Oncology therapy (More on Desktop Resource, March 2007)
Oncology therapy has the potential to become the single leading category promoting drug spending growth, however, the class of drugs is rife with challenges for plans and employers.
Oncology therapy has the potential to become the single leading category promoting drug spending growth, however, the class of drugs is rife with challenges for plans and employers.
The oncology category will be particularly challenging, because it is not only projected to be the top single category driving drug spend growth, but also a challenge clinically to manage patients within this category, according to Ryan Haynes, RPh, director of clinical services at HealthTrans, Greenwood Village, Colo.
"To further complicate the situation, it is often difficult to apply traditional cost management tools-for example, prior authorization, step therapy-to oncology, because timely patient care is critical and with new oncology drugs becoming available there can be uncertainty as to their place in therapy, not to mention the potential political ramifications surrounding new and appropriate therapies in this category," he says. "Managed care executives will continue to be challenged with attempting to balance appropriate, evidence based care with financial considerations involved with new drug therapy."
"Moving these drugs over to dispersion by specialty pharmacies has not been a scenario that payers are eager for. Moving the adjunctive agents, such as those for anemia, white blood cell growth or nausea, to the pharmacy benefit will increase as payers appreciate the savings the pharmacy benefit allows them to receive."
Optimize Your Healthcare Payments with Optum Financial
April 29th 2025Discover how Optum Financial is revolutionizing healthcare payments in our latest whitepaper. Learn how transitioning to electronic payments can reduce administrative costs, streamline claims processing and enhance security.
Read More
Conversations With Perry and Friends
April 14th 2025Perry Cohen, Pharm.D., a longtime member of the Managed Healthcare Executive editorial advisory board, is host of the Conversations with Perry and Friends podcast. His guest this episode is John Baackes, the former CEO of L.A. Care Health Plan.
Listen
Healthcare hasn't been a priority of the second Trump administration so far, panelists at the Asembia agreed. Medicaid may loom large, though, as the administration and congressional Republicans look for ways to slash government spending as a way of offsetting major tax cuts.
Read More
Breaking Down Health Plans, HSAs, AI With Paul Fronstin of EBRI
November 19th 2024Featured in this latest episode of Tuning In to the C-Suite podcast is Paul Fronstin, director of health benefits research at EBRI, who shed light on the evolving landscape of health benefits with editors of Managed Healthcare Executive.
Listen
What 5 Managed Care Trends Experts Say You’re Not Watching Closely Enough
April 29th 2025Managed Healthcare Executive asked several experts in healthcare and managed care to share the trends they think the industry is overlooking. From rising costs and data challenges to shifts in how care is delivered, these are the issues that could have a major impact — and deserve a closer look.
Read More
