Value Peer-spectives

Health Plans Must Monitor the Oncology Pipeline to Apply Appropriate Coverage Criteria, Maintain Treatment Value

James T. Kenney Jr, RPh, MBA

February 2017, Vol 8, No 1 - Payer's Perspective

The 2016 American Society of Hematology (ASH) meeting provided insight into new treatment options and mechanism of action choices for hematologic cancers. Health plans need to continue to expand their knowledge and expertise in all cancer types to maintain the ability to manage and apply coverage criteria appropriately as FDA approvals continue to increase in oncology. [ Read More ]

Employers Look to Manage the Benefits of Specialty Pharmacy

Wayne Kuznar

December 2016, Vol 7, No 11 - Employers’ Perspective

Washington, DC—Employers recognize that oncology care is expensive, and they are shifting their focus on cost management. As such, employers are seeking approaches to determine which drugs and health plan designs will help them manage pharmacy and medical costs to improve patient outcomes, said F. Randy Vogenberg, PhD, RPh, Partner, Access Market Intelligence, and National Institute of Collaborative Healthcare, Greenville, SC, at the Sixth Annual Conference of the Association for Value-Based Cancer Care. [ Read More ]

Cost-Savings Measures Will Dot the Oncology Landscape

Wayne Kuznar

December 2016, Vol 7, No 11 - Value in Oncology

Washington, DC—Risk arrangements with physicians and transferring the costs of care onto patients are expected to increase in 2017, as payers attempt to manage high-cost disease states, such as cancer care, said Marie A. Hollowell, Senior Manager, Syndicated Research, Zitter Health Insights, at the Sixth Annual Conference of the Association for Value-Based Cancer Care. [ Read More ]

ASCO CEO Addresses Quest for Value in Cancer Care

Wayne Kuznar

December 2016, Vol 7, No 11 - Value in Oncology

Washington, DC—Treatments and technologies for cancer care are becoming increasingly expensive, fueling a need to define and improve value. As a result, the American Society of Clinical Oncology (ASCO) is refining its value framework that supports informed shared decision-making between doctors and patients and considers the clinical benefit, cost, and toxicity of cancer treatments. The goal is to have a tool that can customize information for each patient. [ Read More ]

Quality Measures Are Key to Supporting Drug Value

Wayne Kuznar

December 2016, Vol 7, No 11 - Value in Oncology

Washington, DC—An opportunity for value enhancement from the drug manufacturer’s perspective includes the improved use of data to meet the needs of stakeholders, especially the patient. Data that are generated should support the value of the manufacturer’s therapies in light of newly established value-based models, which often rely on quality metrics, for example, that are not obvious from clinical trials. Finally, wraparound services can add to a drug’s value and help to distinguish it from a competitor’s drug. [ Read More ]

Cancer Treatment Costs and Trends Beckon Risk-Sharing Future

Wayne Kuznar

December 2016, Vol 7, No 11 - Value in Oncology

Washington, DC—Oncology care is facing rising costs that will demand a transformation from a fee-for-service reimbursement model to a value-based, shared-risk incentive plan for Medicare and commercial insurance plans. Bruce Pyenson, FSA, MAAA, Principal and Consulting Actuary, Milliman, New York, NY, provided an overview of the cost trends of cancer treatment costs at the Sixth Annual Conference of the Association for Value-Based Cancer Care. [ Read More ]

Budget Impact Concerns Volume, Not Value: Prevention Is Key to Winning the War on Cancer

Jessica Miller

November 2016, Vol 7, No 10 - Value in Oncology

Boston, MA—Are we winning the war on cancer? According to Joshua J. Ofman, MD, MSHS, Senior Vice President, Global Value, Access and Policy, Amgen, the answer is yes. Dr Ofman discussed the economics of cancer, including challenges facing insurance providers and ways to impact the rising cost of cancer care, at the War on Cancer forum hosted by The Economist. [ Read More ]