As national vaccination rates for the human papillomavirus (HPV) remain low, the University of Texas MD Anderson Cancer Center has united with the 68 other National Cancer Institute (NCI)-designated cancer centers in issuing a joint statement endorsing recently revised vaccination recommendations from the Centers for Disease Control and Prevention (CDC).

The new CDC guidelines recommend 11- to 12-year-old boys and girls receive two doses of the nine-valent HPV vaccine at least six months apart. Adolescents and young adults 15 years of age and older should continue to complete the three-dose series.

“This collaborative effort is a tremendous opportunity to raise awareness of these new recommendations and the importance of HPV vaccination, knowing that most people will be exposed to HPV at some point in their lives,” said Lois Ramondetta, MD, Professor of Gynecologic Oncology and Reproductive Medicine. “We hope that requiring two shots instead of three will make it easier for children to be vaccinated, bringing rates closer to the Healthy People 2020 goal of 80%.”

The CDC reports that incidence rates of HPV-associated cancers continue to rise, with approximately 39,000 new HPV-associated cancers now diagnosed each year in the United States. Although HPV vaccines can prevent the majority of cervical, anal, oropharyngeal (middle throat), and other genital cancers, vaccination rates remain low.

Across the U.S., just 41.9% of girls and 28.1% of boys are completing the recommended vaccine series, according to a 2015 CDC report. In Texas, vaccination rates are even lower, with only 40.9% of girls and 24% of boys completing the vaccine series.

“In the spirit of the White House Cancer Moonshot, we must continue to work collaboratively to take advantage of effective cancer prevention strategies that can save thousands of lives in the future,” said Ernest Hawk, MD, Vice President and Division Head of Cancer Prevention and Population Sciences.

Through its HPV-related Cancers Moonshot Program, established in 2015, MD Anderson has made a commitment to reducing the incidence and mortality of HPV-related malignancies by raising awareness and identifying practical solutions to improve vaccination rates. MD Anderson’s program is a novel organizational model designed to more rapidly convert scientific discoveries into life-saving advances.

“Research indicates several barriers limit acceptance of the vaccine, including inadequate parental education and a lack of strong recommendations from health care providers,” said Ramondetta, who is also co-lead of the moonshot. “As oncologists who routinely witness the devastating effects of these diseases, we urge all pediatricians to recommend HPV vaccinations and prevent their patients from becoming our patients.”

Recognizing the need for collective action to overcome these barriers, NCI-designated cancer centers have organized an ongoing series of national summits to share research findings and discuss best practices for improving vaccination rates.

The current endorsement is the result of discussions from a summit hosted this summer by The Ohio State University Comprehensive Cancer Center–Arthur G. James Cancer Hospital and Richard J. Solove Research Institute. Approximately 150 experts from across the country gathered in Columbus to present research updates and plan future collaborative actions across NCI-designated cancer centers.

Source: The University of Texas MD Anderson Cancer Center; January 11, 2017.

Managed Care’s Top Ten Articles of 2016

There’s a lot more going on in health care than mergers (Aetna-Humana, Anthem-Cigna) creating huge players. Hundreds of insurers operate in 50 different states. Self-insured employers, ACA public exchanges, Medicare Advantage, and Medicaid managed care plans crowd an increasingly complex market.

Major health care players are determined to make health information exchanges (HIEs) work. The push toward value-based payment alone almost guarantees that HIEs will be tweaked, poked, prodded, and overhauled until they deliver on their promise. The goal: straight talk from and among tech systems.

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The surge of new MS treatments have been for the relapsing-remitting form of the disease. There’s hope for sufferers of a different form of MS. By homing in on CD20-positive B cells, ocrelizumab is able to knock them out and other aberrant B cells circulating in the bloodstream.

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Having the data is one thing. Knowing how to use it is another. Applying its computational power to the data, a company called RowdMap puts providers into high-, medium-, and low-value buckets compared with peers in their markets, using specific benchmarks to show why outliers differ from the norm.
Competition among manufacturers, industry consolidation, and capitalization on me-too drugs are cranking up generic and branded drug prices. This increase has compelled PBMs, health plan sponsors, and retail pharmacies to find novel ways to turn a profit, often at the expense of the consumer.
The development of recombinant DNA and other technologies has added a new dimension to care. These medications have revolutionized the treatment of rheumatoid arthritis and many of the other 80 or so autoimmune diseases. But they can be budget busters and have a tricky side effect profile.

Shelley Slade
Vogel, Slade & Goldstein

Hub programs have emerged as a profitable new line of business in the sales and distribution side of the pharmaceutical industry that has got more than its fair share of wheeling and dealing. But they spell trouble if they spark collusion, threaten patients, or waste federal dollars.

More companies are self-insuring—and it’s not just large employers that are striking out on their own. The percentage of employers who fully self-insure increased by 44% in 1999 to 63% in 2015. Self-insurance may give employers more control over benefit packages, and stop-loss protects them against uncapped liability.