
Episode #17
Who Gets Access? Understanding the New Reality of Cancer Drug Coverage
Are oncology treatments losing their "special status" with payers? In this episode of Value-Based Voices, host Brian Reid, MS , Principal of Reid Strategic and author of the Cost Curve newsletter, sits down with James Chambers, PhD, MSc, MPharm , Professor at Tufts University School of Medicine and Director of the Specialty Drug Evidence and Coverage (SPEC) Database , to examine how payer coverage decisions are shaping access to cancer therapies in the United States. Drawing on nearly a decade of research, Dr. Chambers discusses the growing use of utilization management tools, including step therapy and clinical eligibility requirements, and explains why oncology, long considered one of the least restricted therapeutic areas, is seeing a noticeable increase in coverage limitations. The conversation explores payer variation, the impact of biosimilars and therapeutic competition, and the unique challenges associated with cell and gene therapies. Listeners will gain valuable insights into the complex balance between innovation, affordability, evidence, and patient access that continues to define the modern oncology landscape. #Oncology #DrugCoverage #CancerDrugs #cancer #PatientAccess #HealthcarePolicy Resources & Links • Specialty Drug Evidence and Coverage (SPEC) Database: https://cevr.tuftsmedicalcenter.org/databases/spec-database • Association for Value-Based Cancer Care (AVBCC): http://avbcc.org Connect with our Guests: Brian Reed: https://www.linkedin.com/in/brianbreid/ James Chambers, PhD, MSc, MPharm: https://www.linkedin.com/in/james-chambers-8845752/ Contact Value-Based Voices - Follow AVBCC on LinkedIn - View our podcast lineup - Contact us at info@avbcc.org Thanks for listening!

