Expert Interviews

An expert highlights that overcoming clinical inertia in US community settings through targeted education and patient advocacy is essential to increase frontline use of CD38 antibodies in transplant-ineligible multiple myeloma, ensuring more patients benefit from proven, life-extending therapies.

Kasey Raetz, Pharm.D., vice president at Express Scripts and a winner of the PBMI Innovator Award, told MHE she takes pride in the role pharmacy benefit managers play in helping patients access needed care while supporting health plans in managing a complex system.

An expert discusses how JAK inhibitors represent targeted therapy that specifically blocks the interferon gamma–driven JAK-STAT pathway responsible for autoimmune melanocyte destruction in vitiligo, offering greater efficacy and safety compared with broad immunosuppressive treatments such as corticosteroids.

An expert discusses how gene therapy represents a breakthrough treatment approach for BCG-unresponsive patients, offering quarterly dosing that reduces treatment burden while showing promising response rates of 50% to 70% in real-world evidence.

An expert discusses how patients with BCG-unresponsive non-muscle invasive bladder cancer (NMIBC) now have several FDA-approved treatment options beyond radical cystectomy, including pembrolizumab, gene therapy and intravesical chemotherapy combinations.

In this second part of a three-part of a video series, Kasey Raetz, Pharm.D., a PBMI Innovator, told MHE about leading the development of EncircleRx, a program that balances patient access, holistic weight loss support and financial protection for health plans amid soaring demand for GLP-1 drugs.

In this final video of a three-part video series, Joshua Fredell, Pharm.D., senior vice president at CVS Caremark and a winner of Managed Healthcare Executive’s PBMI Innovator Award, said most health plans prioritize achieving the lowest net drug costs, whether through rebates, lower list prices or biosimilars.

The next step for the Rise For Health study researchers is to study the health benefits of frequent standing in older men and women.

An expert discusses how home administration of oncology drugs in the US faces significant logistical and reimbursement challenges—despite the safety of subcutaneous and on-body delivery systems. He highlights that regulatory barriers, practice economics, and evolving payer policies limit adoption, even as patient-reported outcomes increasingly support the value of well-tolerated, effective regimens such as those studied in MAIA.

New study results provide insight into improving heart health through behavior changes, such as taking standing breaks throughout the day.

A lack of training and vague, overlapping symptoms can be attributed to more than three-quarters of autoimmune patients being misdiagnosed at least once, according to Veena Joy, the U.S. Lead for Strategic Partnerships, Allergy and Autoimmunity at Thermo Fisher Scientific.

An expert discusses how phototherapy requires 2 to 3 sessions per week in specialized light booths or home units, is particularly useful for vitiligo covering more than 10% body surface area, and can be targeted to specific areas using 308-nm lasers for smaller lesions.

In this second video of a three-part series, Joshua Fredell, Pharm.D., senior vice president at CVS Caremark, said innovation in PBMs comes from simplifying pricing, offering flexible benefit designs, and using technology to create a smoother experience for members.

An expert discusses how non-muscle invasive bladder cancer (NMIBC) creates a significant clinical and financial burden with up to 60% recurrence rates, affecting an estimated 85,000 new patients annually and requiring frequent office visits that impact quality of life for this older population.

An expert discusses how non-muscle invasive bladder cancer (NMIBC) is a localized form of urothelial cell carcinoma that primarily affects older men with smoking as the primary risk factor, requiring close follow-up due to its highly recurrent nature.

This final part of the three-part video series highlights Sharon Faust of Navitus reflecting on how personal challenges, including her husband’s accident, reshaped her perspective and empowered her to lead boldly in the PBM industry.

Children with HIV face a shortened life span, educational barriers and daily stigma, according to Amir Ardeshir, Ph.D., DVM, associate professor of microbiology and immunology at Tulane University.

In this video interview, Amanda Bogle, a healthcare attorney at Sheppard Mullin, explains the importance of compliance officers, documentation systems and leadership for pharmacists looking to adhere to the evolving regulatory landscape.

An expert discusses the evolving role of bispecific antibodies in multiple myeloma, highlighting their off-the-shelf availability, immune-targeting mechanism, and growing potential in relapsed and frontline settings, while emphasizing the need for proactive toxicity management, personalized supportive care, and strategic integration into broader treatment plans.

An expert discusses the operational and financial complexities of integrating bispecific antibodies into multiple myeloma treatment pathways, emphasizing the need for standardized protocols, multidisciplinary training, payer-provider collaboration, and infrastructure investments to support safe, scalable, and value-based delivery of care.

An expert discusses the approval of a third bispecific antibody for relapsed/refractory multiple myeloma (R/R MM), highlighting its potential to reshape treatment pathways, intensify payer scrutiny around formulary positioning and cost-effectiveness, and drive a more competitive, real-world reassessment of the bispecific therapy class.

An expert discusses how choosing between triplet and quadruplet regimens for transplant-ineligible multiple myeloma depends on patient fitness, disease risk, and treatment tolerability. He highlights that anti-CD38 antibodies generally add minimal toxicity, triplets may offer strong outcomes for frail patients, and practical factors such as infection risk, dosing frequency, and subcutaneous vs intravenous (IV) administration also influence regimen selection.

Veena Joy, the U.S. Lead for Strategic Partnerships, Allergy and Autoimmunity at Thermo Fisher Scientific, discusses the latest advancements in autoimmune disease research and explains why industry collaboration is essential to finding disease cures.

In this second part of a video interview series, it was revealed that Sharon Faust, chief pharmacy officer at Navitus Health Solutions and PBMI Innovator Award winner, works to improve the pharmacy benefit system by promoting transparency, educating others about rules and supporting new business ideas that help patients and use healthcare money wisely.

An expert discusses how long-term corticosteroid use carries risks of skin atrophy, systemic effects such as adrenal suppression, and area-specific concerns such as increased intraocular pressure near the eyes. Additionally, topical calcineurin inhibitors have black box warnings for potential infections and malignancies despite their established safety profile.

Kasey Raetz, Pharm.D., transitioned from working at a small independent pharmacy to leading product and pharma contracting strategy at Express Scripts, earning a PBMI Innovator Award for her creative solutions in the evolving pharmacy benefit market.

An expert discusses how community-based gene therapy administration has broadened treatment options for patients with BCG-unresponsive NMIBC by providing easier logistics compared with complex chemotherapy regimens, ultimately expanding bladder-sparing approaches and avoiding radical cystectomy in younger, sexually active patients.

Joshua Fredell, Pharm.D., senior vice president at CVS Caremark and PBMI Innovator Award winner, is calling for a PBM industry focus on making pharmacy experiences more seamless while continuing to keep drug costs affordable.

Access is the central tenet to the success of lenacapavir as a form of preexposure prophylaxis (PrEP), according to Jeremiah Johnson, the executive director of PrEP4All and Mitchell Warren, the executive director of the AIDS Vaccine and Advocacy Coalition (AVAC).

In his second video interview with Managed Healthcare Executive, PBMI Innovator Award winner David Blair discusses why breaking up traditional pharmacy benefit manager models is key to improving transparency, reducing conflicts of interest and delivering better outcomes.