This Week in Managed Care: September 11, 2020

Insomnia is identified as new risk factor for type 2 diabetes, AJMC^®’s Managed Care Cast looks at the growth of telehealth during COVID-19 and its future after, and an overview of the agenda and speakers who will appear at Patient-Centered Oncology Care 2020.

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

Study Finds Insomnia as New Risk Factor for Type 2 Diabetes

This week, a novel global atlas study identified 19 risk factors found to increase the risk of developing type 2 diabetes, with insomnia identified as a risk factor for the first time.

Published in Diabetologia, researchers Susanna Larsson and Shuai Yuan of the Karolinska Institutet in Stockholm, Sweden, utilized a technique called mendelian randomization to delineate possible risk factors.

In their findings, causal associations were identified between 34 exposures (19 risk factors and 15 protective factors) and type 2 diabetes. Among people with insomnia, a 17% greater risk was associated with the development of type 2 diabetes compared with those who did not have insomnia.

Although, after accounting for adulthood body mass index, type 2 diabetes risk among those with insomnia decreased to 7%.

“Prevention strategies should be constructed from multiple perspectives, such as lowering obesity and smoking rates and levels, and improving mental health, sleep quality, educational level and birthweight,” concluded the study authors.

For more, visit ajmc.com.

The Growth of Telehealth During COVID-19 and Its Future After

Telehealth has been around for years in the United States, but it was not until the COVID-19 pandemic that it became regularly used. The growth of telehealth was fueled by the inability to see patients in person at the beginning of the pandemic and a move by the government to temporarily relax regulations.

In the latest Managed Care Cast by The American Journal of Managed Care®, Dr Patricia Salber, of The Doctor Weighs In, speaks with Dr Joseph Kvedar, president of the American Telemedicine Association, on breakthroughs in technology that have helped make virtual visits possible, the future of telehealth, and more.

For the podcast, visit ajmc.com.

Patient-Centered Oncology Care 2020

Last year, the steering committee of Patient-Centered Oncology Care®, or PCOC, opted to move the ninth edition of the meeting from November to late September—and wondered if the biggest challenge would be moving the meeting’s location from Philadelphia, Pennsylvania, to Nashville, Tennessee.

Enter COVID-19, which has upended travel and brought unprecedented logistical, safety, and financial challenges to oncology practices.

Like most other medical meetings, PCOC 2020 will be in a virtual format when it takes place September 25, 2020—but as the scientific community has discovered, from crisis comes opportunity.

“The technology we have here allows us to have the kind of immediacy that we get under the best of circumstances and small sessions to allow individuals in the audience to get questions to the speaker in a really efficient way,” said Dr Joseph Alvarnas [MD], chair of PCOC 2020.

To register for PCOC 2020, visit ajmc.com.

To learn more on the agenda and speakers, visit ajmc.com.

Remaining on this year’s virtual PCOC 2020, the premier meeting of cancer care stakeholders from The American Journal of Managed Care® will be co-chaired by Dr Alvarnas and Dr Kashyap Patel, CEO of Carolina Blood and Cancer Care Associates of Rock Hill, South Carolina.

“I definitely want my colleagues to access this meeting,” said Patel, who called the circumstances a “blessing” because doctors who want to take part will not have to travel and miss as much time from the clinic. “In a virtual meeting, I can essentially reshuffle my schedule here and there to accommodate my patients, and at the same time, learn the most.”

Patel praised the caliber of the faculty taking part in PCOC. This year’s group includes keynote speaker Dr Alexandra Chong, who is the point person for the Oncology Care Model at the Center for Medicare and Medicaid Innovation at CMS, payer representatives from the Blues, leaders from pharmacy benefit managers—along with their critics—and physician and administrative leaders from oncology practices large and small.

For more, visit ajmc.com.

FDA Clears Targeted Therapy, Diagnostic for Metastatic RET Fusion-Positive NSCLC

This week, the FDA cleared a targeted therapy as well as a companion diagnostic for patients with metastatic RET fusion-positive non–small cell lung cancer, who historically have had limited treatment options.

Pralsetinib, sold as Gavreto, developed by Blueprint Medicines, received accelerated approval while Thermo Fisher Scientific's Oncomine Dx Target Test received premarket approval from the FDA as a companion diagnostic to identify patients who are candidates for the once-daily oral RET-targeted therapy.

In July, Roche agreed to invest heavily in Blueprint Medicines, paying $675 million in cash in addition to a $100 million equity investment; Blueprint Medicines is eligible to receive up to $927 million in potential regulatory and sales-based milestones, plus royalties on net product sales outside the United States. The drug may also have promise as a tumor-agnostic treatment.

Non–small cell lung cancer makes up 85% of all US lung cancers, with RET fusions on the list of key markers recommended for multibiomarker testing in non–small cell lung cancer by National Comprehensive Cancer Network guidelines.

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.

COVID-19 brings a need for health investigators to come up with answers quickly, and that’s increased interest in using real world evidence, or Big Data.

However, a 2016 commentary by Austin Frakt and Steven Pizer cautions that Big Data analyses are not a substitute for science, and steps called validity checks can rule out causal interference.

Without these checks, they write, “We run the risk of letting our enthusiasm about big data get ahead of the science and what is best for patients.”

For the paper, visit ajmc.com.

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