CMS’ proposal that patients be enrolled in a clinical trial or registry to get Medicare coverage for chimeric antigen receptor (CAR) T-cell therapies will help improve access, for the most part, but there is the risk that some organizations will choose not to offer this treatment, said John W. Sweetenham, MD, of Huntsman Cancer Institute at the University of Utah.
CMS’ proposal that patients be enrolled in a clinical trial or registry to get Medicare coverage for chimeric antigen receptor (CAR) T-cell therapies will help improve access, for the most part, but there is the risk that some organizations will choose not to offer this treatment, said John W. Sweetenham, MD, Huntsman Cancer Institute at the University of Utah.
Transcript
CMS recently proposed patients be enrolled in a clinical trial or registry to get Medicare coverage for CAR T-cell therapy. Do you think this will help or hinder improving access to these innovative therapies?
I think for the most part, it’s going to help. I think it will mean that, at least initially, I think that these treatments are going to remain under the management of established bone marrow transplant and cell therapy programs. And so, it will enable them to gain more expertise, which I think is important because there is a major learning curve still.
I think the potential downside, as pointed out by Sam Silver, MD, PhD, [of the University of Michigan Rogel Cancer Center] in the session [Thursday] morning was that with the current coverage determination, some organizations may simply choose not to offer this treatment to their Medicare population because there’s too much money at risk. So, that’s the potential downside.
But, overall, I think that the determination is good, the requirement for evidence is absolutely correct, because we really fully don’t understand the true impact of this treatment yet. So, I think in the sort of short- to medium-term this is a good decision.
Dr Kathy Zackowski Discusses the Importance of Rehabilitation Research and Trials in MS
April 26th 2024Kathy Zackowski, PhD, National MS Society, expresses the inherent value of quality rehabilitation trials for broadening clinical understandings of multiple sclerosis (MS) and bettering patient outcomes.
Read More
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
Navigating Health Policy in an Election Year: Insights From Dr Dennis Scanlon
April 2nd 2024On this episode of Managed Care Cast, we're talking with Dennis Scanlon, PhD, the editor in chief of The American Journal of Accountable Care®, about prior authorization, price transparency, the impact of health policy on the upcoming election, and more.
Listen