Understanding Step Edit Requirements in Oncology Care
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What happens when payer requirements begin influencing oncology treatment sequencing before therapy even starts?
Step edit policies are becoming increasingly common across oncology care, creating new considerations for practices navigating access to Bruton’s tyrosine kinase inhibitor (BTKi) therapies.
In this session, Melissa Shimanek, PharmD, BCACP (Rocky Mountain Cancer Centers), will share perspective on how these requirements are showing up across Medicare Part D and commercial plans, along with the operational and clinical implications oncology teams may encounter in practice.
What you’ll learn
- Key differences between step edits, prior authorizations, and other utilization management strategies
- How payer step edit requirements are being applied to BTKi therapy for new patient starts
- Clinical and non-clinical factors that may influence payer-mandated sequencing decisions
- Considerations for navigating treatment access and evolving payer policy requirements within oncology workflows
For additional information or login assistance, reach out to NCODA’s Jonathan Rivera.
