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The fact that you have certain drugs that treat numerous cancers, and that they may treat 1 cancer different or better than another, would suggest that we should probably have differential pricing models, said A. Mark Fendrick, MD, director of the Center for Value-Based Insurance Design at the University of Michigan.

Bo Gamble, director of Strategic Practice Initiatives at the Community Oncology Alliance (COA), believes that broadening communication and education is COA’s main goal in 2018.

Southwest Airlines has set up a split fill program, pharmacy benefit manager, health advocacy program, and a cancer resource guide for employees, said Judy Berger, senior manager, benefits planning, Southwest Airlines.

This week, the top managed care stories included a road map to develop state-level programs to care for complex populations; the Physician-focused Payment Technical Advisory Committee backed 2 new alternative payment models; a new cancer gene profiling test may open doors to new targeted therapies.

While FoundationOne CDx, the comprehensive companion diagnostic test for solid tumors, gives patients the ability to be accurately matched with a targeted therapy, it also has potential benefits for patients with a less common types of cancers, said Stuart Goldberg, MD, chief scientific officer, Cota, in an interview with The American Journal of Managed Care®.

Until more data is available, it’s difficult for a practice or physician group to make an accurate assessment of whether or not 2-sided risk is appropriate, said Sarah Cevallos, chief revenue cycle officer, Florida Cancer Specialists. Physicians would need to see clear metrics in order to know if they will be achievable.

Most primary side effects of CAR T therapies occur early on after treatment and resolve quickly, but there are some that require long-term monitoring, explained Shannon L. Maude, MD, PhD, of The Children's Hospital of Philadelphia.