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The Clinical and Reimbursement Landscape of Immuno-Oncology

Anti-PD-1 Agents as Frontline Therapy

Richard W. Joseph, MD, notes that current treatment guidelines for melanoma recommend anti-PD-1 agents as front line therapy and discusses payer coverage for first-line use of these agents.


Richard W. Joseph, MD, notes that current treatment guidelines for melanoma recommend anti-PD-1 agents as front line therapy and discusses payer coverage for first-line use of these agents.

Although neither pembrolizumab nor nivolumab have FDA approval for the front line therapy indication, guidelines from the National Comprehensive Cancer Network recommended an anti-PD-1 agent as a preferred initial regimen, says Dr Joseph.

Unfortunately, he remarks, healthcare professionals and patients need to worry about whether front line use of these agents will be covered by payers. Currently, coverage of first-line anti-PD-1 therapy is mixed, Dr Joseph adds. While some payers cover anti-PD-1 therapy as front line treatment, others do not.

Front line use of anti-PD-1 therapy has the potential to save payers money, notes Dr Joseph, as these agents are more effective and less toxic than other options.
 
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