, explains that different combination regimens have different dosage requirements. Combinations with ipilimumab require a different dosage regimen than immunotherapy, which impacts decisions on how to allocate financial resources.
Dr George continues by explaining that when looking at the cost-benefit ratio for a combination therapy, the cost should be determined based on the life span of the patient and should include all subsequent therapies.
Jeffrey Weber, MD, PhD, questions whether combination therapies currently in developmental stages, such as PD1 and Ipi, will be affordable to patients due to their high costs.
Because there is no clear answer to whether or not a patient will be able to afford a therapy option, Michael Kolodziej, MD, concludes that oncologists will need to base treatment decisions on the overall value of a treatment’s benefits. If a patient will be treated with a combination therapy, the treatment should be used in a setting where the patient has the potential for long-term survival.
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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