Here We Go Again? Payer Management of Me-Toos in the Modern Oncology Era


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Tremendous progress has been made in recent years for treatment of cancer with the approval of many innovative and transformative oncology drugs. However, with drug pricing at front and center, various stakeholders in healthcare, especially payers are actively focusing on strategies to curb unnecessary spending on high cost treatments. While oncology has for the most part escaped stringent payer management for years, we may now be entering a new era with more aggressive management of oncology drugs intended to drive down the ever-increasing spending on cancer care in the US.

In this webinar, we will focus the discussion on how payers anticipate managing oncology therapies in crowded categories where there are multiple in-class agents with similar labeling (e.g., PD-1s, PD-L1s, PARPs, CD-20s, CDK 4/6s, BTKs, etc.). Moreover, manufacturers are conducting numerous combination trials to create differentiation and competitive advantage for what appears to be me-too drugs. Will such positioning strategies be viewed favorably by payers and for how long? Will these products be forced to compete on price and other value-based payment models? We will dive deeper into the issues of cost and reimbursement when agents in these individual mechanistic classes are used in combination for treatment of various cancers. Finally, we’ll touch on whether next generation agents such as dual functioning antibodies and bi-specifics will obviate the need for high cost combinations and how those treatments will impact the cost of care in oncology in the future.

You are invited to join Defined Health for a collegial, in-depth discussion with our panelists, Drs. Eric Rowinsky and Bruce Feinberg, focusing on the new era of payer management of oncology.