The panel discussion, "Tackling Advanced Care Planning in Payment Reform: People and Politics" at the 2015 Community Oncology Conference, included a provider who is an active proponent of advanced care planning (ACP), a program director at a nonprofit health insurance company, and a healthcare consultant who until recently worked for a big health plan.
A general session at the Community Oncology Conference, Community Oncology 2.0, Moving Forward on Payment Reform, was a panel discussion that saw participation by 2 providers and a payer.
With the rising prices of innovative oncology treatments, many of which fall under specialty pharmaceuticals, curbing the cost of care is high on the agenda of healthcare providers.
One of the challenges providers will face in the new Oncology Care Model that CMS announced earlier this year is measuring quality and meeting quality standards under, according to Patti Forest, MD, MBA, senior medical director of network quality and performance at Blue Cross Blue Shield of North Carolina.
Given the high cost of oncology medications, many specialty pharmacies have dedicated teams to help patients overcome the financial burden, said Kirby Eng, RPh, executive director of clinical oncology management services at Onco360.
During the session on "Federal and State Legislative and Regulatory Updates" at the Academy of Managed Care Pharmacy's 27th Annual Meeting & Expo, there was talk of the ongoing initiatives being proposed by CMS, explained Debbie Meyer, RPh, resident program director, student pharmacists, career programs, Humana, Inc, who moderated the session.
The Patient‑Centered Outcomes Research Institute (PCORI) takes 2 different approaches to conduct research and gather evidence to help patients make decisions, Joe V. Selby, MD, MPH, executive director of PCORI, said at the Academy of Managed Care Pharmacy's 27th Annual Meeting & Expo.
Although Rhode Island is the smallest state in the United States, it had the fourth highest healthcare spend, which meant the state was spending "way too much" on healthcare, according to Beth Hebert-Silvia, RPh, managing director and assistant vice president of pharmacy at Blue Cross and Blue Shield of Rhode Island (BCBSRI).
Although there is a lot of promise for comparative effectiveness research as a tool to help healthcare providers, policy makers, and patients make better decisions, there are a number of issues to be resolved, according to speakers at the Academy of Managed Care Pharmacy's 27th Annual Meeting & Expo.
In a session at AMCP's 27th Annual Meeting & Expo that was so popular that attendees were being directed to an overflow room, Aimee Tharaldson, PharmD, senior clinical consultant in emerging therapeutics at Express Scripts, highlighted specialty pharmaceuticals that are currently in development and expected to come to the market in the next few years.
Orphan medications are gaining a lot of focus from manufacturers, Aimee Tharaldson, PharmD, senior clinical consultant for emerging therapeutics at Express Scripts, said at the Academy of Managed Care Pharmacy's 27th Annual Meeting & Expo in San Diego, April 7-10.
Pathways, particularly in oncology, have been gaining a lot more attention lately as payers are looking to bundle payments, Robert W. Dubois, MD, PhD, chief science officer and executive vice president of the National Pharmaceutical Council, explained at the Academy of Managed Care Pharmacy's 27th Annual Meeting & Expo in San Diego, April 7-10.
Pharmaceutical pricing is opaque for a reason and increased transparency may not be a benefit, said the speakers during the "Drug Pricing: Manufacturer, Payer, Prescriber, and Patient Perspectives" session at the Academy of Managed Care Pharmacy's 27th Annual Meeting & Expo in San Diego, April 7-10.
Trends in healthcare are driven by innovation, which is largely being driven by specialty innovation, Douglas M. Long, MBA, vice president of industry relations at IMS Health, said during the headline session "Marketplace Trends" at the Academy of Managed Care Pharmacy's 27th Annual Meeting & Expo.
As more high-cost drugs reach the market, the meaning of value gains more attention, especially in the specialty pharmacy market. One way to assess value is to use a cost-effectiveness analysis to guide formulary decisions.
The way drugs are priced should have less in common with healthcare services and more in common with a consumer product like a computer operating system, Dana Goldman, PhD, the Leonard D. Schaeffer Chair and Director of the Schaeffer Center for Health Policy and Economics at the University of Southern California, said at AMCP's 27th Annual Meeting & Expo in San Diego on April 7-10.
Employers who manage the high cost of care associated with specialty pharmacy face a number of challenges that are being addressed by the National Employer Initiative on Specialty Pharmacy, said Cheryl Larson, BA, vice president of the Midwest Business Group on Health.
The Cardio-Oncology Intensive during the Annual Scientific Session of the American College of Cardiology reflects the increased need for improved diagnostic tools and cardioprotective strategies as cancer patients live longer. Besides a second malignancy, heart disease accounts for most morbidity and death in cancer survivors.
A study that combined socioeconomic data and hospital-level data on quality care after myocardial infarction showed that hospitals that serve the poorest Americans adhere to high standards, but patient outcomes do not always reflect that high-quality acute care.
The study drug, Bendavia, was developed to improve mitochondrial response when oxygen returns to the tissue affected by a heart attack. Results showed some improvement, but not at levels that were statistically significant.
Patients in the study were given support through a weight loss clinic for a 4-year period. Those who had sustained weight lost and did not let their weight fluctuate were most likely to have arrythmia-free survival.
Amgen's cholesterol-fighting PCSK9 inhibitor was shown to reduce the likelihood that patients would suffer cardiovascular events. The question now is whether FDA will grant approval soon and how widely the drug will be used, given speculation about its cost.
Identifying which patients with diabetes will develop heart disease is not as straightforward as it might seem. This session explored the use of biomarkers, imaging, and how a population health-based model will do a better job of identifying women at risk.
Cardiologists treat patients who are older, sicker, and more reliant on Medicare. That means they must pay attention to new payment models from CMS that reduce reliance on fee-for-service and increase the presence of accountable care organizations.
Results from a study of long-term use of this dual anti-platelet therapy suggest patients may be able to switch to a 60 mg dose at the 1 year mark after a heart attack, rather than 90 mg.
A head-to-head comparison found patients receiving heart CT scans fared about as well as those receiving a variety of functional tests, although CT did a better job of identifying those who needed follow-up procedures. The study's lead author predicts a change in clinical guidelines, although critics question whether patients should receive so much radiation.
During the session "Principles of Immunotherapy" at the National Comprehensive Cancer Network 20th Annual Conference, Anthony J. Olszanski, RPh, MD, from the Fox Chase Cancer Center, described the complex interplay between the immune system and cancer, and some of the current immunotherapies being used today.
Over the years, the National Comprehensive Cancer Network Guidelines have become the market leader for clinical guidelines to consult, but with that success comes responsibility and scrutiny, according to Clifford Goodman, PhD.
The National Comprehensive Cancer Network Guidelines bring the practices of cancer care thought leaders out to the community, said Mary Lou Smith, JD, MBA, co-founder of the Research Advocacy Network.
The most recent Surgeon General Report on Smoking and Health initiated the decision to create smoking cessation guidelines for cancer patients, Peter G. Shields, MD, said during his session announcing the new NCCN Guidelines.
