Laura Joszt, MA

The most popular reimbursement content of 2023 included coverage of the shift from the Oncology Care Model to the Enhancing Oncology Model, reactions to the 2024 Medicare Physician Fee Schedule, and concerns around denial of services in Medicare Advantage plans.

Through interviews and contributed content, Strategic Alliance Partnerships provide insights into changes in health care delivery and medicine.

While the Enhancing Oncology Model is the successor of the Oncology Care Model, it includes some very real challenges for participating practices, explained Lalan Wilfong, MD, senior vice president of payer and care transformation at The US Oncology Network.

In 2023, there were 18 oncology and 7 population health Institute for Value-Based Medicine® events cohosted with organizations such as Optum, OneOncology, Vanderbilt Ingram Cancer Center, Duke Health, Cleveland Clinic, and Memorial Sloan Kettering Cancer Center.

Jun Gong, MD, of Cedars-Sinai Medical Center, discusses the latest data on adagrasib in colorectal cancer, the importance of conducting genomic testing, and more.

A one-size-fits-all approach to alternative payment models (APMs) often isn’t very fair to community practices, said Miriam Atkins, MD, FACP, president of the Community Oncology Alliance.

In 2023, adalimumab biosimilars took center stage in the biosimilar space due to 8 long-anticipated products finally launching.

The government of Australia’s pricing policy links the price of new medications with similar safety and efficacy, resulting in significant savings over the first 3 years after the etanercept biosimilar Brenzys was introduced.

Top coverage from the National Association of Managed Care Physicians (NAMCP) Spring Managed Care Forum 2023 included sessions on value-based care implementation and best treatment practices.

The commercial market got slightly less competitive while the Medicare Advantage market got a little more competitive, but both markets remain highly concentrated.

Activity to regulate pharmacy benefit managers (PBMs) has started in the states and is trickling up to the federal level, said Ted Okon, MBA, executive director of the Community Oncology Alliance.

ABP 959, an eculizumab biosimilar in development, has demonstrated similar efficacy and pharmacokinetics to the reference product for patients with paroxysmal nocturnal hemoglobinuria (PNH), according to research at the 2023 American Society of Hematology Annual Meeting.

The company is changing the way it prices prescription drugs and providing more transparency, which has been one focus of pharmacy benefit manager regulation efforts.

For patients with advanced non–small cell lung cancer (NSCLC), regardless of PD-L1 status, cemiplimab plus chemotherapy had favorable survival benefits and patient-reported outcomes over chemotherapy alone.

A mandatory nationwide transition from reference adalimumab to a biosimilar was implemented in New Zealand.

A new report highlighting the twin pressures hospitals have faced over the last 18 months shows that as reimbursement delays and denials increased and cash and investments decreased, operating expenses have risen sharply.

Managing toxicities for patients on immunotherapy requires collaboration with specialists to manage specific organ toxicities and moving beyond steroids, according to a presentation at the ESMO Congress 2023.

Neoadjuvant cemiplimab followed by surgery resulted in favorable survival outcomes for patients with resectable stage II to IV cutaneous squamous cell carcinoma (CSCC), addressing an area of unmet need, explained Neil D. Gross, MD, FACS, of MD Anderson.

In part 2 of this 2-part podcast, a panel of experts discusses implementation biosimilars in biologic-naïve patients, auto-substitution, and more.

A simulation study estimated the impact of biosimilar substitution on total cost of care (TCOC) and provider financial performance in the final performance period of the Oncology Care Model.

The American Medical Association (AMA) is continuing to urge Congress to stop the impending 3.4% cut to physicians, and other organizations also weigh in on the pros and cons of the 2024 Medicare Physician Fee Schedule.

Patients with diverse skin types can experience diagnostic delays, access to care issues, and quality-of-life burdens that a navigator program may be able to help alleviate.

In part 1 of this 2-part podcast, a panel of experts discusses the provider and payer considerations for transitioning patients to biosimilars, approaches to prescribing biosimilars over reference products, and more.

Tirzepatide is already approved to treat type 2 diabetes, and is now approved for chronic weight management in adults with obesity or overweight with at least 1 weight-related condition.

Regardless of kidney disease subtype, biomarkers can successfully ascertain risk of kidney disease progression, said Steven Coca, DO, MS, of the Icahn School of Medicine at Mount Sinai.

There is great value, both for clinical trials and clinical practice, in biomarkers that identify patients at greatest risk of developing chronic kidney disease (CKD) after acute kidney injury, explained Steven Coca, DO, MS, Icahn School of Medicine at Mount Sinai.

The use of a bioartificial kidney could save the transplant population from a life of immunosuppression drugs and save costs, according to Shuvo Roy, PhD, professor of bioengineering at the University of California San Francisco.