
The ruling by the Supreme Court on 340B reimbursements was narrow, but it sets up a future reimbursement reduction by HHS that is even greater based on survey data, said Ted Okon, MBA, executive director, Community Oncology Alliance.

Laura Joszt, MA, is the vice president of content for the managed care and pharmacy brands at MJH Life Sciences®, which includes The American Journal of Managed Care®, Managed Healthcare Executive®, Pharmacy Times®, and Drug Topics®. She has been with MJH Life Sciences since 2011.
Laura has an MA in business and economic reporting from New York University. You can connect with Laura on LinkedIn or Twitter.

The ruling by the Supreme Court on 340B reimbursements was narrow, but it sets up a future reimbursement reduction by HHS that is even greater based on survey data, said Ted Okon, MBA, executive director, Community Oncology Alliance.

There are some similarities among various value-based payment programs for cancer care, but they are not identical, said Susan Escudier, MD, FACP, vice president, value-based care and quality programs, Texas Oncology.

The involvement of pharmacy benefit managers (PBMs) in 340B is the “colliding of 2 worlds,” said Ted Okon, MBA, executive director, Community Oncology Alliance.

Although there is a paucity of data of switching among biosimilars of the same reference product, the few studies published support the safety and effectiveness of transitioning patients from one biosimilar to another.

Telemedicine visits can make physicians more efficient, but the ability to report symptoms can add to the workload burden as staff try to figure out which symptoms need to be addressed, said Susan Escudier, MD, FACP, vice president of value-based care and quality programs, Texas Oncology.

Getting a more diverse patient population in clinical trials may be as simple as including paperwork in more languages, but good training among investigators and study coordinators can help identify unconscious biases that may also have an impact, explained Vivienne Hau, MD, clinical assistant professor with the Kaiser Permanente Bernard J. Tyson School of Medicine.

Data presented at the American Society of Clinical Oncology annual meeting found non-White patients are less likely to receive immunotherapy for head and neck cancer, said Amila Patel, PharmD, chief clinical officer, Navigating Cancer.

Even though the Oncology Care Model (OCM) ended on June 30, 2022, there are some improvements that practices should continue implementing, said Susan Escudier, MD, FACP, vice president of value-based care and quality programs, Texas Oncology.

There was also an association between outpatient visit burden and comorbidities and the number of inflammatory upper airway diseases.

Navigating Cancer has found patients, including those who are elderly, are adopting applications to stay connected with their care teams, said Amila Patel, PharmD, chief clinical officer, Navigating Cancer.

As part of the investigation into pharmacy benefit managers (PBMs), the Federal Trade Commission (FTC) should delve into how PBMs are impacting and fueling drug prices and set up guardrails to protect Americans, said Ted Okon, MBA, executive director, Community Oncology Alliance.

In retina surgery, obtaining prior authorization is an extra burden, and a delay in treatment for some of these patients could mean loss of vision, said Sabin Dang, MD, ophthalmologist with The Retina Institute.

Understanding that patients who are HER2-low are different from patients who are HER2-positive and -negative means having the right way to evaluate and identify these patients, explained Debra Patt, MD, PhD, MBA, executive vice president of Texas Oncology.

The use of digital health solutions has been a tremendous benefit during the pandemic that should continue, said Susan Escudier, MD, FACP, vice president, value-based care and quality programs, Texas Oncology.

The budget allocates half of the money for the development of low-cost interchangeable insulin biosimilars and the other half for building an insulin manufacturing facility in the state.

Until recently, ophthalmologists in the United States have had no experience with biosimilars, despite the availability of biosimilars for bevacizumab, which is commonly used off label for ophthalmic conditions.

Previously, patients with low expression of HER2 were categorized as HER2-negative but adding the HER2-low classification creates new opportunities for patients with advanced breast cancer, explained Debra Patt, MD, PhD, MBA, executive vice president of Texas Oncology.

While prior authorizations are put in place to ensure appropriate use of expensive therapies, they create a substantial burden for clinicians and patients, said Sabin Dang, MD, ophthalmologist with The Retina Institute.

Two posters presented at the American Society of Retina Specialists 40th Annual Scientific Meeting evaluated the impact of the COVID-19 pandemic on rates of patients lost to follow-up and patient perspectives regarding telehealth for retinal disease.

Posters presented at the American Society of Retina Specialists (ASRS) 40th Annual Scientific Meeting evaluated the association between long-term visual acuity outcomes and use of anti–vascular endothelial growth factor (VEGF) therapy, as well as patient and caregiver experience with ant-VEGF.

While anti–vascular endothelial growth factor (VEGF) therapy is the first-line treatment for diabetic macular edema (DME), a majority of patients discontinue therapy after 6 months and there is no consensus on the ideal dosing paradigm.

Institutional racism within the medical field and the treatment of people from lower socioeconomic communities plays a large role in racial and ethnic inequities, explained Vivienne Hau, MD, clinical assistant professor with the Kaiser Permanente Bernard J. Tyson School of Medicine.

A machine learning model was able to predict visual outcomes and showed that the time from diagnosis to first treatment indicates visual improvement in patients with macular edema due to central retinal vein occlusion (CRVO).

Although technology is allowing for earlier detection of eye conditions, lack of reimbursement and insurance coverage remain major barriers to widespread use, explained speakers at the American Society of Retina Specialists 40th Annual Scientific Meeting.

At the beginning of the pandemic, remote retinal imaging declined sharply due to a recommendation to stop nonessential eye care services in the first months of 2020, said Parisa Emami-Naeni, MD, MPH, assistant professor of ophthalmology at University of California, Davis, and vitreoretinal surgeon and uveitis specialist at UC Davis Eye Center.

Every year, the American Society of Retina Specialists releases the results of its latest Preferences and Trends Survey at the annual meeting. This year, the survey highlighted some surprising differences between US and international retina specialists, including off-label medication use and what drives drug choices for patients, said Paul Hahn, MD, vitreoretinal surgeon at NJRetina.

The retina space is evolving due to new technology that is changing the way specialists deliver care, whether that means offering the ability to do new procedures in the office or providing more virtual or hybrid care.

During a session at the American Society of Retina Specialists 40th Annual Scientific Meeting, speakers highlighted research into the opportunity cost of vitreoretinal surgery and the impact the pandemic had on retinal procedures and reimbursement in early 2020.

The study of postmenopausal women in Iran found the efficacy of the biosimilar was noninferior to the reference product and the safety was comparable after 18 months.

Triamcinolone acetonide injectable suspension (Xipere) uses a novel delivery mechanism that seems to benefit all patients with macular edema due to noninfectious uveitis, regardless of where the inflammation occurs, said Steven Yeh, MD, professor and the Stanley Truhlsen Jr. Chair in Ophthalmology at the Truhlsen Eye Institute, University of Nebraska Medical Center.

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