- Center on Health Equity & Access
- Clinical
- Health Care Cost
- Health Care Delivery
- Insurance
- Policy
- Technology
- Value-Based Care
Parity Laws and the Need for Payment Reform
During this segment, Scott Gottlieb, MD; Brian Kiss, MD; Michael Kolodziej, MD; and Ted Okon, MBA, continue the discussion regarding issues that affect new oncology care models, including drug wastage, patient compliance, and treatment costs.
As more oncology drugs are being dispensed via practice-based pharmacies, intervention is needed to reduce waste, Dr Kolodziej comments. Also, compliance remains an issue even with the advent of practice-based pharmacies.
Although some states have passed parity laws, meaning that patient out-of-pocket (OOP) costs for oral medications should not be greater than OOP costs for intravenous medications, high OOP costs remain a barrier to patient access to treatment.
Dr Kiss discusses the buy-and-bill model’s impact on oncology and suggests that payment reform is necessary. Oncologists should be compensated for providing cognitive and technical services, he believes, rather than for dispensing chemotherapy drugs.
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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STEER Data Open Door to SMA Gene Therapy for Wider Age Range of Children
March 19th 2025Delivery of onasemnogene abeparvovec into the intrathecal space was safe and effective for children with spinal muscular atrophy (SMA) aged 2 to 17 years, who had previously been shut out of receiving gene therapy.
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