Health Equity & Access Weekly Roundup: September 4, 2026

gMG Rescue Therapy Access Varies by Hospital: Richard Nowak, MD, MS

When a generalized myasthenia gravis (gMG) exacerbation escalates to a moderate or severe flare, the therapy a patient receives—intravenous immunoglobulin (IVIG) or plasmapheresis (PLEX)—often hinges more on hospital resources than on clinical judgment, according to Richard Nowak, MD, MS, associate professor of neurology at Yale School of Medicine and global principal investigator of the MINT trial (NCT04524273).

IVIG is administered intravenously over 2 to 5 days and can be offered broadly, while PLEX filters pathogenic autoantibodies and inflammatory factors from the blood but requires central catheter placement, limiting its availability largely to tertiary centers.

Grocery Assistance Shows Potential in Diabetes Care and Beyond

A commercial health plan's grocery assistance benefit was associated with a 3.1-percentage-point decrease in the prevalence of diabetes with complications and improved medication adherence among members with type 2 diabetes, according to a study by Jeff Romine, PhD, and Kofi Essel, MD, MPH, published in the August 2026 issue of The American Journal of Managed Care^®.

The benefit provided members $1200 to $3000 annually for groceries; using a difference-in-differences design, the authors compared utilization and outcomes between benefit recipients and an ineligible control group. Overall health care utilization did not change significantly, but complication-related diagnoses declined while routine diabetes-management visits increased.

Resource Demands Challenge Community Oncology: Christos Vaklavas, MD

Running clinical trials at community cancer centers has grown more difficult as protocols require greater logistical and regulatory infrastructure, Christos Vaklavas, MD, said in the second part of an interview at the Institute for Value-Based Medicine® event in Salt Lake City, Utah.

For centers with only 1 or 2 open trials, building out dedicated study-coordinator staff is often not worthwhile, making long-term follow-up and later-phase studies more feasible than earlier-phase trials at community sites. Central institutional review board approval, such as protocols cleared through Huntsman Cancer Institute, can ease some administrative burden, though Vaklavas said the underlying infrastructure demands remain substantial.

CAR T Access Challenged by Geography, Cost, and Treatment Delays

Access to chimeric antigen receptor (CAR) T-cell therapy remains constrained by its concentration at academic centers, requiring patients to make multiple visits for treatment, hospitalization, and follow-up for complications such as cytopenias and immunosuppression, said Madhav Seshadri, MD, an assistant professor in the malignant hematology group at UCSF Health who specializes in lymphoma and chronic lymphocytic leukemia.

Seshadri, who moderated a discussion at the August 11 Institute for Value-Based Medicine^® event in San Francisco, said travel distance to a CAR T-cell center is a major barrier, compounded by insurance and pharmaceutical support that may not fully cover treatment costs and by the difficulty many patients face finding an available caregiver.

Access, Logistics Shape Multiple Myeloma Immunotherapy Decisions

The choice between CAR T-cell therapy and bispecific antibody combinations for patients with multiple myeloma often comes down to logistics as much as clinical fit, Amandeep Godara, MBBS, said in the second part of an interview at the Institute for Value-Based Medicine^® event in Salt Lake City, Utah.

Godara, whose team at Huntsman Cancer Institute treats any referred patient as needing treatment urgently, said clinicians try to engage patients early—at the first signs of biochemical progression or when a new therapy line is expected to produce only a brief response—so decisions about efficacy, toxicity, and preference happen before a crisis point.