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Jaime is a freelance writer for The American Journal of Managed Care® (AJMC®), where she previously worked as an assistant editor.

She has a BA in print journalism from Penn State University. You can connect with Jaime on 

Articles

This analysis found that the 3000 patients with hemophilia had higher rates of pain, depression, and anxiety medication use.

Use of Pain, Depression, Anxiety Meds Higher Among Patients With Hemophilia

Former NBA star Magic Johnson has partnered with GSK to educate the public about this virus, specifically in seniors and those at high-risk for contracting a severe form of RSV.

 Raising Awareness About RSV in Older Adults

Mary is the associate editorial director for The American Journal of Managed Care® (AJMC®), The Center for Biosimilars®, and Evidence-Based Oncology™. She joined AJMC® in 2013 and oversees speaker recruitment and panel preparations for AJMC®'s premier annual oncology meeting, Patient-Centered Oncology Care®.

She has a BA in communications and philosophy from Loyola University New Orleans. You can connect with Mary on 

Based on promising results, the biotech IMV has moved into phase 2b trials with a cancer vaccine composed of survivin epitopes that uses the company’s proprietary delivery system to elicit persistent immune responses.

Delivery Matters: In Early Studies, DPX Technology Allows  Vaccines to Persist When Cancer Pushes Back 

Between 2019 and 2020, there were 97 reported shortages among sponsor-reported antiseizure medications in Australia, 93% of which were generic brands.

Shortages of Antiseizure Meds Continue, More Common Among Generics: Australian Report

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1rem

Compendium

 Leukemia & Lymphoma compendium is a comprehensive resource for clinical news and expert insights for the blood cancers and their treatments.

This week’s Managed Care Cast conversation took place on the same day President Joe Biden 

 of the Cancer Moonshot, a program he initiated when he was vice president in the Obama administration. The reinvigorated program aims to cut cancer deaths by 50% over the next 25 years and to increase cancer screening, which has dropped sharply during the pandemic.

This Friday, February 4, is World Cancer Day, an initiative led by the Union for International Cancer Control (UICC), and this year's theme is about closing care gaps. For this episode of Managed Care Cast, we spoke with Meghan Gutierrez, CEO of the Lymphoma Research Foundation, about financial toxicity, how the pandemic has affected patients’ financial needs when they have cancer, health care disparities and care gaps, and more.

Listen above or through one of these podcast services:

On this episode of Managed Care Cast, we speak with Meghan Gutierrez, CEO of the Lymphoma Research Foundation, about financial toxicity, how the pandemic has affected patients’ financial needs when they have cancer, health care disparities and care gaps, and more.

Lymphoma Research Foundation CEO on Biden’s Cancer Moonshot, Financial Toxicity 

For one cancer center, an outgrowth of the COVID-19 pandemic spurred plans to create an urgent care center for patients with cancer so that they could stay out of the emergency department (ED). The Winship Cancer Institute of Emory University began planning for construction in 2020 after receiving a sizeable donation and broke ground this year. The Rollins Immediate Care Center is expected to open in 2022.

On this episode of Managed Care Cast, we 

, Gina Mauro, who talks with Charise Gleason, MSN, NP-BC, AOCNP, the advance practice provider chief at Winship Cancer Institute, about how having a dedicated cancer urgent care center will make cancer treatment plans seamless while  helping patients avoid exposure to infectious diseases in ED waiting rooms.

On this episode of Managed Care Cast, we bring you an interview conducted by the editorial director of OncLive® who talks with the advance practice provider chief at Winship Cancer Institute about how having a dedicated cancer urgent care center will make cancer treatment plans seamless whil helping patients avoid exposure to infectious diseases in emergency department waiting rooms.

Keeping Patients With Cancer Out of the ED Through Dedicated Urgent Care

 recaps the top managed care news of the week, and you can now listen to it on our podcast, Managed Care Cast.

This week, the top managed care news included HHS laying out a plan for importing certain prescription drugs from other countries; a potential new standard of care for chronic lymphocytic leukemia; 3 insulin makers get subpoenaed over their pricing practices.

HHS, FDA Outline Foundation for Importing Certain Drugs From Other Countries

CMS Testing Pilot to Give FFS Medicare Providers Historical Claims Data on Patients

Ibrutinib—Rituximab Improves Survival Compared With Current Treatment for Chronic Lymphocytic Leukemia

What We're Reading: Democrats Debate Medicare for All; Insulin Makers Questioned; Best Hospital Rankings

Bipartisan Senate Bill Seeks to Roll Back a Decade's Worth of Insulin Price Hikes

Lilly to Launch Half-Price Version of Humalog

Sanofi Offer Sets Monthly Price of $99 for Insulin Supply

IVBM: Advancing Oncologu Quality Through Value-Based Care

Read more about the stories in this podcast:

Every week, The American Journal of Managed Care® recaps the top managed care news of the week, and you can now listen to it on our podcast, Managed Care Cast.

Podcast: This Week in Managed Care&mdash;Drug Importation Plan and Other Health News

A recent study found that microbiome-based biomarkers may be useful in predicting patient responses to CAR T-cell therapy for non-Hodgkin lymphoma. 

Gut Microbiome May Impact CAR T-Cell Therapy Response in Patients With Lymphoma

Children with acute lymphoblastic leukemia living in US-Mexico border regions had worse 5-year survival rates compared with children living in other parts of Texas, a recent study found. 

Study Shows Survival Disparities Among Children With ALL Living in US-Mexico Border Regions

The phase 3 PhALLCON study found ponatinib plus chemotherapy more effective than imatinib with chemotherapy in patients with Philadelphia chromosome-positive acute lymphoblastic leukemia. 

Ponatinib Demonstrates Increased Efficacy vs Imatinib in Patients With Ph+ALL

While treatment with allogeneic hematopoietic cell transplantation (allo-HCT) showed improved disease-free survival compared with conventional consolidation chemotherapy, the findings suggest there may not be an overall survival (OS) benefit with allo-HCT for patients with intermediate-risk acute myeloid leukemia (AML) during first complete remission.

Allo-HCT Not Linked With Better OS vs Consolidation Chemotherapy in AML Patients in Complete Remission

Despite overall improvements in survival outcomes in recent decades, disparities in survival outcomes persist among children and young adults with acute lymphocytic leukemia (ALL) across racial and ethnic groups.

Racial and Ethnic Disparities Persist in B-Cell ALL Survival in Children, Young Adults 

Lee Greenberger, PhD, chief scientific officer of the Leukemia and Lymphoma Society, discusses the COVID-19 pandemic's impact on 

 and the importance of open communication between patients participating in trials and their physicians.

From your vantage point, is the pandemic still affecting clinical trial enrollment? What strategies have been effective for keeping trials going?

We definitely saw an impact on trial enrollment during COVID. Many of the clinicians told us about that. There's multiple reasons: Patients were afraid to come in, and the staff to do the work, they were either getting infected [or] they were not coming in. So, it definitely had an impact.

What we have seen is actually that enrollment has come back up, and I think that the NCI [National Cancer Institute] has actually reported on that as well—that, in general, clinical trial enrollment has come back up. Physicians and clinics have learned to deal with it, and I don't think that patients should be as concerned.

That being said, patients need to report if they get an infection to their physician on a clinical trial. 

, there are steps that can be taken within the first 5 days. Patients should not hesitate to contact their physician if they're on a clinical trial and in the event that they get COVID.


Videos

Lee Greenberger, PhD, chief scientific officer of the Leukemia and Lymphoma Society, discusses how the pandemic changed clinical trial enrollment in the leukemia/lymphoma space.

Dr Lee Greenberger Discusses the Pandemic's Impact on Clinical Trials in Leukemia, Lymphoma

, PhD, chief scientific officer of the Leukemia and Lymphoma Society, discusses common questions about COVID-19 and vaccination from patients with 

What are the most common questions you receive at the Leukemia and Lymphoma Society from patients about COVID and vaccination? What are the key unresolved issues?

One of the key questions we got was, “I have no anti-spike antibodies. What does that mean?” And then the next question was, “I have some, am I protected or not?” And the answer is [that] if you had if you had no detectable anti-spike antibodies, that definitely was a warning sign. If you had some—and just to put it in perspective, the range of the assay goes from 0-2500 units per mL. This was a LabCorp assay, [and] LabCorp could literally turn around, get the blood, [and] get an answer back within two days, [so] patients knew what they had. And they could go back multiple times to see whether they improved or not. Some of those patients had anti-spike antibodies, let's say in the 100 or 200 range, [which is a] warning sign. We know now that if the anti-spike antibodies weren't over 1000 or in a range that matched normal patients, they were probably at risk. That all said, the immune response to the vaccinations is complicated. There is the so-called B-cell response—those cells produce antibodies, and that's what the anti-spike antibodies measure. There’s also something also called T cells, which can kill viral infected cells. We actually looked at T cells and asked, “Are you getting a T-cell response to the vaccination?” We looked in about 500 patients and did that analysis, and what we found is people can make T-cell responses. The T-cell responses can occur in about 50% of the patients, whether or not they've [had an] anti-spike response. So patients started asking, “Okay, I have a T-cell response. What does that mean?” The answer is, I'm not sure. Obviously, if you had no T-cell response and no B-cell response, that was a clear warning sign. But the patients that have T-cell responses, even if they have low anti-spike levels, they might be protected. It's a lot more subtle than that, and there's work coming out by others. It depends on what type of T cells you you respond by, and are they functional? It's not only the amount of T cells or that you have T cells, but is it functional? Our assay did not measure functional T cells. There are other assays that are measuring functional T cells, and that data is appearing, or will appear shortly. So those are the most common questions. We also got questions [like], “I'm on therapy, should I stop therapy? Should I pause the therapy and get the vaccine? Will I respond?” Those are all questions that still really remain up in the air. We really need to do a better job of understanding that not only for the COVID situation, but in the future, we're going to have to understand when people respond, the amount that they responded, and are they getting a functional response?

Lee Greenberger, PhD, chief scientific officer of the Leukemia and Lymphoma Society, discusses common questions that patients with leukemia and lymphoma ask about COVID-19 and vaccination.

What Patients With Leukemia and Lymphoma Usually Ask About COVID-19 Vaccinations

, PhD, chief scientific officer of the Leukemia and Lymphoma Society (LLS), discusses key takeaways from the creation of a 

You participated in a session during ASH about the use of social media to develop a leukemia and lymphoma registry. What were key takeaways?

This was in LLS’s sweet spot, because the social contacts with our patients, as well as any advocacy organization that’s strong, has direct contact with patients. The way the registry was set up will allow us to go out directly to the patient population. Not only that, [but with] the way the registry was set up, we can get information from patients and then go back to the patients if there were additional questions. That's a unique feature of this registry, and we did that multiple times to either confirm diagnosis to patients who are asking us, “What is this low anti-spike or no detectable mean?” and to have that we could have that conversation. When the registry opened… at the time, sort of vaccines came online in December, January, right? We opened up the registry in February—by March, we were fully open. 

We had thousands of patients that registered. Why did they register? One [reason] is people wanted to know, “Am I responding to the vaccine?” And we did that by a surrogate, looking at the ability to make antibodies in response to the vaccine—the anti-spike antibodies. We not only sent them to LabCorps around the country—they could go anywhere they want and we paid for a free blood test—but that information came back to LLS, so we were informed about the whole population, and the individual patient got the result as well. What that meant was [there were] patients who said, “Oh, my God, no detectable antibodies, warning sign.” Some of those patients said, “Okay, I'm not protected,” or some of those patients went back to their clinicians and said, “Here's the data. What does it mean?” So that was a very valuable experience.

What we did to actually get the message out was we broadcast the that the registry is open to 600,000, patients, caregivers, researchers, and physicians. We also got picked up by many media contacts, so we got the word out there that way. We used all the LLS resources that we already had in place to get the message out, so the uptake of the registry was unbelievable. We thought when we opened up this registry in terms of response to vaccine, we would have 200, maybe 300 patients. Within 2 months after was open, we had like 2000 patients. We've built that up to 12,000 patients. 

Not only that, but we have electronic health care records from 6000 of those patients. What that means is that we ask patients, “Did you get vaccinated? What were your side effects? Did you get COVID? And here's your anti-spike response to the vaccinations.” And we got the electronic health care records from many of those patients. So, when patients said, “I've had rituximab,” we can confirm that and [and ask], “When did you exactly have it? And what did you have it with?” And we know, for example, with rituximab, which is a B-cell suppressive therapy, we were able to go back and say, “You know, if you've had rituximab within the last year, you're not likely to make anti-spike antibodies.” And it made perfect sense because rituximab is a B-cell suppressive therapy and can last 6 to 12 months after the therapy is done. So while a patient [would be] saying, “Well, I've had rituximab 6 months ago, I'm protected.” You're not. And so that was a very important lesson that we learned along with other clinicians and other people who were looking at this collectively. We learned that with B-cell suppressive therapies, some of them have long-term B-cell suppression and other ones don't. We know with the BTK inhibitors very commonly used in CLL patients, that some patients did not make antibodies while others do—we still don't understand why. It has implications for future vaccinations, whether it’s COVID or otherwise. My point is, we used all the social media channels that we built up over the years and deployed that to the registry—and that's why it was so effective.

In this interview, Lee Greenberger, PhD, chief scientific officer of the Leukemia and Lymphoma Society, discusses key takeaways from using social media to grow a leukemia and lymphoma registry.

Dr Lee Greenberger on Using Social Media to Grow a Leukemia and Lymphoma Registry

Dr Beveridge, how do BTKis [Bruton tyrosine kinase inhibitors] fit into a value-based care model for oncology? If you could, discuss your experience with value-based care models in oncology, specifically as it relates to leukemia and lymphoma.

 That’s a great question. I’m not sure I’ve got a great answer. My first comment is in terms of the financial toxicity burn that you were talking about. One of the greatest causes of bankruptcy in this country is medical bills, particularly drug bills. That’s not something we should be proud of as a society. You’re correct that the IRA [Inflation Reduction Act of 2022], which physicians need to spend time understanding, makes a fundamental impact. In 2026, [Medicare] Part D switches over. The legislation says is that the total maximum out-of-pocket cost for a patient is $2000 in Medicare. A lot of this financial toxicity from a drug standpoint will be alleviated at that point. But there’s a corollary problem with IRA in terms of financial toxicity, and that’s the savings to the patient as the payers carrying more risk for drug expenditure. The insurers are taking on a greater proportion of risk when we’re talking about what’s going to happen in 2026 and ’28, which suggests that they’re going to be spending more time thinking about tiering products and how to deal with these expensive drugs, like we’re talking about. One could flippantly say, it will be easier with the $2000, but it’s going to be more complicated than that for this drug class.

Dr Koffman, from the patient’s perspective, what patient support is offered to aid patients to gain access to BTK [Bruton tyrosine kinase] inhibitors? There are patient-support foundations, and there are sponsored programs from the manufacturers. What does that look like for a patient? How do they navigate that area?

Roy Beveridge, MD, and Brian Koffman, MD, explore how the Bruton tyrosine kinase inhibitors (BTKi) fit into value-based care models for oncology and the patient support offered to aid patients in gaining access to BTKis.