(333) Opportunities to improve care in HER2-positive gastrointestinal cancers: recommendations from payer and oncologist regional forums

Background: : Gastroesophageal adenocarcinoma (GEA) and biliary tract cancers (BTC) impose a significant burden on patients with gastrointestinal cancers. Managed care professionals desire more awareness of disease severity and have limited knowledge of evidence-based treatment and biomarker testing recommendations, contributing to gaps in coverage policies.

Objective: : To identify opportunities and develop actionable recommendations by analyzing insights on clinical evidence, biomarker testing, multidisciplinary care, and health plan utilization management strategies for HER2-positive gastrointestinal cancers, gathered through collaborative discussions between oncology specialists and managed care decision makers.

Methods: : Three virtual forums were conducted across the South, North, and West U.S. regions in January and February 2025. Participants provided quantitative insights through polling and engaged in discussions to identify opportunities and recommend strategies to improve patient care.

Results: : Insights from 27 participants (14 managed care professionals, 12 oncology specialists, 1 patient) highlighted key challenges in managing HER2-positive GI cancers, including insufficient biomarker testing guidance, limited payer awareness of clinical trial data, and inconsistent coverage policies. Polling showed top collaboration opportunities in guideline-directed treatment (33.3%), biomarker testing alignment (25.9%), and targeted therapy coverage (25.9%). Major gaps included lack of testing guidance (53.8%) and limited awareness of trial data and therapy costs (50% each). Developing HER2 testing and treatment guidance was the most effective strategy (63.0%) to address known barriers in HER2-positive GI cancers.

Conclusions: : Open communication between managed care professionals, oncology specialists, and a patient proved to be an effective approach for identifying treatment barriers and providing recommendations for payer strategies with HER2-positive GI cancers. The insights highlight that informed collaborative interactions can inform meaningful improvements in payer utilization management strategies in oncology.

Sponsorship:: Jazz Pharmaceuticals