This Week in Managed Care: August 28, 2020

August 28, 2020

This week, the top managed care news included HHS defending a CDC change limiting COVID-19 testing for asymptomatic people; an inside look at the Facing Metastatic Breast Cancer Together campaign; a conversation with Dr Kashyap Patel on his new book.

HHS defends CDC change limiting COVID-19 testing for asymptomatic people, an inside look at the Facing Metastatic Breast Cancer Together campaign, and a conversation with Dr Kashyap Patel on his new book, “Between Life and Death: From Despair to Hope.”

Welcome to This Week in Managed Care, I’m Matthew Gavidia.

Amid Controversy, HHS Defends Change in COVID-19 Testing Guidance

This week, HHS defended a change by the CDC on who to test for COVID-19, and said the recommendation to limit testing of asymptomatic individuals was not politically motivated.

Earlier in the week, the CDC changed its guidance on testing, saying that even if one had come into contact with an infected individual, a test is not necessary if there are no symptoms, unless the person has health conditions that makes them more vulnerable to the virus or if a health care provider or local health official suggests getting one.

However, The New York Times reported Wednesday afternoon that the White House had pressured the CDC to make the change.

Admiral Brett M. Giroir, MD, the HHS official in charge of COVID-19 testing, said reports of pressure were untrue, even as the move was denounced by public health officials and Democratic governors, such as Andrew Cuomo of New York. New York and Connecticut were among the states Wednesday saying the change will not shift their advice telling people to get tested.

Giroir said during a media briefing that the guidelines are the product of the CDC and that about “probably 20 drafts” were reviewed by the coronavirus task force, and that all medical personnel on the task force had signed off on them.

For more, visit ajmc.com.

Being Each Other’s Hero: Facing MBC Together

At diagnosis, approximately 6% of breast cancers are metastatic, with experts predicting that 276,480 women and 2620 men would receive such a diagnosis in 2020.

For men especially, metastatic breast cancer, or MBC, can be difficult to talk about, much less open up about as men represent only 0.95% of the full number of cases of MBC in women.

“My perspective all along has been that we don't really get to choose or pick things the way we would like things to be in our life,” said Kirby Lewis, a stage 2 breast cancer survivor. “We are dealt this hand and what really matters is how we live it. I’ve tried to be a realist.”

Lewis is 1 of 9 patients, and the only male, with metastatic breast cancer who serve as the faces of Facing MBC Together, a campaign from Athenex Oncology, a US-based division of global biopharmaceutical giant Athenex.

The overarching message of the campaign is that patients with MBC do not have to go it alone, which Facing MBC Together fosters through its digital offerings that include a customizable calendar supporters can consult to fulfill a loved one’s everyday requests such as meal or grocery delivery and a real-time video channel, which enables live one-to-one or group chatting.

For more, visit ajmc.com.

When the Topic Is Dying: A Conversation With Kashyap Patel, MD

Released August 1st, Between Life and Death: From Despair to Hope is a roadmap for the journey every human being takes at some point, the topic of death, and how we can all do so with greater purpose, and less fear.

Author Dr Kashyap Patel, MD, the longtime oncologist, now CEO of Carolina Blood and Cancer Care Associates of Rock Hill, South Carolina, had known for years that he would write about dying.

Patel knew there was a great, unmet need to teach medical students and young physicians how to guide patients through the end-of-life process in a meaningful way.

And yet, despite a decade of movement toward greater quality in cancer care, dying remained a mostly taboo subject.

Patel spoke with The American Journal of Managed Care® about the subject of death, which he now hopes to make a theme of his upcoming tenure as president of the Community Oncology Alliance.

For more, visit ajmc.com.

How Virtual Care, Back-to-School Support, Health Inequities Are Influencing Employer Action

Amongst the extensive fallout of the COVID-19 pandemic, employers are now at the forefront of providing essential services to address issues ranging from health and social disparities to an intensifying mental health crisis.

In addition to expanding availability of behavioral health and virtual care services, returning to the workplace is now a task burdened by not solely the risk of infection, but the responsibilities that may be awaiting each employee back home. As school for children and teens is now transitioning toward virtual learning, many employees must now take on a more caregiving role than before.

In 2 separate surveys, 1 each from the Pacific Business Group on Health and Business Group on Health, employers identified efforts to increase availability of virtual care, support employees undertaking greater caregiving roles, and address social and health inequities as a result of the pandemic.

For more on survey findings, visit ajmc.com.

After FDA Approval, EMA Accepts Marketing Authorization Application for First Oral SMA Therapy

This month, the FDA approved risdiplam, sold as Evrysdi, to treat patients 2 months and older with spinal muscular atrophy, or SMA, marking the first FDA-approved oral therapy for patients with the disease.

SMA, a rare and often fatal hereditary disease that causes weakness and muscle wasting,causes patients to lose lower motor neurons that control movement.

The FDA approved the drug on August 7, and on August 17, the European Medicines Agency accepted the marketing authorization application, or MAA, for the treatment.

“The acceptance of the MAA for Evrysdi marks an important milestone as we continue towards the goal of making this ground-breaking therapy available globally to a broad range of SMA patients," said Dr Stuart W. Peltz, PhD, CEO of PTC Therapeutics, in a statement. "Evrysdi has consistently demonstrated clinically meaningful results in multiple clinical trials with a favorable safety profile.”

Risdiplam is created by PTC Therapeutics but will be marketed by Genentech, a member of the Roche Group.

For more, visit ajmc.com.

Paper of the Week

And, now our paper of the week, which looks back at some of the most important papers over the past 25 years of The American Journal of Managed Care® and why they matter today.

A 2015 report from the Institute of Medicine, Dying in America, found poor quality of care for patients at the end of life. A 2018 paper in The American Journal of Managed Care® helps explain the problem. Authors from The Dartmouth Institute of Health Policy and Clinical Practice found that movement to accountable care organizations, designed to improve quality, fell short because dying patients were often not properly attributed to any organization. If no one was responsible for a dying patient, then there was no downside risk of the person received poor care.

For the full paper, visit ajmc.com.

For all of us at AJMC®, I’m Matthew Gavidia. Thanks for joining us!