Depending on the patient’s needs, the clinical pharmacist may also work with other staff members, such as financial counselors or social workers, to optimize patient care. Similarly, clinical pharmacists confer with specialty pharmacists to ensure that insurance issues are resolved so that the patient receives timely access to treatment.

It is exciting to see that patients with advanced breast cancer are able to receive additional treatment options, because a primary concern of patients with stage IV breast cancer is a lack of awareness of laboratory and clinical research targeted for those battling advanced disease.

Outside of initial clinical trials, few tools are available to assess the real-world impact of breast cancer on patients. In a research letter published in February 2017 in the Journal of the American Medical Association, the authors compared the impact of several new cancer drugs on progression-free survival (PFS) with their impact on the patient’s quality of life and annual cost.3

Ongoing patent litigation and the “patent dance” in general have been thorns in the side of biosimilar drug manufacturers and payers who are anticipating lower-cost alternatives to high-cost reference biologics.
In the past 5 years, there has been a large increase in the number of employers focused on effective ways to manage the rising cost of specialty drugs. At the same time, employers have been working hard to comply with the Affordable Care Act (ACA) and are cognizant of the expected excise tax.
With the 2015 extension of time offered to employers for Affordable Care Act (ACA) compliance, many employers are back to focusing their attention on cost management efforts.
After the passage of the Affordable Care Act (ACA) in 2010, market changes beyond those already in play began to emerge. Traditional roles, responsibilities, and authority of various healthcare stakeholders could now be tested or altered as a result of some sections of the ACA.
The development of innovative medications is largely a private enterprise that relies chiefly on the investment of pharmaceutical companies in research and development (R&D).
True managed care is based on the notion of an integrated delivery system, an industrialized system of care designed to enhance population, as well as individual health status. The Affordable Care Act (ACA) and the philosophy embodied in the Triple Aim (ie, the triangle of care, population health, and costs)1 are leading the evolution toward the integrated delivery system and away from the component-based episode of care strategy or the fee-for-service method, where goods and services are applied and reimbursed individually, usually during an episode of sick care.
The increased approvals and rising costs of specialty pharmacy drugs have created a significant management challenge for health plans. The 3 primary disease areas that account for the majority of the specialty drug spending include autoimmune disorders, multiple sclerosis, and cancer.
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