Providers

This week, the top managed care news included CMS started planning for life after the Oncology Care Model; a judge blocked a rule requiring immigrants to have health coverage; Election Day brought news for Medicaid work rules.

Researchers have identified complement genes that appear to play a role in vision loss associated with multiple sclerosis (MS), and this finding could help researchers monitor and predict the progression and severity of MS, according to a study published in Brain.

A majority of patients with acute graft-versus-host disease (GVHD), but not all, have significant responses to the addition of ruxolitinib, said David Snyder, MD, associate chair of the Department of Hematology & Hematopoietic Cell Transplantation at City of Hope.

Approximately 4% of the total world population is affected by a rare disease at any given time, according to new research on 3585 rare diseases.

New trials are looking at what could be the next therapy or one that layers on top of present therapies to treat lung diseases, said Lisa Lancaster, MD, assistant professor of medicine at Vanderbilt Health.

The rapid advance of technology has ushered in new paradigms when it comes to healthcare, particularly for patients managing chronic conditions. Rather than traveling to a doctor’s office or healthcare facility, patients now have the ability to use digital tools at home to improve their care or connect with their providers.

This week, the top managed care stories included a report from the FDA considering how to avoid drug shortages; a white paper finds rising comfort with telehealth even as use of digital health tools stagnates; data show a spike in the number of uninsured children.

Prithviraj Bose, MD, of MD Anderson Cancer Center discusses the risk of patients being treated with JAK inhibitors developing non-Hodgkin lymphoma.

By using the available evidence, data, and facts surrounding healthcare spending, we can begin conversations on necessary innovations, said Ceci Connolly, BA, president and chief executive officer of Alliance of Community Health Plans.

Broad population-based genomic screening has the potential to improve patient care by detecting genetic causes of disease before they occur; however, the economics behind this approach have not fully been validated, according to a session on the clinical and economic utility of whole-genome sequencing at the AMCP Nexus 2019 meeting.

Although the number of people with nonalcoholic fatty liver disease, which progresses to nonalcoholic steatohepatitis (NASH), is growing, the health system is still trying to get a handle on which patients to target and how to identify them before the first treatments come to market, explained panelists during a session at AMCP Nexus 2019.

The lack of FDA approvals for the treatment of nonalcoholic steatohepatitis (NASH) and safety concerns surrounding 2 recommended treatments contribute to the barriers blocking effective progress, said Karen Watkins, PharmD, pharmacist for emerging therapeutics strategy, MedImpact Healthcare Systems.

As the number of disease-modifying therapies available for multiple sclerosis increases, patients and physicians can struggle to identify the right one for the right patient, highlighting the need for a patient decision aid.

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.

Value needs to be considered early in the development life cycle of a therapy and should be continued throughout, even into the postlaunch space using real-world studies, according to a presentation on value-based services and their life cycles at the AMCP Nexus 2019 meeting.

New high-cost therapies require new financing mechanisms, but the challenge is coming to an agreement on what should be considered in these new payment models, said Jane Barlow, MD, MPH, MBA, executive vice president and chief clinical officer for Real Endpoints.

As the number of high-cost orphan drugs and gene and cell therapies continues to grow, there will be a greater need for alternative payment models to help figure out the best way to pay for these treatments.

As the number of expedited FDA approvals for cancer drugs that are based on surrogate end points increases, so does the need for new ways to uncover efficacy and safety data to justify the costs associated with these treatments. With the growth of data innovations and collaborations, the answer might be found in real-world evidence.

Use of digital health tools appears to have leveled off in 2019, according to one study, but another finds that use of telehealth is poised to grow considerably.

The local community doctor has an important role in recognizing, diagnosing, and managing myelofibrosis, said Naveen Pemmaraju, MD, associate professor in the Department of Leukemia at MD Anderson Cancer Center.

Unlike many other cancer rates that have been on the decline, liver cancer rates for new liver and intrahepatic bile duct cancer cases have been rising. This October, which is Liver Cancer Awareness Month, Global Liver Institute is joining with more than 30 other leading health and medical organizations, to issue a global call-to-action to increase the 5-year survival rates for patients with liver cancer from 18% to 36% by 2030.

Childhood conditions can have a long-lasting impact on the health of those individuals into their adulthood.

Less than half of Medicare patients newly diagnosed with blood cancer are receiving treatment for their cancer shortly after diagnosis, which may be attributed to the high cost burden they face, according to a new report from Milliman commissioned by The Leukemia & Lymphoma Society.

As costs for cancer care continue to rise, Pontchartrain Cancer Center does benefit and cost analyses for all patients before they start therapy and also takes into account any social needs they might have, said Kathy W. Oubre, MS, chief operating officer at Pontchartrain Cancer Center.

Serum neurofilament light chain is associated with brain atrophy and disability worsening, which means it can be used as an objective surrogate of ongoing disease activity in multiple sclerosis (MS), according to research published in JAMA Neurology.

While freestanding emergency departments (EDs) can reduce wait times and reduce the burden on overcrowded EDs, they increase utilization of emergency care and local market spending.

Pairing a cyclin-dependent kinase 4 and 6 (CDK4/6) inhibitor with fulvestrant significantly improved overall survival (OS) for women with hormone receptor (HR)-positive, human epidermal growth factor 2 (HER2)-negative advanced breast cancer, according to 2 abstracts presented at the European Society of Medical Oncology 2019 Congress.

Lisa Lancaster, MD, assistant professor of medicine at Vanderbilt Health, discusses how sleep apnea is a comorbidity for other lung diseases, such as chronic obstructive pulmonary disease (COPD) and interstitial lung disease.

Millennials and Generation Z consumers are driving significant change in the US healthcare system.

Data from EXPLORE, a prospective, multinational, natural history study, is used to characterize disease activity and clinical management of patients with acute hepatic porphyria (AHP) who experience recurrent attacks. The findings highlight the high unmet need for effective treatments.