Changing NSCLC Immunotherapy Practice: Data, Formulations, Payers, and Operations

"Changing NSCLC Immunotherapy Practice: Data, Formulations, Payers, and Operations" takes up the question of what could move clinicians toward a different checkpoint inhibitor.

Dr. Cass asks what it would take to change practice patterns and choose a different immune checkpoint inhibitor first.

Dr. Luon begins with data. In the absence of safety or efficacy differences, he says other advantages would carry weight. Subcutaneous formulations could matter if they shorten infusion times and improve turnaround in treatment chairs. Fiscal considerations also play a role, including drug cost, reimbursement from insurers, and the reimbursement tied to the treatment chairs themselves. He does not get deeply involved in the fiscal side. He explains that the more financial decisions are determined by pharmacy and therapeutics committees rather than at the physician or pharmacist level.

Dr. Lynch echoes these points and agrees that Dr. Luon explained them well. Without head-to-head data showing superior efficacy or safety, she believes payer preferences would push her practice toward one regimen or another. Otherwise, her team remains creatures of habit and keeps using a regimen once they are comfortable with it. She also considers operational factors important, though likely secondary to payer considerations.

Dr. Lynch suggests that creative approaches to administration could change the landscape. For example, getting patients out of the infusion center and giving maintenance immunotherapy in a clinic setting might free capacity. Dr. Cass agrees that operational benefit is a big factor, especially when all other things are equal. She adds that the panel will return to this topic, and she does not think some agents are quite there yet.

In "Where NSCLC Treatment Stalls: Staffing, Testing, and Infusion Chair Access," the panel will describe where patients encounter the most friction between diagnosis and treatment.