- Center on Health Equity & Access
- Clinical
- Health Care Cost
- Health Care Delivery
- Insurance
- Policy
- Technology
- Value-Based Care
Segment 7 - The Payer's Role and Future Trends
Panelists all agree that there needs to be evidence and guidelines for both payers and providers. There are not enough resources to try every drug on every patient. Although it will be costly, there needs to be evidence on putting these drugs together as combinations.
Panelists all agree that there needs to be evidence and guidelines for both payers and providers. There are not enough resources to try every drug on every patient. Although it will be costly, there needs to be evidence on putting these drugs together as combinations. “We have the American ingenuity and the wherewithal that we’ll find better ways to do it, or other drugs that come along that are less expensive in the same category,” said Dr Crawford. “I think we really owe that to men with advance state prostate cancer to make that step and start doing it.” “I think there is a blend here of continuing to do the envelope-pushing combination strategies,” said Dr George. “With cost to the wind, let’s try to cure the disease because that’s going to be the most cost-effective manner of managing these patients in the long-run anyway.”
Dr Shore offers his rebuttal by saying he thinks that a real issue is having patients reimbursed for all of the expensive newly approved agents. He says, by law, if there is a level 2 recommendation by the National Comprehensive Cancer Network the Centers for Medicare & Medicaid Services has to reimburse which is important to the payer population
Managed Care Reflections: A Q&A With A. Mark Fendrick, MD, and Michael E. Chernew, PhD
December 2nd 2025To mark the 30th anniversary of The American Journal of Managed Care (AJMC), each issue in 2025 includes a special feature: reflections from a thought leader on what has changed—and what has not—over the past 3 decades and what’s next for managed care. The December issue features a conversation with AJMC Co–Editors in Chief A. Mark Fendrick, MD, director of the Center for Value-Based Insurance Design and a professor at the University of Michigan in Ann Arbor; and Michael E. Chernew, PhD, the Leonard D. Schaeffer Professor of Health Care Policy and the director of the Healthcare Markets and Regulation Lab at Harvard Medical School in Boston, Massachusetts.
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