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    Watch list 2017: Top therapeutic areas

    Cancer and diabetes remain top therapeutic areas for healthcare executives to watch in 2017, but other conditions, such as autoimmune diseases, fatty liver disease and the rarer Duchenne muscular dystrophy are sparking interest in the upcoming year.

    With an explosion of new and combination specialty and other drugs, these areas are ripe for grabbing the attention of managed healthcare. The projected specialty/biotech trend rate for 2017 is 18.7%, according to Segal Consulting.

    “Specialty drugs are the largest driver for all areas,” says Carmelina Rivera, practice leader, West Division Pharmacy, Willis Towers Watson. “It’s where we will feel the most pain, and they will continue to be a problem.”

    Here are some of the latest developments in top therapeutic areas for 2017.

    Oncology

    Heather Morel, chief operating officer, The US Oncology Network, says oncology is a key therapeutic area no matter which way you slice it. She attributes the focus to an aging population—a cohort that cancer is most likely to affect—advances in treatment, early detection, patients living longer and more multi-modal therapies, including surgery, radiation and medication therapies. She says, however, that the biggest cost contributor is hospital care.

    Immunotherapy, a treatment designed to help the body naturally fight cancer, is the big thing in oncology right now—a trend continuing from last year, says Julie Rubin, director of clinical services, CompleteRx, a pharmacy management company. Biologic therapies like nivolumab (Opdivo) and pembrolizumab (Keytruda), commonly referred to in practice as “checkpoint inhibitors” are recent examples of drugs designed specifically for this purpose.

    Immunotherapy is an expensive, incredibly novel set of treatments that have a great impact on survival, Morel adds, pointing out its six indications: non-small cell lung cancer, renal cell carcinoma, melanoma, Hodgkin’s lymphoma, head and neck cancer and urethral cancer (bladder cancer).

    “Historically, if you had breast cancer, we treated you for breast cancer, but now we’re going way beyond that looking at how all of the immune pathways work and how drugs can be used to manipulate those pathways to therapeutic advantage. We’re developing biomarkers that allow us to identify patients who will be most likely to respond well to immunotherapies,” Rubin says. “Not all cancers look alike so there are going to be more granular options.”

    Next, she says, it’s expected that the FDA will approve immune checkpoint inhibitors as a first-line therapy for more cancer types, which should have a huge impact on disease spread and growth. These inhibitors have been approved only as a second-line therapy for advanced lung and kidney cancers that have not responded to other therapies and as a first-line therapy for advanced, unresectable melanoma, she adds.

    David Lassen, chief clinical officer for Prime Therapeutics, a pharmacy benefits manager, says there is a “rich pipeline” for oncology drugs with unique mechanisms of action and an organic expansion of new indications for existing drugs. He says oral cancer drugs consume 5% of the PBM’s drug costs.

    Up until recently, treatment for bladder cancer has remained the same for decades. Nivolumab received a breakthrough therapy designation in June 2016 and is expected to be approved in March of 2017 for the condition. It already received the designation for previously treated non-small cell lung cancer, advanced melanoma and metastatic cell carcinoma.

    Rivera at Willis Towers Watson says oncology is growing because many new and existing drugs are targeting specific cancers. “Many manufacturers seek one indication to get a drug on the market but once in use, provide evidence of value for other indications,” she says.

    She warns payers and PBMs that they should evaluate pathways to ensure drugs are being used for the right indications. “Pathways drive evidence-based ways to treat patients,” she says.

    Tecentriq (atezolizumab) is another recently approved drug for bladder cancer and is due to hit the marketplace in late 2017 or early 2018. Its price tag will be about $12,500 a month, or about the same as Opdivo.

    Two generics for Gleevec (imatinib mesylate) that treats myelogenous leukemia joined the market in 2016. The cost of brand Gleevec since its approval in 2001 has quadrupled. In anticipation of patent expiry, the average wholesale price (AWP) of Gleevec jumped 45% from January of 2014 ($102,000 per year) to  $148,000 per year today, per Medi-Span database figures.

    And in October 2016, the FDA approved Keytruda as a first-line therapy for non-small cell lung cancer, making this the first-time immunotherapy has been designated as an initial treatment for lung cancer. 

    Another important drug is Lynparza (olaparib), a new drug treatment for women with advanced ovarian cancer associated with defective BRCA genes, as detected by an FDA-approved test. “The approval constitutes the first of a new class of drugs for treating ovarian cancer,” Morel says.

    In addition, Mylan N.V, and Biocon Ltd. submitted a biologics license application for a proposed trastuzumab biosimilar to Roche’s Herceptin treating certain HER2-positive breast and gastric cancers.

    Next: Diabetes

     

    Mari Edlin
    Mari Edlin is a frequent contributor to Managed Healthcare Executive. She is based in Sonoma, California.

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    • perfectukc@------.com
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    • perfectukc@------.com
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    • charlesxavi096@------.com
      Hello, My Name Is Charles Xavi i am an admiral in the American Navy i want to tell you my testimony of how i was cured of HERPES by DR IVIE i had been affected by this illness for the past 8 years and i had been up to many hospitals and clinics i even tried a surgical procedure but it yielded no results so i heard of DR IVIE from friend who has been helped by him and i decided to try him out although i was afraid of scam but i know all men are not the same and i tried his herbal medicine to my greatest surprise he was able to cure me within 2 weeks and then i had my health back and i want to refer you to him through this contacts PHONE NUMBER:+2348114173124 WHATSAPP:+2348134357220 EMAIL ADDRESS: [email protected] and then he also has medicine for the following illnesses *HIV1/2 *SYPHILIS *LOW SPERM COUNT *STROKE *CANCER *OBESITY *KIDNEY PROBLEMS. you can contact me for verification on facebook Charles Xaxi
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    • MIZEXNELSON@------.com
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    • suzpatrick1@------.com
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    • suzpatrick1@------.com
      Hello my dear viewers,I am Suzan Patrick, i will say to the world to celebrate with me on this numerous testimony, i never believe i could ever get rid of this horrible disease until one fateful day,my story and appreciation goes to Dr.Bude the powerful great doctor that help me to cure my HIV/AIDS disease from my life,he is truly a truthful man with high herbs power's he uses on saving people's life, just a few days back i came in contact with Dr.Bude emails which many individuals have testify so much about of his kind work, so i decided and contacted him quickly because the disease was almost at the last minute of taking my life, i have tried all remedies from several physicians from hospitals but none could help me apart from Dr.Bude who finally cure my HIV/AIDS disease, i was amazed and overwhelmed when the doctor confirmed me negative in the same hospital i have been before,i wish to anyone that is sick today and want healing to please contact this doctor ([email protected]) so if you have any problem HIV, HERPES, CANCER, ALS,HEPATITIS B, DIABETIC,or call +2349035820114.
    • suzpatrick1@------.com
      Hello my dear viewers,I am Suzan Patrick, i will say to the world to celebrate with me on this numerous testimony, i never believe i could ever get rid of this horrible disease until one fateful day,my story and appreciation goes to Dr.Bude the powerful great doctor that help me to cure my HIV/AIDS disease from my life,he is truly a truthful man with high herbs power's he uses on saving people's life, just a few days back i came in contact with Dr.Bude emails which many individuals have testify so much about of his kind work, so i decided and contacted him quickly because the disease was almost at the last minute of taking my life, i have tried all remedies from several physicians from hospitals but none could help me apart from Dr.Bude who finally cure my HIV/AIDS disease, i was amazed and overwhelmed when the doctor confirmed me negative in the same hospital i have been before,i wish to anyone that is sick today and want healing to please contact this doctor ([email protected]) so if you have any problem HIV, HERPES, CANCER, ALS,HEPATITIS B, DIABETIC,or call +2349035820114.
    • clifffordjones889@------.com
      Well done sir. for helping millions of people around the globe to know that you are there to save them. I'm also very grateful to have met you. when i have suffered Diabetes type 2 for more than 8years and also visited several places and finally found you are the very stage of giving up. i will appreciate when i some people testify of how you have cure theirs HIV aids. Herpes disease. Hepatitis B. High blood pressure. arthritis. brain disease. multiple sclerosis and so on. when i went through all this different testimony. and i knew i was at my final place to be cured and when i emailed him on his email:[email protected] and he wrote back after so few minutes. telling me i will suffer no more once i get his medicine and use it. i will see the wonderful work of his herbal herbs. i beckoned on his words and gave him what he needed to prepare my cure and he sent to me and told me how to take it and should go and test my self after the last day. which i did and my result was very overwhelming. if there is so many herbal doctors are out there like Dr Okusu. the world will be in a better hand. contact him today if you need help like i did. on his Mobile:+2349037835860 or his email:[email protected]
    • clifffordjones889@------.com
      Well done sir. for helping millions of people around the globe to know that you are there to save them. I'm also very grateful to have met you. when i have suffered Diabetes type 2 for more than 8years and also visited several places and finally found you are the very stage of giving up. i will appreciate when i some people testify of how you have cure theirs HIV aids. Herpes disease. Hepatitis B. High blood pressure. arthritis. brain disease. multiple sclerosis and so on. when i went through all this different testimony. and i knew i was at my final place to be cured and when i emailed him on his email:[email protected] and he wrote back after so few minutes. telling me i will suffer no more once i get his medicine and use it. i will see the wonderful work of his herbal herbs. i beckoned on his words and gave him what he needed to prepare my cure and he sent to me and told me how to take it and should go and test my self after the last day. which i did and my result was very overwhelming. if there is so many herbal doctors are out there like Dr Okusu. the world will be in a better hand. contact him today if you need help like i did. on his Mobile:+2349037835860 or his email:[email protected] or visit his website:https://drokususolutiontem.wixsite.com/dr-okusu
    • Anonymous
      Hello, I am so happy that is why i take it upon my self to broadcast about Dr Abai, He is a great Herbal doctor enrich herbally by God he cured me of HERPES disease. He has done great research on herbal cure for deadly diseases and he is very able to cure many deadly diseases such as HERPES, HEPATITIS, LASSA FEVER, GONORRHEA, HIV/AIDS, LOW SPERM COUNT, MENOPAUSE DISEASE, EPILEPSY, ASEPSIS, Gonorrhea/Staphylococcus, Weak ejaculation, Weak erection etc. He can also help you get your ex lover back. Dr Abai Natural Herbal Medicine is the best, He cured me and my partner of one of the above deadly disease and we are completely negative now without any side effect i guarantee that you will get your problem solved with Dr Abai Natural Herbal Medicine, visit Dr Abai website: drabaiherbalcure.webs.com and contact him through his WHATS-APP NUMBER +2348156769001, or contact him via email, [email protected]
    • beckettasheley@------.com
      Hello, I am so happy that is why i take it upon my self to broadcast about Dr Abai, He is a great Herbal doctor enrich herbally by God he cured me of HERPES disease. He has done great research on herbal cure for deadly diseases and he is very able to cure many deadly diseases such as HERPES, HEPATITIS, LASSA FEVER, GONORRHEA, HIV/AIDS, LOW SPERM COUNT, MENOPAUSE DISEASE, EPILEPSY, ASEPSIS, Gonorrhea/Staphylococcus, Weak ejaculation, Weak erection etc. He can also help you get your ex lover back. Dr Abai Natural Herbal Medicine is the best, He cured me and my partner of one of the above deadly disease and we are completely negative now without any side effect i guarantee that you will get your problem solved with Dr Abai Natural Herbal Medicine, and contact him through his WHATS-APP NUMBER +2348156769001, or contact him via email, [email protected]
    • Anonymous
      i want to share this great and wonderful testimony to the general public on how i got cured from my sickness called (HEPATITIS B) by DR OGUN healing herbal medicine , I have been suffering from (HEPATITIS B) for good 6 years now and I was almost going to the end of my life due to the constant pain, especially in my LIVER . all I have in my mind is let me just give up because life was no longer intestine to me any more but I just pray to God every day to accept my soul when ever I die, luckily to me , my kid sister ran to me that she found a doctor in the internet who can cure (HEPATITIS B, HERPES,CANCER, and HIV/AIDS ) she helped me out on everything, the great Dr OGUN only ask for my Details and some items , so that he can prepare a Herbal medicine for me and send it to me in my country , which i did.. so after two days of getting the medicine and taking it as prescribe to me from him , I started getting more stronger my blood started flowing normally , i started experiencing changes all over my Body as the great DR OGUN assured me that i should go for medical check up that i have been cured, so after some time i went to my doctor to confirmed if i have be finally healed , behold it was TRUE and i was very Happy ,so if you have HERPES , HEPATITIS B ,CANCER , HIV/AIDS or any kind of sickness YOU HAVE , you can contact him and, any illness get cured, i advice you all to contact himon Via mail at ([email protected]) whatsapp number +2349071799626 Good luck.
    • perfectukc@------.com
      I Am Here Again To Say A Big Thanks To Dr.Sebi Fori Making Me A Complete woman Again, I Was Infected With Herpes For 5 Years I Have Been Seriously Praying To God And Searching For Cure. I Came Here Last Month To Search For Solution To My Problem And I Saw A Comment Of People Talking About Different Doctors And God Directed Me To Choose Dr.Sebi And I Contacted Him, He Sent Me A Medicine And Directed Me On How I Will Take The Medicine For 7 Days, I Did So And Went For A Test And My Result Came Out As Negative. I Am So Happy, I Shared Tears Of Happiness And I Have Taken It Upon My Self To Always Testify About How God Used Dr.Sebi To Solve My Problem. I Am A Clean woman Now, Without Any Virus If You Are Infected With Any Disease Like HIV, AIDS, CANCER HERPES Or Any Other Disease You Can Also Be Happy Like Me By Contacting Dr Sebi Through His Email: [email protected] Or Whatsapp +2348153863900
    • UBM User
      Unbeleivable that they are still missing the mark on where healthcare should focus resources and it is mental health to include drug and alcohol addiction, depression, bipolar disease, ADHD, ADD. They are repeating the same mistakes because for a high of all these disease processes they are choosing to pour money in research into have their beginnings and cores in the mental health. Obesity for many is sugar addiction, food addiction and obsessive compulsive behavioural disorders. All this will do is bandaid the problem and I doubt if even it does that much good. Causes and conditions need to be the center of these conversations in medical fraternity.
    • UBM User
      Unbeleivable that there is such a focus on the conditions and not the causes. We are still missing the mark on where healthcare should focus resources and it is in mental health to include drug and alcohol addiction, depression, bipolar disease, ADHD, ADD. We are repeating the same mistakes vy not addressing behavioural health because for a high percentage of the disease mentioned are caused from underlying mental health problems. It appears we are choosing to pour money in research of the samne things to no avail. Instead we should pour it into mental health. Obesity for many is sugar addiction, food addiction and obsessive compulsive behavioural disorders. All this will do is bandaid the problem and I doubt if even it does that much good. Causes and conditions need to be the center of these conversations in medical fraternity.
    • essayreviews123@------.com
      You have shared some useful updates here. It will help to know about the oncology department and cancer patients are waiting for better medicines to cure their diseases. Essay writing service

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