Referencing patients as attributable examples of necessary care has assisted in developing strategies for pharmacy and medication benefits, said Jeremy Whalen, PharmD, BCOP, Specialty Clinical Program Director for Oncology at Prime Therapeutics.
Referencing patients as attributable examples of necessary care has assisted in developing strategies for pharmacy and medication benefits, said Jeremey Whalen, PharmD, BCOP, Specialty Clinical Program Director for Oncology at Prime Therapeutics.
Transcript
How has your experience as a pharmacist influenced your perspective toward developing strategies for pharmacy and medication benefits?
Practicing for almost a decade as an oncology pharmacist, when I moved over into managed care, I brought a couple of things with me. The first thing is keeping the patient first. So, having all of those stories and experiences that the patients went through, whether they were success stories or really obstacles through their care, I brought those with me so then when we develop new strategies for programs, keeping that in center and how do we help alleviate some of those burdens or really enhance the care. Then also, having the understanding of how an oncology practice really functions—what are their strengths, what are some of their gaps in care—so, then we can start to develop programs that help augment that and really elevate and provide more benefit to the patients receiving care.
Medication synchronization is key to efficient care. How have emerging programs or strategies promoted advancements in patient care and medication adherence?
One of the things I think is by understanding the complexities of an oncology patient and the care they receive. They require medication, whether that’s medical benefit or IV or oral medications—to kind of complete the regimen. So, understanding that, and then learning how we can do integration of benefits whether that’s through the UN process or really the delivery of care has really helped increase access to care and adherence to care because patients can get medication either directly through the clinic, through a retail pharmacy, through a mail-order pharmacy, or through a medically integrated pharmacy. So, helping coordinate that benefit and putting that all together really has provided a better benefit to the patients.
Exploring Racial, Ethnic Disparities in Cancer Care Prior Authorization Decisions
October 24th 2024On this episode of Managed Care Cast, we're talking with the author of a study published in the October 2024 issue of The American Journal of Managed Care® that explored prior authorization decisions in cancer care by race and ethnicity for commercially insured patients.
Listen
Examining Low-Value Cancer Care Trends Amidst the COVID-19 Pandemic
April 25th 2024On this episode of Managed Care Cast, we're talking with the authors of a study published in the April 2024 issue of The American Journal of Managed Care® about their findings on the rates of low-value cancer care services throughout the COVID-19 pandemic.
Listen
Use of AI Lets Health System Find Lung Cancer at Early Stages
March 8th 2025Artificial intelligence (AI) helps a Sarasota, Florida, health system catch lung nodules that appear on CT scans for patients treated for scores of conditions, allowing them to be referred for a possible lung cancer diagnosis.
Read More