Managed Care Considerations Within Bispecific Landscape

EP: 1.Conditions for Administering Bispecific Therapy

EP: 2.Navigating Barriers Which Inhibit Optimal Use of Bispecifics

EP: 3.Key Decision Makers and Contributors Involved In Bispecific Administration

EP: 4.Pain Points In Bispecific Operationalization

EP: 5.Risk Evaluation and Mitigation Strategies [REMS] Program Considerations For Bispecific Therapy

EP: 6.Optimizing Bispecific Use Through EMR Utilization

EP: 7.Best Practices For Uptake and Use of Bispecific Therapy

EP: 8.Achieving Seamless Care Transitions With Patients Receiving Bispecific Therapy

EP: 9.Intro to Bispecific Therapy: Implementation Essentials for Novice Institutions

EP: 10.Key Elements In Monitoring for Potential Adverse Events with Bispecific Antibodies

EP: 11.Protocol For Urgent and Around-the-Clock Bispecific Care

EP: 12.Obstacles to Optimal Transitions of Care Between Academic and Community Settings When Utilizing Bispecific Antibodies

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EP: 13.Managed Care Considerations Within Bispecific Landscape

EP: 14.Payor-Provider Collaboration Driving Optimal Bispecific Therapy Strategies

EP: 15.Medication Assistance Programs Mitigating Financial Burden For Patients Receiving Bispecific Therapy

EP: 16.Bispecific Therapies: Current and Future Considerations

This is a video synopsis/summary of a Peer Exchange involving Ryan Haumschild, PharmD, MS, MBA, CPEL; Kirollos Hanna, PharmD, BCPS, BCOP, FACCC; Sarah Rockwell, PharmD, BCOP; Melody Chang, RPh, MBA, BCOP; and Ryan Cain, PA-C.

Haumschild asks about unmet needs in operationalizing bispecific antibodies for hematologic malignancies. Chang shares her experience with bispecific coverage and reimbursement. While her organization has not encountered payer denials or unexpected prior authorizations, most bispecifics lack classified codes, delaying claim processing. Additional documentation like invoices may be requested. She emphasizes open communication with payers to facilitate approvals. Haumschild notes the importance of collaboration between providers and payers for timely access. Hanna describes how his pharmacy and therapeutics committee and clinical practice committee assessed bispecific operational considerations and clinical value. Quick adoption was justified by unprecedented response rates in highly refractory multiple myeloma. Similarly transformational impacts are expected across hematologic malignancies as familiarity increases. Haumschild concurs this is an exciting time, with many game-changing innovations emerging for lymphomas and myeloma. The discussion highlights the need to align operational logistics and payer policies with the clinical promise of bispecific therapies.

Video synopsis is AI-generated and reviewed by AJMC® editorial staff.