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Varied Access: The Pharmacogenetic Testing Coverage Divide
On 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.
On this episode of Managed Care Cast, we are speaking with Jai N. Patel, PharmD, the associate director of shared resources management at Atrium Health Wake Forest Baptist Comprehensive Cancer Center.
His study, "Medical Policy Determinations for Pharmacogenetic Tests Among US Health Plans," uncovered significant differences in coverage decisions for pharmacogenetic tests across major US health insurers and laboratory benefit managers. Pharmacogenetic testing examines how an individual's genetic makeup impacts drug response.
In our discussion, Patel shares what motivated this research, key takeaways from his findings, and steps needed to improve consistency in evidence evaluation and pharmacogenetic test coverage.
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Community Oncology Reacts to Trump's Drug Pricing Executive Order
May 2nd 2025An executive order signed on Tuesday, May 15, necessitated a change in plans for this panel discussion from the 2025 Community Oncology Conference, with the assembled experts, moderated by Ted Okon, MBA, executive director of the Community Oncology Alliance, speaking to how the order would reverberate across the community oncology space.
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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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Personalized Care Key as Tirzepatide Use Expands Rapidly
April 15th 2025Using commercial insurance claims data and the US launch of tirzepatide as their dividing point, John Ostrominski, MD, Harvard Medical School, and his team studied trends in the use of both glucose-lowering and weight-lowering medications, comparing outcomes between adults with and without type 2 diabetes.
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