Clinical

Specialty drugs expected to account for 40% of total prescription spending by 2016, according to Catamaran Corporation.

In a final rule (PDF) issued Thursday afternoon, HHS formally set an Oct. 1, 2015, compliance date for conversion to ICD-10 diagnostic and procedure codes, incorporating the absolute minimum delay imposed by Congress when it ordered HHS to roll back the conversion date previously set for Oct. 1, 2014.

Most providers associate clinical documentation improvement (CDI) with the transition to ICD-10 coding, however, CDI - a process in which care providers receive feedback from specialists who review clinical documents - may also deliver clinical and financial benefits for healthcare organizations.

Once strictly the domain of research labs, gene-sequencing tests increasingly are being used to help understand the genetic causes of rare disease, putting insurance companies in the position of deciding whether to pay the $5,000 to $17,000 for the tests.

This study examines whether patients treated with specialty pharmaceuticals have improved outcomes compared with patients treated with conventional therapies, and evaluates costs associated with these treatments.

The American Society of Clinical Oncology's algorithm to help oncologists evaluate the clinical benefits, side effects and costs of a cancer drug or therapy will be fine-tuned over the summer and should be available for public comment by the fall, said Dr. Lowell Schnipper, chair of the society's Value in Cancer Care Task Force.

Hospice care is associated with improved median survival time for the patients diagnosed with metastatic melanoma, accompanied by decreased end-of-life costs.

Enrollees in some of the health law's most popular plans will face high cost-sharing requirements that the pharmaceutical industry says could keep patients from getting the drugs they need.

Lee Newcomer, MD, MHA, of Oncology, Genetics and Women's Health for UnitedHealthcare, says the National Comprehensive Cancer Network is transforming genetic testing by utilizing a tool called the NCCN Biomarkers Compendium, which encourages evidence-based decision-making.

Pharmacists and drug manufacturers are pushing the CMS for a one-year transition period before states attempt to implement a new formula mandated under the Patient Protection and Affordable Care Act that will significantly trim Medicaid reimbursement rates for generic drugs.

Cancer survivors often encounter a variety of health issues, the most common of which include fatigue, peripheral neuropathy, and depression. To address those specific issues, the American Society of Clinical Oncology (ASCO) has developed 3 new sets of guidelines on cancer survivorship care.

Christine Strahl, PharmD, MBA, BCPS, specialty pharmacy program manager, HealthPartners, says there are several new distribution channels in specialty pharmacy.

The American Society of Clinical Oncology (ASCO) has launched a strategic initiative to define value in cancer care.

In his talk, Melanoma Guideline Update: New Agents and Opportunities for Treatment, John A. Thompson, MD, of the Fred Hutchinson Cancer Research Center in Seattle, Washington, first showed the preferred list of treatments for advanced or metastatic melanoma: ipilimumab, vemurafenib, dabrafenib, dabrafenib plus trametinib, high-dose interleukin-2, and the drugs-to-come in the category: clinical trials.

Who should receive genetic counseling and screening for colorectal cancer (CRC)? And how early should annual colonoscopies happen once those at risk are identified? These are important questions with equally important and complex answers.

Life-saving therapies that halt cancer can take a toll on the skeletal system, leaving survivors with bone loss or more serious injuries such as broken wrists, ribs, or hips. Watchful attention, screening, and therapy are needed to prevent these outcomes.

Conference Highlights from the 2014 Annual Meeting of the American Academy of Allergy, Asthma & Immunology (AAAAI) in San Diego, California.

A coalition of patient advocates, dialysis-care providers and manufacturers today will unveil a comprehensive new framework for kidney care across the country that identifies four goals: improve survival, reduce hospitalizations, improve health-related quality of life, and improve patient experience with care.

Session highlights from the Managed Markets Summit in Orlando, FL, February 25-27.

Laurie Wesolowicz, PharmD, director, pharmacy services clinical, Blue Cross Blue Shield of Michigan (BCBSM), says that clinical evidence and other factors can drive formulary decision-making. Evidence can influence the value and coverage recommendations for drugs covered under the pharmacy (formulary) and medical benefits.

Organizations can better understand the link between workforce health and business performance by thoughtful integration of relevant metrics from both HR and business operations.

Using bronchiolitis clinical practice guidelines (CPGs) was linked to reduced use of chest X-rays (CXRs), bronchodilators, steroids, and length of stay (LOS) in hospitalized children without affecting 7-day all-cause readmissions.

The value of the mammogram is being questioned after 1 study found that the mortality rates resulting from breast cancer were the same in women who got screened and those who did not.

Once limited to filling and dispensing drugs, pharmacists are increasingly providing direct care to patients. Across the country, they are working with doctors to give immunizations and help patients safely manage medications.

Providing a solid base of primary-care service and coordinating specialty care for high-risk patients has been advocated as a method of lowering overall healthcare costs. Doing so would presumably reduce repeat hospitalization and emergency department visits.