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Increased competition is making its way into the specialty drug market, affecting orphan conditions, cancer types, and even common specialty conditions, which is presenting some cost savings opportunities, explained Aimee Tharaldson, PharmD, senior clinical consultant for emerging therapeutics at Express Scripts, who presented on the specialty pharmaceutical pipeline during her regular session at AMCP Nexus 2019.

Heading into 2019, the idea that oncology practices would fully embrace financial responsibility for clinical decisions still seemed far-fetched for many. And yet, when it was time to make the call, moving to 2-sided risk proved a “simple” decision, said Travis Brewer of Texas Oncology, who took part in a panel offering an update on the Oncology Care Model (OCM) at the start of the Community Oncology Alliance (COA) Payer Exchange Summit, which opened Monday in Tyson’s Corner, Virginia.

This week, the top managed care stories included CMS giving chimeric antigen receptor T-cell payments a boost; a US task force announcing that those at risk for pancreatic cancer should be screened; FDA revealing Novartis withheld data about a high-cost gene therapy.

Nearly 700 people at California State University and the University of California, both in Los Angeles, were still in quarantine over the weekend after possibly being exposed to measles; the world’s largest seller of cancer drugs, pharma company Roche Holding AG, will lose its top spot with competition from lower-cost drugs, namely biosimilars; findings from a new study showed that blood pressure regulation at or below 130/80 mm Hg lowered the risk of heart attack, stroke, or other complications in patients with type 2 diabetes (T2D).

At the Association of Community Cancer Centers (ACCC)'s 45th Annual Meeting & Cancer Center Business Summit, Ali McBride, PharmD, MS, BCPS, BCOP, clinical coordinator of hematology/oncology in the Department of Pharmacy at The University of Arizona Cancer Center and president of ACCC, discussed the role of biosimilars in oncology and how familiar oncologists and their teams are with them.

Although there is still a need for more education around the use of biosimilars in cancer, it seems oncologists have become more knowledgeable in the past few years, said Gary H. Lyman, MD, MPH, of Fred Hutchinson Cancer Research Center and Seattle Cancer Care Alliance.

Health Canada announced that all biologics, including biosimilars, will be identified by their brand names and nonproprietary names without the addition of a product-specific suffix; a boom in the use of connected health and fitness monitors that are connected to insurance plans and employers is providing an increasingly valuable source of workforce health intelligence, raising privacy concerns, and adding a new dimension to the worker-employer relationship; as the number of spare embryos from in vitro fertilization rises, giving birth with donated embryos is becoming more popular, although many of the agencies that provide donated embryos are supported by federal funds and restrict whom they help.

Presumed 2020 presidential candidates are trying to stake a claim to one of healthcare’s main concerns—surging prescription drug prices; enrollment in Idaho's health insurance exchange is expected to drop by 20% due to Medicaid expansion; employer groups can help overcome barriers, such as patient fears and misinformation, and create confidence about using biosimilars.

Despite their growing prevalence, there is still a lack of biosimilar education amongst stakeholders, said Robert Rifkin, MD, FACP, medical director, biosimilars and associate chair, hematology research, McKesson Specialty Health.

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