Have you heard that the world of cervical cancer therapy is evolving? There are two players who recently stepped onto the field of oncology for the treatment of recurrent, metastatic, or persistent disease. In 2021, FDA approval moved Keytruda® (pembrolizumab) from second-line to first-line therapy in PD-1 positive patients. Tivdak™ (tisotumab vedotin-tftv) also obtained FDA approval as second-line and subsequent therapy in the same space.

Why is the approval of two therapies in the same year significant? Since the 2014 approval of bevacizumab, no new first-line therapy for cervical cancer has hit the oncology market, and prior to bevacizumab, the last new approval in the category was the combination therapy with topotecan and cisplatin in 2006. So Keytruda and Tivdak are possible game-changers for patients!

From 1975-2010, new diagnoses of cervical cancer have decreased by more than 50% due to screening. With the introduction of the HPV vaccine in 2006, there was hope that HPV infection prevention would lead to decreased cervical cancer cases. In 2020, a Swedish study published in the New England Journal of Medicine found that the quadrivalent HPV vaccination was associated with a significant reduction in the risk of invasive cervical cancer. In 2018, there were 293,394 women living with cervical cancer in the U.S. As cervical cancer cases decline, according to SEER data, there were an estimated 14,480 new cases and 4,290 deaths reported in 2021. The total annual medical cost of cervical cancer care is estimated to be $1.6 billion. Due to its move from second to first-line, Keytruda will likely demonstrate a net neutral effect on the budget. A forecasted cost impact model for Tivdak is demonstrated below:

Our nation recognizes April as the Month of the Military Child, celebrating and acknowledging the children of our service members. Through the Adolescent Support and Counseling Services (ASACS) program, overseas middle and high school youth enrolled at Department of Defense Schools have access to in-school counseling and prevention education lessons at no charge. Whether or not ASACS services are available in your area, it’s worth taking a look at the challenges military children often face, and the resources available to support their mental health.

The Challenges Military Children Face

Military children must learn to be resilient because their households may relocate every 2 to 3 years — sometimes overseas and to new cultures. For many kids, this is a difficult challenge. Middle school and high school are particularly challenging ages, where social connections, friendships, and romantic relationships become more important.

A term has been developed to describe children who spend formative years growing up outside their parents’ native culture—Third Culture Kids. Military children often represent this demographic when they relocate to other countries, which can translate into culture shock and create unique challenges that typical American teens may not experience.

In addition to being susceptible to frequent family moves, COVID-19 has impacted everyone across the globe, and our military children are no exception. They faced attending virtual schools in communities where they are already feeling isolated due to being in a new country and community. We have seen mental health concerns like depression, anxiety, and alcohol and drug use increase due to the pandemic, and many parents and students do not often seek help. But here is how they can and should.

Support Services for Overseas Youth

The key to effectively transitioning military children to their new surroundings is working with a counselor on their terms. Magellan Federal delivers the Adolescent Support and Counseling Services (ASACS) program on more than 14 locations in 6 countries.  ASACS is a school and community-based program providing counseling and educational prevention-based services that are confidential for students in grades 6 -12.

Magellan Federal counselors focus on issues unique to military children such as transitioning to new environments, coping with stress and challenges associated with moves, and alcohol and drug prevention. Additionally, our counselors support these young individuals with all the other “typical” issues teens face.

As the demand for mental health services has increased, getting on a waitlist for psychological services is a real challenge for students. So often, many students are ineligible for on-base counseling due to staffing limitations, and off-base options are usually nonexistent or not adequate for English-speaking students. Through ASACS, Magellan Federal provides tailor-made, in-school counseling and prevention education lessons at no charge to overseas middle and high school youth enrolled at Department of Defense Schools. The Magellan Federal staff works with students and teachers to identify an appropriate time so that the student is staying in class as much as possible. Our team develops counseling schedules, ensuring kids receive timely, critical emotional and behavioral support while maintaining academic requirements. Because of our programming, parents do not need to leave work early and drive to accommodate a counseling session, positively impacting family engagement.

It’s important to address the unique needs of military children overseas during formative years, to proactively ease their transition and bolster confidence and resiliency. ASACS services are available to any military ID card holder student and their families. To connect with your regional ASACS counselor contact your child’s school at the front desk or the guidance department or contact Allison Welliver at WelliverAL@MagellanFederal.com to inquire about local services.

Sharon Butler is our leader of people strategies at Magellan Rx Management and is an integral part of our thriving culture. She inspires our teams to use their strengths to overcome challenges and deliver a pharmacy experience unlike any other. We sat down with Sharon to talk about her love of human resources, the current state of the industry, how the pandemic has affected HR professionals and how people make the difference in any organization.

What’s your background, and how did you get into Human Resources?

I love sharing this story because it’s the last place I thought I would be. I grew up in a poor neighborhood in Albany, NY in a family that didn’t value education. It wasn’t until I had the opportunity to attend college later in life that I met so many people who were resetting their path and going back to school after finding themselves in a job that didn’t fulfill them. It was then and there I realized my passion for people and believe there is so much more to illuminate a person if they are exactly where they want to be versus where they can be.

This realization led me to study organizations and leadership, dedicating my career to understanding the power of giving people an opportunity to do great things. There’s not an organization out there that’s great because of something other than people. If you think about it, organizations can’t achieve anything without people driving change.

How do you think your life experiences have shaped your work as a Human Resources professional?

I have learned through personal experience that some of the hurdles in your life are the ones you create and put in your own way. You can do anything if you have the passion and power to do it. You can’t just dream it. A dream isn’t a strategy, it’s the motivation that pushes you forward.

I’ve also learned that your career can have a huge impact on your overall wellbeing.

I have now been with Magellan for 14 years, and I’ve seen firsthand that when you tap into someone’s personal strengths, you unleash an incredible amount of potential within not only yourself, but your team as well. As a leader or manager, placing people in the right seat creates a highway for growth and development.

Our data tells us that we’ve had 455 internal promotions over the last 12 months and that we continue to focus on supporting effective career conversations and encourage every employee to start a conversation. I’ve seen a correlation between employee driven career discussions and success of achieving aspirational goals.

We can’t impact what we don’t measure. We are focused on pulsing engagement and investing in what makes our employees feel valued. Our pulse surveys provide us with data for leaders to use to ensure they are having the impact intended. This is one tool that should be used with a variety of tools to ensure we continue to understand each other regardless of role. These surveys allow us to have impactful conversations to gauge overall organizational wellbeing. Now that we are far more virtual than ever before, we must continue to create connectedness, check in with each other in a variety of ways and respond to the ever-changing climate of our work.

How has the pandemic impacted Human Resources professionals?

HR professionals have really had to stretch outside their comfort zones, beyond the predictable outcomes they are used to. What we’ve all seen happen over the last few years in our communities with regulations, politics, human behaviors and attitudes changing is also happening within organizations. We can’t build a policy to navigate it, we must lean in and care about it.

We have had to consider every perspective to make the right decisions for us as an employer, and to make the right recommendations for employees as one size does not fit all. While some organizations have used this as an opportunity to be defined by their policies, we’ve found that we’re too complex and dynamic to pick one side or another on many points related to the pandemic. The passionate people at Magellan Rx are navigating through every circumstance in the most caring way possible.

These last few years have impacted everyone. Leaders, managers and employees are recognizing the need to practice self-care first before care for others. I’ve been starting my day with MAGIC Mornings, which I’ve recoined for myself ‘Miracle Mornings,’ this practice affords me a margin of time to focus on myself and set my day through exercise, meditative prayer, affirmational writings, gratitude journaling and intention or goal setting. I’ve been doing this for four months now and have noticed a complete shift in how I approach and move throughout my day. I encourage teams and individuals to rethink how they start their days and prioritize their wellbeing to avoid burnout.

What’s your perspective on the Great Resignation?

My observation of what the data suggests is that people are reacting to what adds value to their lives. The notion of an employee leaving their job, and possibly their career, is changing attitudes and expectations. Employees have more of a voice than ever before in what they are willing to do, and not do, for a paycheck. We need to listen.

Do you think organizational culture plays a role in the Great Resignation?

Absolutely. For a long time, organizations have been trying to define an attractive culture with policies and programs like education reimbursement, wellness credits and unlimited PTO. What we are seeing during this Great Resignation is a shift in focusing on employee’s wellbeing and how they are treated. Cultures are formed by how leaders behave and employees feeling truly valued. It isn’t about a program; it’s about behavior.

What we’ve noticed at Magellan is that while our turnover rate has inched up, it isn’t at the national average, and we are still able to attract talent to our positions. We believe that this is a direct reflection of our strong culture of caring people who are leveraging their strengths in their everyday work and modeling positive behaviors.

What do you think is needed to create a thriving culture? 

First and foremost, authenticity and accountability from leaders. Then, you must focus on people because people make the difference. You do this by unlocking their strengths and unleashing their potential. Mix that with a little fun, and you’ve got a solid foundation to build a thriving culture.

Our secret sauce at Magellan Rx is that we don’t have a one size fits all strategy for any person. We start by focusing on an individual’s core strengths, which allows leaders and employees to deploy very tailored career development, growth performance and learning opportunities.

How do you think teams have remained resilient these last few years while some haven’t?

I think there is a lot of masked resiliencies happening right now – pushing through versus truly evolving through the challenges – which can be very dangerous because it means we are closer to burnout than we know.

You can tell resiliency is occurring when you are faced with the next challenge, and it energizes you because you learned from the last challenge and are able to use your learnings to evolve through the next obstacle.

For those that haven’t, do you have any advice?

There is no time like the present to pause and take inventory of all the things that you have pushed through, map those things to what you have learned, and really understand the impact of your work. When you are focused solely on what’s ahead and what’s not done, you deprive yourself the opportunity to pause and learn. Look back at the path you’ve laid and the wake you’ve made.

What should organizations do to invest in their people?
Create safe spaces and support systems for employees to stretch, learn and grow in their careers.

Think about their world, their environment and what they are trying to transform. Don’t forget to ask their opinion on what great looks like and listen, because at the end of the day it’s the people who make the difference in any organization.

Food security requires ongoing access to nutritious meals. This is fundamental to a family’s overall health and wellness. With today’s economic challenges, more families are facing financial hardships, making it difficult to access healthy meals and maintain a high level of food security. In this webinar, Magellan Federal experts will discuss the impact of food insecurity on civilian and military families, and provide practical guidance on connecting families with viable resources.

Magellan Federal experts hosted a webinar to:

• Properly identify food insecurity on the hunger spectrum
• Acknowledge food insecurity prevalence across civilian and military families
• Discuss the stigma associated with help-seeking behavior
• Distinguish casual inquiry versus formal screening of food insecurity
• Q&A session

Webinar Replay

To learn more about this topic, watch the replay today! Be sure to download the additional resources:

• Casual Inquiry Questions
• CORE Approach Guide
• Food Insecurity Resource List
• White paper

Read More

You can also read a personal account from one of the webinar hosts in the Tackling Food Insecurity in the Military Community article.

This article was co-authored by Nikki Walker

In April, we celebrate the children of active duty service members. Whether you work in a school, child development center, or youth center, there are many engaging activities available to highlight their unique strengths as military kids and celebrate what makes their military families special.

Here are some suggested activities for April’s Month of the Military Child:

• Spirit Week: For one week in April, conduct military-themed activities each day of the week. You can plan a spirit week around Purple Up Day (April 15^th), along with additional military theme days, such as Red, White, and Blue Day, Camouflage Day, Military Hat Day, and Military Show & Tell Day.
• School Morning Announcements: Ask students to participate in morning announcements by reading a military fact or a military trivia question. Provide students the fact or trivia question the day before to allow students to practice at home. To ease students’ nervousness, offer to stay with the student during the announcements as friendly support.
• Arts & Crafts: Engage students in creating posters and drawings about military life or ask them to identify positive traits about military children (e.g., brave). Display artwork on bulletin boards or blank walls. Show students how to create and design paper parachutes, using coffee filters and pipe cleaners. If your site has a calendar of events, ask if you can offer an arts & crafts activity during a special event.
• S. Map Bulletin Board: Find a map of the United States and post it on a bulletin board. Ask students to find where they lived prior to living in their current home. Use different colored push pins or thumbtacks to mark the cities and states. If serving children of multiple ages, select a color to represent each age group/grade level and create a map legend for each color. You can include staff who are service members themselves or are military spouses, on the map as well.
• Military Board Game: Create a board game with questions that highlight various aspects of military life (e.g., deployment, moving). Use popular board games as inspiration for your game’s design (e.g., Candy Land).
• Special Guests: If your site allows outside visitors, invite service member parents to come and eat lunch with their children one day in April. You could also request the installation’s military band or chorus to come and perform for the children.

If you are a part of a military community, you can see what events are planned near you by searching for events with the base Public Affairs office, Military Family Readiness Centers, Department of Defense Dependent School admin offices, and on-base Child Development Centers.

Activities may also be listed at Morale Welfare and Recreation (MWR) Centers at military installations overseas and stateside. The official sites for all these organizations often post calendars of upcoming events and programs.

Whether your organization is military-associated or not, it’s important to honor the sacrifices made by military families worldwide and emphasize the experience of military children serving at home and overseas.

Additional Articles on Supporting Children:

• How can I help my children during COVID-19?
• A pandemic’s impact on children’s mental health
• ADHD: Helping Your Child Get the Most From School
• Bullying: Building a Child’s Self-Esteem

Haita Makanji, vice president, clinical strategy and innovation supporting the specialty division of Magellan Rx Management, has worked for MRx for nearly 10 years, where she has focused on helping to support payers as they navigate the pharmacy space. Makanji, who is based out of Massachusetts, leads a team of highly trained pharmacists and experts in development and implementation of clinical solutions for customers in various high-cost specialty conditions across both the medical and pharmacy benefits including but not limited to cancer, hemophilia, and rare diseases. Her team focuses on utilization management, dose optimization, care management and technology-based programs for commercial, Medicare and Medicaid patients across the country. Continue reading to learn more about the innovative projects Makanji and her team are working on in the pharmacy space:

What sort of projects are you currently working on?

I’m passionate about working closely with payers and supporting them as they navigate the evolving landscape of new, expensive treatments, while also helping to deliver the highest quality of care to patients. For exceedingly high-cost specialty conditions, our emphasis is always on value through delivering clinical solutions that offer the most appropriate treatment to patients while combating the rising spend payers are facing.

For example, a recent project centers on a one-of-a-kind solution for payers focused on precision medicine in the oncology space, which is the highest-spend category for specialty drugs on the medical benefit for over 10 years. This is an exciting, next-generation pharmacy initiative where we will be combining genomic testing with drug selection for providers who treat cancer patients and meeting a critical need for payers who are looking for more complete solutions on both the medical and pharmacy benefit.

In 2021, we launched a comprehensive high-cost therapy program to provide enhanced utilization management strategies and case management referral for ultra-rare diseases. Payers often struggle to identify specialized experts, either internally or within their network, so our ability to leverage our MRx Expert Clinical Network of more than 175 key opinion leaders who practice various specialties, combined with our team of experts, offers a unique opportunity to support treatment decisions that leads to better health outcomes.

Why is Magellan the best place for these projects?

I’m proud to work for an organization that has a deep understanding of medical and pharmacy trends and a history of pioneering industry-first solutions for specialty drug management. With 17 years of experience in managing specialty conditions, we are unique in the marketplace.  Our customers routinely expand their collaborations with us because we continuously elevate our suite of solutions with innovative and forward-thinking approaches. Our mission is to help patients live healthy, vibrant lives and we accomplish this by ensuring that the right patients receive the right therapies at the right time.

What are your thoughts on the culture here at Magellan? How has that culture impacted your work?

We have a family-oriented culture where we collaborate and have a true understanding and trust of each other. Magellan fosters an environment that encourages open, honest feedback in all teams. Magellan also provides employees with the opportunity to challenge themselves and embrace new opportunities. This is imperative as we innovate and bring new programs to the market.

What exciting trends are you noticing in the healthcare industry? In what direction do you see healthcare going and what lessons are there to learn from other industries that can be applied to healthcare?

I’m energized by how quickly our industry is adapting to new technologies and advancements in the delivery of healthcare. Particularly in digital health solutions with the shift towards value-based care strategies and the pivot to personalized medicine.

The market will need to be laser-focused on providing clinically appropriate, personalized care at the lowest cost for both payers and patients.

One lesson we can take from other industries is the ability to be nimble and flexible. Disruptors in every sector of healthcare are bringing new offerings directly to consumers in the hopes that simplicity and transparency will cultivate consumer loyalty. We can take advantage of the availability of data and deployment of new technologies to respond quickly to changing market dynamics and the needs of our customers and their unique patient populations. While we have a proven track record and hundreds of successful case studies across our suite of solutions, it’s important that we never stop innovating!

In the midst of a national children’s mental health crisis, families are doing the best they can to assess how well their children are coping with increased stressors from the pandemic and figure out what to do if it seems they are having difficulty. Psychotropic medication is among the options to consider when indicated. However, over the years, children and adolescents with behavioral health challenges have generally been prescribed an alarming number of medications. This high prescription rate, paired with questions about the appropriateness of the diagnoses used to justify the drugs’ use, has raised many concerns among families, practitioners, and youth advocates alike. Prescribing medication to treat children’s mental health conditions can be appropriate, but parents, caregivers, and practitioners need to fully understand the risks and monitor their use.

In this post, we will contemplate these issues and draw on knowledge from Magellan Healthcare’s recently updated clinical monograph, Appropriate Use of Psychotropic Drugs in Children and Adolescents, which highlights evidence-based research on the use of psychotherapeutic agents in children and principles for optimal children’s psychopharmacotherapy practice.

Considerations for treatment with medication for children’s mental health

When families consider medication as an option to treat a child’s mental health condition, Magellan’s monograph offers the following to contemplate:

The practice of evidence-based medicine for children and adolescents requires health professionals and child welfare advocates to engage in a careful assessment of the risks and benefits of using psychopharmacological treatments while addressing serious concerns of over-diagnosis and overtreatment in this vulnerable population. As attention to these issues has grown, a strong undercurrent of anxiety and confusion exists about whether the use of psychotropic agents to remove undesirable impulses and behaviors of children may affect their neurological development, personality, character, and temperament. Suspicions exist that over-diagnosis and overtreatment are driven by a supply-induced demand created by pharmaceutical companies and medical providers.

Addressing the shortage of children’s mental health professionals

Another consideration for parents and families is the shortage of professionals providing specialized mental healthcare services for children. Mental healthcare for children is often initiated at the pediatrician’s office, Magellan’s monograph provides the following insights:

Given the significant national shortage of child psychiatrists, there remains a realistic need to rely on primary care clinicians to perform screenings of children for mental health disorders and treat uncomplicated ADHD, anxiety, or depression. However, the problem of follow-up care and ongoing monitoring of mental health problems in pediatric primary care is a matter that must be addressed.

Principles for optimal use of medication to treat children’s mental health

The American Academy of Child and Adolescent Psychiatry published the Practice Parameter on the Use of Psychotropic Medication in Children and Adolescents to promote the appropriate and safe use of medication to treat children’s mental health by emphasizing the best practice principles that underlie medication prescribing. These principles, as highlighted in the monograph, are as follows:

Principle 1: Before initiating pharmacotherapy, a psychiatric evaluation is completed.

Principle 2: Before initiating pharmacotherapy, a medical history is obtained, and a medical evaluation is considered when appropriate.

Principle 3: The prescriber is advised to communicate with other professionals involved with the child to obtain collateral history and set the stage for monitoring outcomes and side effects during the medication trial.

Principle 4: The prescriber develops a psychosocial and psychopharmacological treatment plan based on the best available evidence.

Principle 5: The prescriber develops a plan to monitor the patient, short and long-term. Clinicians should use standardized, objective measures to measure the efficacy of pharmacologic interventions.

Principle 6: Prescribers should be cautious when implementing a treatment plan that cannot be appropriately monitored.

Principle 7: The prescriber provides feedback about the diagnosis and educates the patient and family regarding the child’s disorder and the treatment and monitoring plan.

Principle 8: The child’s assent and parent’s consent are completed and documented before initiating, and at important points during, medication treatment

Principle 9: The assent and consent discussion is focused on the risks and benefits of the proposed and alternative treatments.

Principle 10: Medication trials are implemented using an adequate dose and for an adequate duration of treatment.

Principle 11: The prescriber reassesses the patient if the child does not respond to the initial medication trial as expected.

Principle 12: The prescriber needs a clear rationale for using medication combinations.

Principle 13: Discontinuing medication in children requires a specific plan.

We encourage you to learn more about medication to treat children’s mental health in the full clinical monograph and Understanding and Meeting the Needs of Children and Adolescents at High Risk: Foundations of a Model, which highlights evidence-based prevention and treatment approaches for problematic behaviors and various types of behavioral health challenges in children and adolescents, here. Both provide valuable insights and information to support the critical behavioral health needs of our nation’s children.

This article is part two of our discussion about the impacts on mental health and the war in Ukraine. Click here to read our tips for adults. 

Information on the war is continually changing. The youngest viewers, children, are watching and may experience the fear and stress associated with images from the war in Ukraine.

To add to the stress and concern, this global crisis comes on the heels of being exhausted and socially isolated by the pandemic. The following are some tips to help children that are impacted or stressed by the Ukraine situation.

Listen to children. Children hear and see things. This can be especially frightening if they have a parent deployed. It is important not to force them to talk. Find alternative ways to communicate with children such as drawing or playing with toys.

Calm conversation. It is important for parents to be calm when talking to their children about Ukraine. Parents need to be careful not to be the source of a child’s anxiety. Parents are encouraged to check-in and ask their children how they are doing.

Answer children’s questions. Support and acknowledge what your child is saying and their potential fears. Reassure your child but do not make unrealistic promises. Answer questions and help in separating fact from fiction.

Provide support. Do not let children watch the images of violence on television. Children who have experienced trauma may need extra attention. Some children may not want to talk about the event. It is okay if they would rather play or be outside.

Limit exposure to media and social media. Limit the exposure to graphic violence on media. For older children, watch the news with the child and then talk about how the child is reacting to what they are seeing.

Maintain a normal routine. Encourage the daily routines such as homework, sports, activities to continue.

Watch for changes in mood. Some children show their reactions in nonverbal ways. Watch for anger, physical symptoms, mood changes, or withdrawing from usual activities and conversations.