Payer’s Perspective

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

James T. Kenney, 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 ]

The Challenge of Balancing Access to and Paying for New, High-Cost Cancer Therapies

James T. Kenney, RPh, MBA

August 2016, Vol 7, No7, Special Issue: Payers’ Perspectives in Oncology - Payer's Perspective

Many significant and interesting topics highlighted at ASCO 2016 are discussed in this publication, covering clinical, safety, and economic issues related to cancer therapies. The challenge for health plans and other insurers is to balance the need to provide reasonable and appropriate patient access to new therapies and the ability to pay for them, because many new cancer treatments are designed for orphan diseases and are launched into the market at extremely high costs.

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