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Exploring Payer Coverage Decisions Following FDA Novel Drug Approvals
On this episode of Managed Care Cast, Ari D. Panzer, BS, lead author and researcher, then at Tufts Medical Center—now at Duke University—discusses the findings from his team’s investigation into coverage decisions by health plan insurers of the 66 drugs approved by the FDA in 2018.
In 2018, the FDA approved a record 66 novel drugs. Among them were cancer treatments, orphan drugs for rare diseases, drugs under expedited review, and biosimilars. However, access to each of these drugs for patients covered by different health plans was not uniform.
On this episode of Managed Care Cast, we speak with Ari D. Panzer, BS, a master of public policy candidate at Duke University, and lead author of “Patients’ Access to 2018 FDA-Approved Drugs 1 Year Post Approval,” which was published in the April issue of The American Journal of Managed Care®. He delves into why it’s important to ensure patients receive optimal treatment and maximize their outcomes, understanding why health plans vary in their coverage decisions despite having access to the same evidence, and the difficulty of striking the right balance between drug access, cost, and coverage to ensure patients can get the drug therapies they require when appropriate.
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Diagnostic Oversights Limit Luspatercept Benefits in MDS
May 8th 2024Investigators of a retrospective study encourage colleagues to utilize molecular testing for patients with an established diagnosis of lower-risk myelodysplastic syndromes (MDS), to be sure they don’t miss out on treatments, like luspatercept, for which they qualify.
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CMS Medicare Final Rule: Advancing Benefits, Competition, and Consumer Protection
May 7th 2024On this episode of Managed Care Cast, we're talking with Karen Iapoce, senior director of government products and programs at ZeOmega, about the recent CMS final rule on Medicare Part D and Medicare Advantage.
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Tackling Health Inequality: The Power of Education and Experience
April 30th 2024To help celebrate and recognize National Minority Health Month, we are bringing you a special month-long podcast series with our Strategic Alliance Partner, UPMC Health Plan. Welcome to our final episode of this limited series and our conversation with Janine Jelks-Seale, MSPPM, director of health equity at UPMC Health Plan.
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The Joint Commission is launching the Rural Health Clinic Accreditation Program to standardize staff training and patient care practices at rural health clinics nationwide; the American Cancer Society recently launched the largest-ever study of cancer risk and outcomes in Black women; the HHS COVID-19 vaccination campaign saved $732 billion by preventing illness and related costs.
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