Leonard Lichtenfeld, MD: There are obviously a lot of political issues surrounding the ACA. One of them is the eligibility question—that is, when people come into the system and they may have a job, and this is what happened to cancer patients. They have a job. They try to keep their job. Their insurance comes with their job, and they lose their job. And somebody says, you can go on COBRA (Consolidated Omnibus Budget Reconciliation Act). I don’t know if you’ve ever priced out COBRA. COBRA is not exactly an inexpensive policy for many people who have employer-based insurance. So, they fall off the insurance rolls. We would like to see, and I would like to see, a better ability for people to transition into coverage.
One of the problems is that whoever certifies—people who are eligible to go into the ACA because of a life event like cancer—can get it quickly without a lot of hassle. A number of years ago, we did something with Social Security, where Social Security had patients’ disability but had a long waiting time for everybody who applied for Social Security disability. And the Commissioner took it upon himself—well, it was obviously with a lot of consultation—to move forward with a diagnosis-based a priori: a decision that on its face, was appropriate. So, if somebody had pancreatic cancer, they could get into the disability system quickly, as opposed having to wait an interminable period of time. That system of getting people onboard is important.
From a personal point of view, I wish the deductible issue could be faced. People in poor communities—a lot of them don’t have the money. In fact, in the entire country, a lot of people don’t have the savings to pay for those deductibles. I’m not sure if there’s an easy answer to that one, but it’s something that we need to recognize—that there are a lot of care situations where people need the care and they can’t pay for the care. And with medicine being the way it is today, one of the things we see happening, developing, and evolving is that more health professionals and more hospitals—everyone—want their money upfront. There is no easy answer to that one.
Access to care is the other piece, and this is not necessarily a legislative issue, but a lot of people have insurance for the first time in their lives. We need to help people understand. We were talking, in a previous discussion, about genomics and education for genomics in the population. What about people who don’t even know how to take care of themselves? And that’s not a negative; it’s just a reality. What about various communities that may have English as a second language that don’t know what’s available? How are we going to address that issue? How are we going to take people who live in communities where you know there may be other side issues?
It may not be drugs, but it may be violence, and there’d be questions. How do we get them from their communities? How do we get the care into their communities? Those are all issues that we have to address. Now, that’s not necessarily an ACA issue, but it’s the kind of issue we need to be talking about as a country. We need to start talking about the people, and we need to talk about systems of care. And then we’ve got to figure out how we are going to pay for that because it’s not going to come from charging for an office visit.
There’s a coming expectation that the medical—particularly the primary care—system is about to expand beyond taking care of your blood pressure or your diabetes. It needs to move more into the social arena as well. You can’t layer that on top without having a system of care that’s flexible, adaptable, responsive, and paid for.
Specialty Pharmacists at the Forefront: Elevating Care for Rare Diseases
May 1st 2024In the US, a disease is considered rare when it affects fewer than 200,000 persons, or 1 in every 1500 individuals, with an estimated total of 25 to 30 million Americans overall living with a rare disease at any given time.
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
BRCA-Like Classification May Be a Useful Biomarker for Olaparib Response in Ovarian Cancer
May 1st 2024Adding olaparib to maintenance therapy with bevacizumab was associated with significantly longer survival for patients with ovarian cancer whose tumors have a BRCA-like genomic profile, but not among those with non-BRCA-like tumors, a study found.
Read More
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
The Federal Trade Commission (FTC) issued letters to 10 companies to warn them that certain drug patents were improperly listed; the US Department of Agriculture (USDA) will begin testing ground beef for bird flu particles; rural Americans are more likely to die early from 1 of the 5 leading causes of death than those who live in urban areas.
Read More
Diving Deep Into Specialty Pharmacy: Insights and Forecasts From IQVIA’s Doug Long
May 1st 2024Doug Long, MBA, vice president of industry relations at IQVIA, covered a bevy of stakeholder investment–related topics in his presentation at AXS24 on trends in specialty pharmacy, chief among them challenges facing the industry, obesity medications, generics and biosimilars, new product launches, and the outlook for the US market.
Read More
Specialty Pharmacists at the Forefront: Elevating Care for Rare Diseases
May 1st 2024In the US, a disease is considered rare when it affects fewer than 200,000 persons, or 1 in every 1500 individuals, with an estimated total of 25 to 30 million Americans overall living with a rare disease at any given time.
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
BRCA-Like Classification May Be a Useful Biomarker for Olaparib Response in Ovarian Cancer
May 1st 2024Adding olaparib to maintenance therapy with bevacizumab was associated with significantly longer survival for patients with ovarian cancer whose tumors have a BRCA-like genomic profile, but not among those with non-BRCA-like tumors, a study found.
Read More
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
The Federal Trade Commission (FTC) issued letters to 10 companies to warn them that certain drug patents were improperly listed; the US Department of Agriculture (USDA) will begin testing ground beef for bird flu particles; rural Americans are more likely to die early from 1 of the 5 leading causes of death than those who live in urban areas.
Read More
Diving Deep Into Specialty Pharmacy: Insights and Forecasts From IQVIA’s Doug Long
May 1st 2024Doug Long, MBA, vice president of industry relations at IQVIA, covered a bevy of stakeholder investment–related topics in his presentation at AXS24 on trends in specialty pharmacy, chief among them challenges facing the industry, obesity medications, generics and biosimilars, new product launches, and the outlook for the US market.
Read More
2 Commerce Drive
Cranbury, NJ 08512