While discussing the factors that managed care professionals review when assessing a pharmaceutical product’s cost versus its overall benefit, the panelists explain that the process is often challenging.
Oncologists and other health care providers, along with the FDA, must assess several factors, most importantly a drug’s risk-benefit ratio, before deciding how to approve it. And in the United States, there is no current threshold for what constitutes a reasonable price on drug therapy or helps determine what necessary approaches can help pay for expensive therapy, clarifies Michael Kolodziej, MD.
Because the money that is being spent to help pay for expensive therapy comes through insurance agencies, from taxpayers’ dollars, reminds Dr Kolodziej, the decision about how to pay for expensive treatments such as immunotherapy should be a societal decision.
The panelists agree that as our country shifts toward a value-based insurance design, the consumer will have to become more active in the economic decision-making process.
Daniel J. George, MD, explains that the decision-making process will rely heavily on providers, as they will need to supply the information important to patients so that they can make valued decisions.
Oncology Onward: A Conversation With Thyme Care CEO and Cofounder Robin Shah
October 2nd 2023Robin Shah, CEO of Thyme Care, which he founded in 2020 with Bobby Green, MD, president and chief medical officer, joins hosts Emeline Aviki, MD, MBA, and Stephen Schleicher, MD, MBA, to discuss his evolution as an entrepreneur in oncology care innovation and his goal of positively changing how patients experience the cancer system.
Listen
Lawsuits target initiatives aimed at reducing racial disparities; less than 10% of trials for COVID-19 treatments included children in the first 3 years of the pandemic; the World Health Organization requests more information on increased respiratory illnesses in China.
Read More
Insufficient Data, Disparities Plague Lung Cancer Risk Factor Documentation
September 24th 2023On this episode of Managed Care Cast, we speak with the senior author of a study published in the September 2023 issue of The American Journal of Managed Care® on the importance of adequate and effective lung cancer risk factor documentation to determine a patient's eligibility for screening.
Listen
IQVIA Report Spotlights Shortages for Pain, Obesity, and Oncology Therapies
November 21st 2023A new report from IQVIA provides an overview of current US drug shortages, shedding light on major areas of concern, such as medications to address pain, cardiovascular conditions, obesity and diabetes, and multiple forms of cancer.
Read More
HMO and EPO Insurance Plans More Likely to Promote Use of Biosimilars
November 21st 2023Health plan type highly influences the likelihood of biosimilar uptake, with low-flexibility insurance plans more likely to have patients who either switched to a biosimilar or were initiated on a biosimilar.
Read More