Payers

Patients who cardiologists see once every few months are getting handed over to pharmacists who can monitor them more frequently and get them to their goals, said Crystal Zhou, PharmD, assistant professor of Clinical Pharmacy at the University of California, San Francisco (UCSF).

Many of the accountable care organization (ACO) models are being tested to find changes to make to the Medicare Shared Savings Program, but there is a general problem with short-lived models ending and being replaced by new ones, said Michael Chernew, PhD.

With more people living with HIV now reaching advanced ages and qualifying for Medicare coverage, this new study investigated HIV-related influences on their health care spending, particularly antiretroviral therapy (ART), compared with a population who does not have HIV.

Many oncologists oppose white bagging because they prefer to be able to adjust doses during a visit based on lab reports taken that day.

Implementing changes in a health system to promote biosimilar adoption is not easy, but by implementing a program, there could be substantial savings.

The clinical effectiveness of chimeric antigen receptor (CAR) T-cell therapies adds a new weapon in the arsenal to treat patients with relapsed and refractory disease; however, they come with access, logistical, and reimbursement challenges that make it difficult to treat all the patients who could benefit.

Value-based contracts are growing as drugs get more expensive and effective, but it’s still an emerging area with a lot of unknown and uncertainty.

In 2022 and 2023, there are a number of big therapies losing patent exclusivity, which opens the door to generics that could save as much as $30 billion.

While the pandemic will have lasting impacts on the US health care market, much of it has bounced back and returned to normal, said Doug Long, MBA, of IQVIA, during the Thursday keynote at the Academy of Managed Care Pharmacy annual meeting.

Although the medication therapy management program in Tennessee's Medicaid population did not reduce costs, some adherence to medication improved and emergency department visits improved.

Racial and ethnic health disparities are documented and substantial, but the data are out there to create programs that successfully address these disparities, said panelists.

The accountable care organizations (ACOs) participating in the new ACO REACH model will have a health equity benchmark adjustment and need to collect more data to help better understand the populations being cared for and serve those from underserved communities, said Michael Chernew, PhD.

The study by the Veneto Institute of Oncology (IOV) in Padua, Italy, examined 286 patients for genomic mutations in cholangiocarcinoma as well as survival status.

A comparison of type 2 biologics indicated for the treatment of chronic rhinosinusitis with nasal polyps identified dupilumab as the most effective drug in decreasing nasal polyp score and nasal congestion severity, whereas benralizumab was least effective.

Robert Sidbury, MD, MPH, chief, Division of Dermatology, Seattle Children's Hospital, spoke on considerations for dermatologists in seeking payer coverage of novel, expensive therapies for atopic dermatitis.

The annual spring meeting of AMCP 2022 will include keynote sessions on health care and marketplace trends and the specialty pharmaceutical pipeline, with a featured preconference session on bias in health care.

Patients switched from the originator product maintained their clinical outcomes and remissions status while biologic-naïve patients recorded positive responses and remission outcomes after initiating infliximab-dyyb.

Coverage of COVID-19 tests and treatment bills halted for uninsured; Moderna low-dose vaccine in children under 6 years of age shows promise in early clinical trial findings; Pfizer recalls blood pressure medications due to potential carcinogen.

On this episode of Managed Care Cast, Teresa Tyson, DNP, MSN, FNP-BC, FAANP, and Paula Hill-Collins, DNP, MSN, FAANP, discuss how The Health Wagon, a free mobile-based and nurse-managed clinic, provides accessible health care to rural residents in Virginia's Appalachian region.

The Global and Professional Direct Contracting model is going to be replaced with a new accountable care organization (ACO) model, which addresses some of the pushback there had been on the direct contracting model, said Michael Chernew, PhD.

A provisional clinical opinion from the American Society of Clinical Oncology (ASCO) recommends that patients with advanced cancer with specific genomic alterations undergo genomic sequencing.

Jim Schwartz, RPh, corporate pharmacy manager, Texas Oncology, discussed pharmacy challenges regarding equitable care and distribution of specialty drugs in the community oncology setting.

Incident end-stage kidney disease cases more than doubled among Asian individuals, and prevalent cases more than tripled for Asian, Native Hawaiian or other Pacific Islander, and Hispanic individuals.

While filgrastim biosimilars had substantial uptake, there was low uptake of infliximab biosimilars. In addition, there was a lack of price competition.

Michael Diaz, MD, president and managing physician, Florida Cancer Specialists & Research Institute, speaks on takeaways from his discussions on site of care and pharmacy benefit managers (PBMs) at the 2022 Community Oncology Conference.

The phase 3 trial of valoctocogene roxaparvovec for severe hemophilia A showed it reduced bleeding events as well as the use of factor VIII concentrates.

The FDA based its approval on OlympiA trial data, which show the PARP inhibitor has the ability to reduce risks of invasive breast cancer recurrence, second cancers, and death, and to improve overall survival.

A study from Japan identifies markers for a presurgical staging system in intrahepatic cholangiocarcinoma, with results on par with an existing postsurgical staging system.

After years, the biosimilars horizon may be here with valuable opportunities to improve patient outcomes and reduce costs, said Eric Palmer, president and CEO of Evernorth.