Clinical

The United States is in the midst of an opioid epidemic that has been responsible for a 200% increase in deaths due to overdose of heroin or an opioid pain reliever since 2000. Guidelines provide clinicians with ways to identify patients at risk of opioid use disorder and best practices of prescribing opioids.

By using telemedicine and relocating the center of care to where a person lives, we have an opportunity to address more unmet demand for palliative care, while giving more control to the seriously ill to meet their stated needs.

This week, the top stories in managed care included poll results that show growing numbers of Republicans want the Affordable Care Act scaled back instead of repealed, Jardiance received a new indication for patients with type 2 diabetes, and CareMore reported care coordination gaps for seniors.

This article examines the integration of palliative care in a community cancer center-an example of how one program integrated palliative care.

A panel of 21 expert clinicians from the field conducted a systematic review of meta-analyses randomized clinical trials, observational studies, and clinical experience, to develop recommendations that have been published in the Journal of Clinical Oncology.

What we're reading, December 7, 2016: health insurers provide demands if Republicans repeal Obamacare; women face 20% higher healthcare costs in retirement; and immunotherapies are being considered for sepsis.

Bundled payments are an interesting experiment, but they should have more clinically relevant time periods and include more quality measures, said Ashish K. Jha, MD, MPH, the K.T. Li Professor of Health Policy at the Harvard T.H. Chan School of Public Health and the director of the Harvard Global Health Institute.

In high-risk patients with chronic lymphocytic leukemia (CLL), CD19 chimeric antigen receptor (CAR) T-cells of defined composition can be administered with an acceptable early toxicity.

Representatives from the Beat acute myeloid leukemia (AML) and National Cancer Institute-Molecular Analysis for Therapy Choice (NCI-MATCH), which incorporate genomic profiling to assign patients to different treatment arms, provided an insight on trial design and a progress report.

Older patients diagnosed with chronic lymphocytic leukemia (CLL) and small lymphocytic lymphoma (SLL) continue to present a favorable response to single-agent ibrutinib, at a follow-up of 29 months, in phase 3 of the RESONATE-2 trial.

Pam Mangat, MS, associate director TAPUR study at the American Society of Clinical Oncology, says that the organization has developed a number of initiatives to educate oncology practitioners on the potential of precision medicine, such as testing guidelines, online courses, a virtual tumor board, and clinical trials.

Phase 3 results from the LyMa trial show that rituximab maintenance therapy after autologous stem cell transplant (ASCT) prolongs event-free survival, progression-free survival, and overall survival (OS) in previously untreated young patients with mantle cell lymphoma (MCL).

Early phase 1 results show that including the cyclin-dependent kinase 4/6 inhibitor palbociclib in the treatment of patients with mantle cell lymphoma (MCL) can help overcome resistance to ibrutinib.

Distinct genetic signatures can help distinguish responders from nonresponders of chimeric antigen receptor (CAR) T-cell treatment in patients diagnosed with chronic lymphocytic leukemia (CLL).

Chimeric antigen receptor (CAR) T-cells have been dramatically effective in treating B-cell cancers, according to David L. Porter, MD, of the University of Pennsylvania Health System. He also identified the use of CAR T-cells for treating solid tumors as a research area that will see more development in the coming years.

NICE recommends pembrolizumab for use in advanced lung cancer following additional data review and a further discount in price.

In an increasingly tech-focused world, the use of phones, tablets, and computes, combined with social media sites, have allowed patients to find the emotional and social interactions they need when dealing with their care, said Mike Payne, MBA, MSci, chief healthcare development officer at Omada Health.

Interim data analysis of a phase 1 trial of chimeric antigen receptor-T cells (CAR-T) targeting the B-cell maturation antigen in heavily pretreated patients with multiple myeloma has identified an objective anti-tumor response, with limited toxicity.

The PIONEER AF-PCI trial studied bleeding in patients with atrial fibrillation undergoing percutaneous coronary intervention with 3 different treatments. The study found that a rivaroxaban (Xarelto)-based strategy had a significant reduction of bleeding complications, explained Roxana Mehran, MD, FACC, FACP, professor of medicine and director of Interventional Cardiovascular Research and Clinical Trials at the Zena and Michael A. Weiner Cardiovascular Institute at Mount Sinai School of Medicine.

Statin use was associated with a reduction in all-cause and multiple myeloma-specific mortality.

What we’re reading, November 30, 2016: the FDA agrees to clinical trials of Ecstasy to treat posttraumatic stress disorder; University of Pittsburgh Medical Center workers strike to protest wages and union rights; a New York pharmacy owner will spend 4 years in jail for distributing 500,000 oxycodone pills without prescriptions.

A nationally representative study among patients enrolled in Medicare, who were diagnosed with cancer, found that out-of-pocket costs averaged at 23.7% of their household income. A majority of these costs could be attributed to hospitalization.

The American Society of Clinical Oncology (ASCO) has released the Criteria for High-Quality Clinical Pathways in Oncology, which is expected to help providers assess the quality, utility, and integrity of pathway programs in the United States.

Trial data on the use of plinabulin for mitigating chemotherapy-induced neutropenia with docetaxel will be presented as a poster at the American Society of Hematology’s annual meeting in San Diego.

The general stigma and bias circulating obesity hinders the ability to improve the patient’s health, explained Ted Kyle, RPh, MBA, principal at ConscienHealth. With number of individuals with obesity, patients, physicians, and payers can’t afford to think of obesity as a purely cosmetic condition.

Within 4 months of the last reported incident, Juno Therapeutics has again halted the phase 2 “Rocket” trial of JCAR015 in patients with relapsed or refractory B cell acute lymphoblastic leukemia (ALL).

Here's a glimpse into what The American Journal of Managed Care’s 5th annual Patient-Centered Oncology Care® meeting had in store for its attendees.

This week, the top managed care stories included the FDA's approval of rival combination therapies for type 2 diabetes, the American Medical Association issued mHealth guidelines, and a study found the dementia rate declining.

What we're reading, November 23, 2016: Alaska has a novel plan to hold down insurance premiums; MedPAC's executive director discusses continuation of value efforts; and new findings regarding microcephaly in Zika-infected babies.

What we're reading, November 22, 2016: Virginia declares opioid addiction a public health emergency; House calls for a pause of ongoing Obamacare lawsuit; and Anthem-Cigna antitrust trial begins.