Thank you, Lisa for sharing the issue with medicare & the 480mg dosing of Opdivo. I will need to bring this to the attention of my financial folks as they have been clearing a bunch of our patients during the past week-mostly medicare pts.

Regarding the time extension, for the majority of our pateints, they were prepared & looking forward to the change in schedule. During trials we did not (are not seeing) any more appreciable side effects (anecdotal).
We really push alot of education up front with the empahasis on pts “calling at the onset of any changes”.
We empahsize that this is the most important job that they are responsible for and we are in the best position to help when we are aprised of any symptomatic changes.
I think this topical issue directly relates to health literacy (current hot topic), and our assessement of each individual patients understanding and potential needs. Our own health literacy proficiency as nurses comes into play with identifying the patient who may not be as adherent vs the one who may be very nervous and need more support have different needs and we as nurses are pretty great at identifying the pt who may need that interim follow up.

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