
As a result of vertical integration, health plans may have 2 different coverage policies on the medical benefit side and the pharmacy benefit side for the same drug.

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.

As a result of vertical integration, health plans may have 2 different coverage policies on the medical benefit side and the pharmacy benefit side for the same drug.

Patients with schizophrenia have a lot of life-changing consequences when they are being treated properly, and these are only amplified when the patient goes untreated, explained Megan Ehret, PharmD, of University of Maryland, School of Pharmacy.

Schizophrenia may be misdiagnosed as depression or bipolar disorder, which delays treatment and negatively impacts the prognosis, explained Megan Ehret, PharmD, MS, BCPP, of the University of Maryland, School of Pharmacy.

Because sickle cell disease isn’t as progressive a disease as others that have gene therapies available, there isn’t as much urgency to start on these expensive therapies, said Kevin Niehoff, PharmD, BCMAS, associate director, Market and Financial Insights, IPD Analytics.

Two posters compared health care resource utilization (HCRU) and financial burdens of people living with HIV with a non-HIV population and people with HIV who are heavily treated with those have experienced less treatment.

Although the cost of biomarker testing isn’t cheap, the cost of therapy for patients can be much higher, making it important to conduct these tests to start the right therapy, explained Susan Wescott, RPh, MBA, of Mayo Clinic.

There are many misconceptions patients might have about clinical trials that prevent them from participating, and it’s important to understand what they are in order to overcome them, said Terry L. Keys, of University of Kentucky Markey Cancer Center.

Allowing patients to stay in their homes to receive bispecific antibodies can make the whole cancer journey easier, explained Courtney VanHouzen, PharmD, of Cowell Family Cancer Center, Munson Healthcare.

Financial advocacy in health care should advocate for system change and community work to give people better access to health and well-being before they get a life-changing cancer diagnosis, said Nadine J. Barrett, PhD, MA, MS, FACCC, of Wake Forest University and the Association of Cancer Care Centers.

Naoto T. Ueno, MD, PhD, FACP, of the University of Hawai’I Cancer Center outlines the underrepresentation in clinical trials, the lack of permanent medical oncologists, and issues of trust affecting care for the populations living in Hawaii.



Speakers from across the care continuum will discuss legislative updates, glucagon-like peptide-1 (GLP-1) use for weight management, and more at this year’s AMCP Nexus.

Otulfi from Formycon and Fresenius Kabi was approved simultaneously in the US and the European Union. In the US, it will launch in February 2025.

There are some short-lived, common adverse events for patients using cannabis, but also some more dangerous, less common ones in chronic users, explained Marie Parish, PharmD, BCOP, of Mayo Clinic.

Finerenone is at least as effective in patients who are in the hospital or were recently hospitalized for heart failure as those with stable condition, said Akshay Desai, MD, of Brigham & Women’s Hospital.

As cancer therapies extend patients’ lifespans, it’s important to implement cardioprotective strategies, said Aaron Adkisson, PharmD, of University of Kentucky.

The pharmacist is a critical member of the care team to help manage patients on treatment and contain costs of cancer care, said Kirollos S. Hanna, PharmD, BCPS, BCOP, FACCC, director of pharmacy, Minnesota Oncology.

After a small number of practices joined the Enhancing Oncology Model (EOM) in 2023, CMS has made some changes and opened the model back up for new practices to join.

Multiple sessions at ESMO Congress 2024 covered antibody-drug conjugates (ADCs), which are an emerging therapy that holds great promise in cancer but comes with challenges.

Demonstration projects to show accurate use of artificial intelligence (AI) in cancer care are important to prevent a loss of credibility in the technology, explained Glenn Balasky, executive director, Rocky Mountain Cancer Centers.

The evolving landscape of artificial intelligence (AI) use in cancer care requires evaluation of algorithms before implementation and continual monitoring after, explained Amy Abernethy, MD, cofounder of Highlander Health and former FDA official.

The legalization of recreational marijuana in Minnesota has created daily conversations about how to incorporate the use of cannabis into treatment plans for patients with cancer, explained Marie Parish, PharmD, BCOP, of Mayo Clinic.

While neoadjuvant therapy in stage III or greater melanoma is already the standard of care, new research presented at European Society of Medical Oncology (ESMO) Congress 2024 shows that what therapy is used is important for outcomes.

Using real-world data, researchers compared 2 chimeric antigen receptor (CAR) T-cell therapies with a bispecific antibody, teclistamab, in multiple myeloma (MM).

It’s hard for practicing oncologists to stay on top of the latest clinical data, but good partnerships and clinical decision support tools can assist.

Panelists discussed how the Inflation Reduction Act and the Enhancing Oncology Model are impacting value in cancer care and access to treatment.

The work might take long, but cancer advocate and survivor Matthew Zachary drove home the importance of advocacy to continue improving the lives of patients with cancer and provide them better options.

With the advances in cancer care, focus has mostly been on lamenting the high cost of these innovations instead of making patients and populations healthier, said A. Mark Fendrick, MD, director of the Center for Value-Based Insurance Design at the University of Michigan.

During the first fireside chat at the Patient-Centered Oncology Care® meeting, Alyssa Schatz, MSW, of National Comprehensive Cancer Network, discussed work being done to improve care for patients with cancer.

259 Prospect Plains Rd, Bldg H
Cranbury, NJ 08512
© 2025 MJH Life Sciences®
All rights reserved.
