Sickle-Cell Trait as a Risk Factor for an Unprovoked Venous Thromboembolism: A Case Report.

In this case report, we examine the increased risk of venous thromboembolism (VTE) in patients with sickle-cell trait (SCT), illustrated by a patient with SCT who developed pulmonary embolism (PE) despite low scores on conventional risk assessment tools. The case prompts both a discussion of risk assessment and management strategies in this population.

A path to improve colorectal cancer screening outcomes: faculty roundtable evaluation of cost-effectiveness and utility.

The American Journal of Managed Care® and Exact Sciences Corporation hosted a roundtable meeting to discuss the impact of colorectal cancer (CRC) screening modalities on improving patient outcomes. The roundtable participants were a diverse panel of experts, including primary care, gastroenterology, and oncology providers; experts in health outcomes research and health policy; and managed care executives with commercial and public payer experience. Participants discussed CRC prevention and treatment strategies, screening modalities and adherence, molecular diagnostics, patient navigation, evaluation of large data sets, managed care, outcomes research, quality improvement, and reimbursement policies. They focused on developing better value-based medical policies and payment procedures, identifying knowledge, practice, and access deficits related to CRC screening. Participants also provided suggestions on how to improve care quality and patient outcomes through effective evidence-based approaches. They also discussed costeffectiveness modeling for CRC screening, specifically the advantages and the real-world limitations of these models.

NCCN Biosimilars White Paper: regulatory, scientific, and patient safety perspectives.

Biologics are essential to oncology care. As patents for older biologics begin to expire, the United States is developing an abbreviated regulatory process for the approval of similar biologics (biosimilars), which raises important considerations for the safe and appropriate incorporation of biosimilars into clinical practice for patients with cancer. The potential for biosimilars to reduce the cost of biologics, which are often high-cost components of oncology care, was the impetus behind the Biologics Price Competition and Innovation Act of 2009, a part of the 2010 Affordable Care Act. In March 2011, NCCN assembled a work group consisting of thought leaders from NCCN Member Institutions and other organizations, to provide guidance regarding the challenges health care providers and other key stakeholders face in incorporating biosimilars in health care practice. The work group identified challenges surrounding biosimilars, including health care provider knowledge, substitution practices, pharmacovigilance, naming and product tracking, coverage and reimbursement, use in off-label settings, and data requirements for approval.

Proceedings adapted from a payor panel.

BACKGROUND: This panel featured four representatives from the healthcare industry and government, offering an opportunity for critical care professionals to pose questions and discuss issues and concerns relevant to anyone caring for critically ill and injured patients today. A brief biography is provided for each panelist. DISCUSSION: The Society of Critical Care Medicine Advocacy Committee recognized that there are not enough opportunities for clinicians and other members of the critical care team to discuss questions or issues with their counterparts on the payor side of providing clinical care. That is, much of the difficulty faced by providers after providing critical care services could be resolved if the channels of communication were opened, and so a payor panel was organized to start the process. CONCLUSION: Each of the panelists provided a prepared statement on issues relevant to critical care, as evident from their respective roles. Specific scenarios and other suggestions regarding payment policy, coding, and quality of care are provided.