National Harbor, MD—Multiple benefitswere observed for contralateral prophylactic mastectomy (CPM), including cost-effectiveness, in studies presented at the 2010 ASCO Breast Cancer Symposium by investigators from the Mayo Clinic, Rochester, MN. CPM not only reduced the risk of breast cancer in [ Read More ]
Milan—Because the toxicity profiles for the 3 monoclonal antibodies used in treating metastatic colorectal cancer (mCRC) differ, there are substantial differences in the cost of treating side effects, according to research presented at the 35th ESMO Congress. “The cost of [ Read More ]
The floodgate has opened for molecularly targeted antitumor agents, and with each novel compound the cost of treating cancer soars ever higher. Approval by the US Food and Drug Administration (FDA) is usually based on a delay in disease progression, [ Read More ]
Some molecularly targeted agents are proving to be less effective, not more so, when administered earlier in the disease course. Researchers say this is counterintuitive, because advanced disease is associated with treatment refractoriness, and cancer agents will typically perform better [ Read More ]
February 2011, Vol 2, No 1 - Uncategorized
San Antonio, TX—It turns out that for women with HER2-overexpressing breast cancer, treatment with trastuzumab (Herceptin)—which cuts the risk of recurrence by half—may be just the beginning. At the annual San Antonio Breast Cancer Symposium, several key studies evaluated [ Read More ]
February 2011, Vol 2, No 1 - Uncategorized
San Antonio, TX—Higher prescription copayments contribute to early discontinuation of aromatase inhibitors (AIs) for breast cancer, according to a study presented at the annual San Antonio Breast Cancer Symposium. “Noncompliance is a problem, even among patients with pharmaceutical plans,” said [ Read More ]
San Francisco, CA—The optimal treatment of early-stage colorectal cancer (CRC) is not well-established. At the 2011 Gastrointestinal Cancers Symposium, several studies presented involved molecular assays that stratify patients according to a tumor’s genetic profile. 18-Gene ColoPrint Assay Outperforms Clinical Variables [ Read More ]
San Francisco, CA—Advances in molecular profiling of colorectal cancer (CRC) are leading to an explosion in novel agents that target pathways above and beyond the epidermal growth factor receptor (EGFR). Joseph Tabernero, MD, Director of Clinical Research, Vall d’Hebron Institute [ Read More ]
San Francisco, CA—For patients with gastrointestinal stromal tumors (GIST) being treated with sunitinib (Sutent), the development of hypertension during treatment was associated with a survival benefit, said Suzanne George, MD, Dana-Farber Cancer Institute, Boston, at the 2011 Gastrointestinal Cancers Symposium. [ Read More ]
San Francisco, CA—Two thirds of patients with advanced gastrointestinal stromal tumor (GIST) whose disease progressed on available therapies achieved disease control with sorafenib (Nexavar), according to Nicholas P. Campbell, MD, of the University of Chicago, who reported results of a [ Read More ]
Orlando, FL—Lung cancer studies made news at the 2011 American Association of Cancer Research annual meeting. Research groups identified potential new therapeutic targets; developed a biomarker panel to detect lung cancer in nonsmokers and, possibly, in early-stage mesothelioma; and outlined [ Read More ]
Nearly 2% of patients with cancermay file for personal bankruptcy 5 years after their diagnosis, according to researchers from Fred Hutchinson Cancer Research Center in Seattle who presented their data at the 2011 American Society of Clinical Oncology (ASCO) Annual Meeting. [ Read More ]
Chicago, IL—Whole genome sequencing was the topic of a session at the 2011 ASCO annual meeting in which specialists discussed the implications of “genome-forward medicine” in lung cancer.
This entails “how to get to the nature of tumors and their heterogeneity,” said Elaine Mardis, PhD, Codirector of the Genome Institute at Washington University, St Louis, MO. Next-generation sequencing, she said, will eventually guide treatment decisions.[ Read More ]
Comparing the Value of Denosumab versus Zoledronic Acid in Preventing Cancer-Related Skeletal Events
Chicago, IL—Two agents are vying to be the preferred option for bone protection in patients with cancer—the blockbuster drug zoledronic acid (ZA; Zometa, Reclast) and the newer drug denosumab (Prolia), which was ap - proved last year for the prevention of skeletal-related events (SREs) in patients with cancer.[ Read More ]
Accountable care organizations (ACOs) are a prominent part of the Patient Protection and Affordable Care Act (ACA), better known as the healthcare reform. [ Read More ]
Dose-monitoring programs for oral chemotherapy drugs can reduce wastage and reduce the risk of serious adverse effects associated with these drugs. This translates into cost-savings for patients and for payers of >$2500 per patient, suggested researchers from Walgreens Specialty Pharmacy.
The company developed an oral chemotherapy cycle management program (CMP) that offers a “split-fill” option and close monitoring of pa - tients for adverse events. This is an optional program, and payers can elect to participate.[ Read More ]
An analysis of payer and provider responses to key clinical information presented at the ASCO 2011 annual meeting offers a glimpse of the oncology landscape shared by oncologists and health plans.
The research was conducted by Xcenda (AmerisourceBergen Consulting Services), a specialty pharmaceutical research and consulting firm. The full study, led by Loreen M. Brown, MSW, Vice President of Xcenda’s Access and Reimbursement Consultancy, was published online in the Oncology Business Review (www.oncbiz.com; July 2011).[ Read More ]
Ongoing efforts to screen asymptomatic persons for pancreatic cancer have been unsuccessful, but targeting persons at high risk for the disease appears to be clinically effective as well as cost-effective.
Researchers have combined the use of a serum biomarker, CA 19-9, and endoscopic ultrasonography to create a screening protocol for persons at risk for the malignancy on the basis of family history and age and reported their results in the July issue of Gastro - intestinal Endoscopy (Zubarik R, et al. Gastrointest Endosc. 2011;74:87-95).[ Read More ]
Medicare may be paying for more screening colonos - copies than are warranted for the prevention of colorectal cancer (CRC), according to a new study (Goodwin JS, et al. Arch Intern Med. 2011 May 9 [Epub ahead of print]). [ Read More ]
Stockholm, Sweden—The cost of cancer therapies is a growing concern not only for patients but also for providers and payers. Addressing the cost burden for those involved in cancer care is becoming a priority that cannot be avoided with the growing role of targeted therapies in oncology.
Cost Nearly Doubles in Metastatic Breast Cancer
A study presented by Melissa Brammer, MD, Medical Director, Genentech, San Francisco, CA, shows that complications associated with treating cancer essentially double the cost of treating metastatic breast cancer.[ Read More ]
Stockholm, Sweden—An investigational alpha-pharmaceutical not only prevented skeletal-related events (SREs) in patients with prostate cancer with bone metastases in a phase 3 study presented at the 2011 European Multidisciplinary Cancer Congress, but it also improved overall survival. [ Read More ]
Stockholm, Sweden—Two expensive drugs may be better than 1 for maintenance treatment of advanced non– small-cell lung cancer (NSCLC), according to a study at the 2011 European Multidisciplinary Cancer Congress. Adding pemetrexed (Alimta) to bevacizumab (Avastin) maintenance therapy reduced the risk of disease progression in the phase 3 AVAPERL trial.[ Read More ]
Stockholm, Sweden—The indefinite use of bevacizumab (Avastin) in patients with re lapsed ovarian cancer got another boost at the 2011 European Multi disciplinary Cancer Congress, with a subanalysis of the phase 3 OCEANS trial showing consistent benefit across subgroups. The main finding of OCEANS, which was reported earlier at the 2011 American Society of Clinical Oncolo - gy annual meeting, was that the addition of bevacizumab to carboplatin (Paraplatin)/gemcitabine (Gemzar) in patients with advanced ovarian cancer reduced the risk of disease progress - ion by 52%.[ Read More ]
Stockholm, Sweden—In patients with advanced non–small-cell lung cancer (NSCLC) and anaplastic lymphoma kinase (ALK) gene rearrangements, treatment with crizotinib (Xalkori) provided clinically meaningful antitumor activity, producing responses in 51% of patients, in the multicenter phase 2 PROFILE 1005 study reported at the 2011 European Multidisciplinary Can cer Congress.[ Read More ]
Stockholm, Sweden—The use of everolimus (Afinitor) together with the aromatase inhibitor exemestane (Aromasin) more than halved the risk for disease progression in patients with advanced breast cancer, adding an average of 4 disease-free months, investigators reported at the 2011 European Society for Medical Oncology European Multidisciplinary Cancer Congress. [ Read More ]
Stockholm, Sweden—Trastuzumab emtansine (T-DM1), a novel monoclonal antibody–guided therapy for HER2- positive metastatic breast cancer, achieved almost a 40% reduction in the risk of disease progression compared with standard treatment with trastuzumab (Herceptin) and docetaxel (Taxotere), investigators reported at the 2011 European Multidisciplinary Cancer Congress.[ Read More ]
San Francisco, CA—Accelerated partial breast irradiation using brachytherapy (APBIb) for breast cancer has been rapidly adopted in the United States, although its use varies by region, race, and ethnicity. Jona A. Hattangadi, MD, Harvard Radiation Oncology Program, Boston, reported the findings at the 2011 ASCO Breast Cancer Symposium, which was sponsored by 6 breast, oncology, and surgical societies.[ Read More ]
The population of cancer survivors is rapidly growing. More than 12 million Americans are alive after a cancer diagnosis: most are living at least 5 years and 16% are alive 20 years after diagnosis.
This growing population of cancer survivors is at risk for many comorbidities, especially as they age. A study of 10,397 childhood cancer survivors showed that group is 8 times more likely to have a severe or life-threatening condition than their siblings (Oeffinger K, et al. N Engl J Med. 2006; 355:1572-1582).[ Read More ]
San Antonio, TX—It is becoming increasingly clear that 2 agents are better than 1 in treating HER2-positive advanced breast cancer.
The latest evidence comes from the results of the phase 3 clinical trial CLEOPATRA (Clinical Evaluation of Pertuzumab and Trastuzumab), which were presented at the 2011 CTRC-AACR/San Antonio Breast Cancer Symposium by Jose Baselga, MD, PhD, Professor of Medicine, Harvard Medical School and Associate Director of the Massachusetts General Hospital Cancer Center, Boston.
[ Read More ]
San Antonio, TX—Updated results from the phase 3 Breast Cancer Trials of Oral Everolinmus (BOLERO-2) showed that adding everolimus to the treatment regimen with the aromatase inhibitor exemestane more than doubles the time to disease progression in patients with advanced estrogen receptor (ER)-positive breast cancer whose disease has become refractory to hormonal therapy.
[ Read More ]
San Antonio, TX—The treatment of ductal carcinoma in situ (DCIS)— breast cancer confined to the ducts—is a clinical challenge, as patients carry varying risks of recurrence and may easily be undertreated or overtreated. But Genomic Health, which markets Oncotype DX for assessing risk of recurrence in invasive cancers, has developed a similar test for DCIS that may prove useful for individualizing treatment in this subset of breast cancer. The test is expected to become available for physicians for use on December 28, 2011.
[ Read More ]
San Antonio, TX—Two antiestrogen agents may be better than one in the treatment of metastatic hormone receptor-positive breast cancer patients, according to a study conducted by the Southwest Oncology Group (SWOG) clinical trials network and presented at the 2011 CTRC-AACR San Antonio Breast Cancer Symposium.
[ Read More ]
Medical practices in the United States spend much more money and time dealing with third-party payers than do Canadian practices, according to a recent report (Morra D, et al. Health Aff. 2011;30:1443-1450).
The study showed that medical staff in the United States spend nearly 21 hours weekly dealing with insurance issues—addressing drug coverage, prior approvals, and other reimbursement issues—while their Canadian counterparts spend less than 3 hours weekly.
[ Read More ]
Stockholm, Sweden—The development of venous thromboembolism (VTE) in patients with cancer has a significant impact in terms of morbidity and mortality and healthcare costs, according to a “real-world analysis” reported at the 2011 European Multi - disciplinary Cancer Congress.
[ Read More ]
Stockholm, Sweden—A consortium of world cancer specialists, economists, and policymakers is tackling the issue of equitable cancer care in the face of rising cost of care in high-income countries. Their report (Sullivan R, et al. Lancet Oncol. 2011;12:933-980) coincided with a key presentation at the 2011 European Multidisciplinary Cancer Congress.
The report focused on the delivery of equitable and affordable care in the United States, Europe, Canada, Australia, and New Zealand.
[ Read More ]
San Francisco, CA—Breast cancer in women under age 40 years is often considered a more aggressive disease than in older women, and this often leads clinicians to recommend mastectomy over breast-conserving therapy (BCT), that is, lumpectomy or radiation. However, 2 studies presented at the 2011 Breast Cancer Symposium suggest that younger age in itself is not a reason for mastectomy.
[ Read More ]
New Orleans, LA—The House of Delegates of the American Medical Association (AMA) laid out guidelines for patient navigator programs during their November 2011 Interim Meeting. The aim is to ensure that patient navigators “enhance, rather than undermine, the delivery of high-quality patient care,” the resolution states.
[ Read More ]
Alternative versions of biologic agents—biosimilars—will be coming soon to a formulary near you. In the meantime, many details must be worked out before patients can be safely and effectively treated with these new products.
[ Read More ]
San Antonio, TX—One of the few clinical science symposia at the 2011 CTRC-AACR San Antonio Breast Cancer Symposium focused not on clinical issues but on delineating the economic issues facing oncologists.
Elena B. Elkin, PhD, Center for Health Policy and Outcomes, Memorial Sloan-Kettering Cancer Center, New York, reviewed the unprecedented concerns regarding health expenditures, calling for more cost-effectiveness analyses and more realistic thresholds for cost-effectiveness.[ Read More ]
At the 2012 Gastrointestinal Cancers Symposium, Value-Based Cancer Care (VBCC) asked Al B. Benson, III, MD, FACP, Professor of Medicine, Associate Director for Clinical Investigations, Robert H. Lurie Comprehensive Cancer Center, Northwestern University Feinberg School of Medicine, Chicago, Immediate Past President, ACCC, and editorial board member of VBCC, to discuss the growing importance of molecular profiling in cancer care.
VBCC: Where is the field of molecular profiling at this point, and where is it heading?[ Read More ]
San Francisco, CA—The novel tyrosine kinase inhibitor (TKI) regorafenib, used as a single agent to treat treatment-refractory metastatic colorectal cancer (CRC), significantly improved survival and delayed disease progression in an international phase 3 trial presented at the 2012 Gastrointestinal Cancers Symposium.[ Read More ]
Instituting guidelines-based test ordering could lead to more effective, accurate, and complete diagnosis and monitoring of hematolymphoid malignancies, while reducing costs, according to hematopathologists at Vanderbilt University Medical Center, Nashville, who said that tests were frequently overordered by their hematologists.[ Read More ]
A large, ongoing Canadian study provides an overview of the cost of managing non-Hodgkin lymphoma (NHL). “Our study provides total and stage-specific cost estimates for NHL, where attributable costs were 3- to 7-fold higher than those for non-NHL controls, and increased by stage,” said Pierre K. Isogai, BSc, of Sunnybrook Health Sciences Centre in Toronto.[ Read More ]
The first-generation proteasome inhibitor bortezomib changed the treatment paradigm of multiple myeloma. Data are now maturing for the next-generation agent carfilzomib, with US Food and Drug Administration approval expected soon. Several novel agents in this class are also in the pipeline. These second-generation agents appear to be as effective as bortezomib but less neurotoxic, according to studies presented at ASH 2011.[ Read More ]
Venous thromboembolism (VTE) is a common cause of serious morbidity and mortality, and patients with cancer are at particular risk. “VTE has a substantial burden on the current US medical system. Its preventable costs and indirect costs from premature deaths are substantial,” said Alex C. Spyropoulos, MD, of McMaster University, Hamilton, Canada.[ Read More ]
Miami, FL—Direct-to-consumer (DTC) marketing of genetic tests represents personalized medicine in evolution. High-throughput genetic technologies have made it possible to evaluate individuals at a relatively affordable price, but a number of technologic, social, regulatory, and ethical issues must first be settled before DTC genetic testing takes personalized medicine to new heights.
At the 2011 Best of ASCO meeting, Gary H. Lyman, MD, MPH, Director of Comparative Effectiveness and Outcomes Research, Duke University School of Medicine, Durham, NC.[ Read More ]
Feedback from their peers helped physicians refrain from ordering unnecessary tests for patients with newly diagnosed cancer, according to a recent study (Miller DC, et al. J Urol. 2011;186:844-849. Epub 2011 Jul 23).
Physicians ordered fewer tests after becoming more aware of practice guidelines and being presented with comparative data on tests they and their colleagues ordered. The program also improved the quality of care by reducing variations in practice patterns.[ Read More ]
San Francisco, CA—Using a prediction model to analyze the impact of adding targeted agents to the treatment of pancreatic neuroendocrine tumors (pNETs), everolimus (Afinitor) had a minimal overall impact on healthcare expenditures, by reducing infusions and surgical procedures costs, according to a study presented at the 2012 Gastrointestinal Cancers Symposium. For patients with advanced pNETs, the median overall survival is typically approximately 2 years. [ Read More ]
New Orleans, LA—According to the American Medical Association (AMA) and many oncologists, the International Classification of Diseases, Tenth Revision (ICD-10) diagnostic coding system will be a needless and expensive burden to oncology practices, without enhancing patient care. ICD-10 is being developed by the World Health Organization. The Centers for Medicare & Medicaid Services (CMS) ordered the switch in 2009 as part of carrying out the Health Insur ance Portability and Accountability Act. [ Read More ]
San Antonio, TX—In a retrospective utilization and cost analysis, nab-paclitaxel (Abraxane) therapy was associated with substantially lower total use of prophylactic colony-stimulating factor (CSF) than docetaxel (Taxotere) and paclitaxel (Taxol) in the treatment of breast cancer. The study was reported at the 2011 San Antonio Breast Cancer Sympo sium by Rex W. Force, PharmD, Professor and Director of Research, Family Medicine and Pharmacy Practice, Idaho State University, and Partner, ImproveRX, LLC, and colleagues. [ Read More ]
San Antonio, TX—Women with estrogen receptor (ER)-positive breast cancer are unlikely to benefit from dosedense chemotherapy, but many are receiving this type of treatment, which involves the use of colonystimulating factors (CSFs), that is, growth factors. Limit ing the use of these therapies in a population that is unlikely to benefit from it, would save nearly $40 million annually, suggests a study presented at the 2011 CTRC-AACR San Antonio Breast Cancer Symposium. Dawn L. [ Read More ]
San Francisco, CA—For resectable pancreatic cancer, administering chemo - therapy and radiation before surgery results in better outcomes and lower costs than performing surgery first, reported researchers from M.D. Anderson Cancer Center, Houston. "Compared with a surgery-first approach, the neoadjuvant approach eliminates an ineffectual, costly, and potentially morbid treatment in patients with early metastases or a prohibitive function status. It is associated with improved survival, and it costs less per patient," said lead investigator Daniel Erik Abbott, MD. [ Read More ]
San Diego, CA—Among patients with non-Hodgkin lymphoma (NHL), costs related to febrile neutropenia (FN) treated with hospitalization exceed $11,000 per episode, researchers reported at ASH 2011. Although the research was conducted on patients in the United Kingdom, the investigators converted costs to US dollars and noted that their findings were in keeping with previous published US studies. [ Read More ]
San Diego, CA—A novel inhibitor of B-cell receptor signaling, PCI-32765, produced high rates of remission and was well tolerated in patients with chronic lymphocytic leukemia (CLL) whose disease was refractory to at least 2 previous treatments, reported Susan O'Brien, MD, of the University of Texas M.D. Anderson Cancer Center, Houston. "To have agents that are this effective and that are not myelosuppressive is very exciting," Dr O'Brien said. [ Read More ]
San Diego, CA—Venous thromboembolism (VTE) occurs in 1% of hematologic malignancies and can lead to fatal pulmonary emboli, postthrombotic syndromes, bleeding as a result of anticoagulant treatment, and recurrent VTE. VTEs are potentially preventable with appropriate thromboprophylaxis, and numerous quality measures have been developed to enhance this practice. The "curve ball" is that there is "much confusion" regarding VTE prophylaxis, said Richard H. [ Read More ]
A review of treatment patterns for higher-risk myelodysplastic syndrome (MDS) shows growing use of lenalidomide, despite the lack of phase 3 survival data supporting this approach, according to research conducted at the Mayo Clinic Flori da, Jacksonville, in collaboration with Xcen da, a research and consulting firm. Since 2006, lenalidomide has been approved for the treatment of anemia in lower-risk patients with MDS and deletion of chromosome 5q (del[5q]). [ Read More ]
Houston, TX—The need to optimize the treatment of patients with cancer while using healthcare resources wisely—in other words, providing “value-based cancer care”—is not a topic of debate, but how to achieve this pressing goal is far from clear. In a panel discussion during the Association for Value-Based Cancer Care’s Second Annual Conference, strategists from the payer side of the issue discussed the current trends and the challenges they are facing.[ Read More ]
Houston, TX—Defining value in cancer care is like a group of blind men trying to define what an elephant is, by touch: it is described according to one’s own experience and perceptions, said Mark Zitter, MBA, Founder and Chief Executive Officer, The Zitter Group, San Francisco, CA.[ Read More ]
Houston, TX—Jennifer Malin, MD, PhD, Manager and Medical Director of Oncology at WellPoint, described new approaches that can help to align reimbursement in oncology to enhance value and patient outcomes by focusing on episode of care rather than on the drugs, by shifting physicians’ incentives to support patient-centered decision-making.
Dr Malin described WellPoint’s new reimbursement programs in oncology at the 2nd Annual Conference of the Association for Value-Based Cancer Care.[ Read More ]
Houston, TX—In the past 2 decades, community oncologists have experienced an era of stability (1991-2003) and a time of adaptation (2004-2006), and are now practicing in an era that may best be described as feeling the “squeeze” (2007-present), said Thomas A. Marsland, MD, President of Cancer Specialists of North Florida, Jacksonville, who discussed the current crisis in the community oncology setting at the Association for Value-Based Cancer Care second annual conference.[ Read More ]
Chicago, IL—“Precision medicine” is the new catch phrase in oncology, and examples of it were evident across the vast halls of McCormick Place at the 2012 American Society of Clinical Oncology (ASCO) meeting.[ Read More ]
Houston, TX—The use of the Level I Pathways Program at McKesson Specialty Health/US Oncology Network over the past 5 years has reduced treatment variability and resulting costs, according to Roy A. Beveridge, MD, chief medical officer, McKesson Specialty Health/US Oncology Network.
“We fundamentally believe that the use of these pathways significantly reduces the variation in patient care, and we have been able to demonstrate this,” Dr Beveridge said at the Second Annual Conference of the Association for Value-Based Cancer Care.[ Read More ]
Houston, TX—“Personalized medicine can improve healthcare delivery, improve healthcare outcomes, and help manage healthcare costs and spending,” said Jeffrey Scott, MD, Senior Vice President, General Manager for P4 Healthcare/Cardinal Health Specialty Solutions, at the Second Annual Con ference of the Association for Value-Based Cancer Care.[ Read More ]
Houston, TX—The Oncology Management Program at CareFirst Blue Cross Blue Shield (BCBS) continues to evolve, producing nearly 10% in cost-savings over prepathways practice, and ensuring that patients get more appropriate care, said Winston Wong, PharmD, Associate Vice President of Pharmacy Management at CareFirst BCBS, who described the program at the Second Annual Conference of the Association for Value-Based Cancer Care.[ Read More ]
Houston, TX—Patient navigation assures timely access to care for many patients, especially the medically underserved population, and it will soon become mandated for institutions accredited by the Commission on Cancer, reported Mandi Pratt-Chapman, MA, Associate Director of the Community Programs, Codirector of the Center for the Advancement of Cancer Survivorship, Navigation and Policy, George Washington Cancer Institute, Washington, DC, at the Second Annual Conference of the Association for Value-Based Cancer Care.[ Read More ]
Chicago, IL—Researchers from the University of North Carolina in Chapel Hill reported at the 2012 American Society of Clinical Oncology meeting that endocrine therapy is substantially underutilized among the low-income breast cancer population.
For women with estrogen receptor (ER)-positive or progesterone receptor (PR)-positive disease, endocrine therapy reduces the 5-year recurrence risk by as much as 40%, but this study showed that low income may be an obstacle to receiving this guideline-recommended treatment.[ Read More ]
Chicago, IL—Adverse events (AEs) related to chemotherapy for metastatic breast cancer create a substantial economic burden that is primarily explained by increased inpatient, outpatient, and pharmacy costs, said lead investigator Sara A. Hurvitz, MD, Director of the Oncology Breast Can cer Program at University of California, Los Angeles (UCLA) Jonsson Comprehensive Cancer Center and Assistant Clinical Professor at UCLA School of Medicine, who presented an economic analysis at the 2012 Ameri can Society of Clinical Oncology meeting.[ Read More ]
Houston, TX—There is no question that evidence-based guidelines and pathways are critical to the success of value-based oncology, but not all stakeholders have an equal voice, said Craig Deligdish, MD, Chief Medical Officer at Oncology Resource Networks of America at the Second Annual Meeting of the Association for Value-Based Cancer Care. The goals inherent in value-based oncology benefit programs include:[ Read More ]
Houston, TX—Payer-sponsored programs that promote appropriate endof- life care are beneficial to all stakeholders, according to Ira M. Klein, MD, MBA, Chief of Staff to the Chief Medical Officer, Aetna Oncology Strategy.
At the Second Annual Conference of the Association for Value-Based Cancer Care, Dr Klein discussed advancedcare directives and emphasized that the patient and family “should be at the center of what you do.”[ Read More ]
Houston, TX—Hard times are getting even tougher for small oncology practices, said Leonard Natelson, Chief Executive Officer, Hematology/Oncology Associates, Rockland, NY, at the Second Annual Conference of the Association for Value-Based Cancer Care.
Hematology/Oncology Associates is an independent practice of 5 physicians, which in the Northeast region is considered “large,” Mr Natelson said. He cited 5 main challenges facing community oncologists today:[ Read More ]
Houston, TX—“The key question on everyone’s mind is, how do we monetize the value of pathways?” said Peter G. Ellis, MD, Deputy Director of Clinical Services and Associate Chief Medical Officer, University of Pittsburgh Cancer Centers, PA, at the Second Annual Conference of the Association for Value-Based Cancer Care. Clearly, Dr Ellis said, the use of pathways has internal practice value.
Pathways:[ Read More ]
San Francisco, CA—Although the upfront cost of vemurafenib is high, its use to treat patients with metastatic melanoma actually results in a costsavings per health plan member per month (PMPM), according to an analysis presented at the 2012 Academy of Managed Care Pharmacy annual meeting.
In a hypothetical health plan of 500,000 enrollees, the use of vemurafenib for the treatment of patients with BRAF V600E mutation is costsaving by $0.04 PMPM, reported William B. Wong, MS, PharmD, of the University of Washington, Seattle.[ Read More ]
San Francisco, CA—The vast majority of published evidence indicates that the relative treatment effect of chemotherapy for stage III colon cancer is as good for elderly patients as it is for younger ones, according to a systematic literature review by Anna Hung, a student in the program, and C. Daniel Mullins, PhD, Professor, Pharmacoeconomics, Pharmaceutical Health Services Research Department, Associate Director, Center on Drugs and Public Policy. The study was presented at the 2012 Academy of Managed Care Pharmacy annual meeting.[ Read More ]
Houston, TX—Despite much talk about biomarkers and a field that is exploding, only a few biomarkers can be reliably and routinely used to improve patient care at this time, according to Peter G. Ellis, MD, Deputy Director of Clinical Services, Associate Chief Medical Officer, University of Pittsburgh Medical Center Cancer Centers.
A biomarker is any measure (ie, gene mutation, staining pattern, gene expression microarray) that can be associated with a clinically distinct prognosis, diagnosis, or response to a specific therapy.[ Read More ]
San Francisco, CA—The indirect costs of metastatic breast cancer are substantial and are much higher than the costs of early breast cancer, according to what may be the first study to compare costs related to lost productivity in the population with breast cancer.
The study was reported at the 2012 Breast Cancer Symposium by Yin Wan, MS, of Pharmerit International, Bethesda, MD. The senior research-
er was Lee Schwartzberg, MD, Medical Director of the West Clinic in Memphis, TN.
Vienna, Austria—In a head-to-head comparison of 2 treatments for metastatic renal-cell carcinoma (mRCC), pazopanib (Votrient) showed similar efficacy to sunitinib (Sutent), with a 1-month survival advantage for sunitinib, which was associated with fewer side effects and an increased quality of life (QOL), suggested Robert J. Motzer, MD, Professor of Medicine, Weill Medical College of Cornell University, and an attending physician at Memorial Sloan-Kettering Cancer Center, New York. [ Read More ]
Continuation of Bevacizumab Beyond Progression Improves Outcome in Patients with Metastatic Colorectal Cancer
Vienna, Austria—More support for the continuation of treatment with bevacizumab beyond disease progression in patients with metastatic colorectal cancer was reported at the 2012 European Society for Medical Oncology (ESMO) Congress, validating a small but growing body of previous data.[ Read More ]
Vienna, Austria—“One of our themes at the 2012 ESMO Congress is personalized oncology,” European Society for Medical Oncology (ESMO) President Martine J. Piccart-Gebhart, MD, PhD, Professor of Oncology at the Université Libre de Bruxelles and Director of the Medicine Department at Jules Bordet Institute, Brussels, Belgium, said at a press briefing at the meeting. She noted that the numerous presentations on targeted therapy and diagnostics at ESMO are evidence that the field is rapidly moving forward.[ Read More ]
Vienna, Austria—“Is personalized cancer care affordable?” asked Richard Sullivan, MD, PhD, Director of Kings Health Partners Institute of Cancer Policy and Global Health in the United Kingdom, in an invited presentation at the 2012 European Society for Medical Oncology Congress.
The short answer he gave was “no,” barring seismic shifts not only in the oncology landscape but also in the larger societal picture. He described 3 trends that will be disastrous for controlling the cost of care.[ Read More ]
San Francisco, CA—When cancer treatment is equal among patients, the outcomes are equal as well, “but there is not equal treatment” within the US population with cancer, according to Otis W. Brawley, MD, Chief Medical and Scientific Officer of the American Cancer Society, and Professor of Hematology, Medical Oncology, Medicine, and Epidemiology at Emory University, Atlanta.[ Read More ]
Houston, TX—To eliminate coverage inconsistencies and enhance relationships with providers, health plans should have specific policies for dealing with off-label use of oncologic drugs, said Kristen M. Reimers, RPh, Specialty Pharmacy Director and Clinical Operations Manager for Excellus Health Plans.
At the Second Annual Association for Value-Based Cancer Care Conference, Ms Reimers described the rationale for and the process of development and benefits of the off-label drug policy that she helped to develop at Excellus.[ Read More ]
Houston, TX—With the onslaught of drugs that will target genetic subsets of patients, companion diagnostic testing will become vitally important, said Jane F. Barlow, MD, MPH, MBA, Vice President of Clinical Innovation, Medco Health Solutions (now Express Scripts), New York, who spoke on personalized medicine during the 2012 Annual Conference of the Association for Value-Based Cancer Care.[ Read More ]
?Houston, TX—Delta Air Lines has a commitment to preventive health and comprehensive cancer care for its 140,000 health plan members; the company is piloting a “high-performance cancer network,” said Lynn Zonakis, Managing Director of Health Strategy and Resources, Delta Air Lines, Atlanta, GA, at the 2012 Second Annual Conference of the Association for Value-Based Cancer Care. Ms Zonakis was part of the employers’ panel at the conference who presented perspectives from different employer groups related to cancer care.[ Read More ]
Cumulative Financial Impact of Skeletal-Related Events on Patients with Breast Cancer Is Significant
?San Francisco, CA—In patients with breast cancer with bone metastases, skeletal-related events (SREs) are associated with high treatment costs. For example, the cumulative cost of treating 1 spinal cord compression exceeds $100,000, according to a new cost analysis presented at the 2012 Breast Cancer Symposium.[ Read More ]
?Vienna, Austria—The identification of genetic mutations and tumor biomarkers to select the right drug for the right patient are not enough to satisfy the need for personalized cancer care, according to Kathy Redmond, MSc, RN, Editor of Cancer World magazine, a publication of the European School of Oncology and former president of the European Oncology Nursing Society, who addressed the topic of personalized medicine at the 2012 European Society for Medical Oncology Congress.[ Read More ]
?San Francisco, CA—Three frequently used radiologic tests rarely detect metastases in patients with a new diagnosis of breast cancer and should not be routinely performed, according to a comprehensive literature review presented at the 2012 Breast Cancer Symposium.[ Read More ]
?Houston, TX—Employers’ health plan managers must “balance members’ access to new treatments with the fiscal responsibility of managing the healthcare financial resources wisely,” said Bridget Eber, PharmD, Senior Consultant and Clinical Lead of Rx Group Purchasing, Towers Watson, at the 2012 Second Annual Association for Value-Based Cancer Care Conference. Towers Watson’s clients include 175 employers with self-funded benefits programs totaling $3 billion in annual drug spending.[ Read More ]
?Houston, TX—Most employers do not understand biologics and specialty pharmacy well enough to use services appropriately and to take advantage of their benefits, said F. Randy Vogenberg, RPh, PhD, Principal, Institute for Integrated Healthcare, Sharon, MA, an employer benefit consulting company.
Speaking at the Second Annual Association for Value-Based Cancer Care Conference, Dr Vogenberg drew from a recent survey of employers to suggest actions that need to be taken to better integrate healthcare stakeholders.[ Read More ]
?Vienna, Austria—Costs associated with first-line pemetrexed/cisplatin are significantly lower than those of carboplatin/paclitaxel/bevacizumab for the treatment of advanced non–small-cell lung cancer (NSCLC), according to an analysis presented at the 2012 European Society for Medical Oncology Congress.[ Read More ]
San Antonio, TX—The national cost of screening mammography could vary by as much as $7 billion annually, depending on the screening strategy, according to a new study reported at the 2012 CTRC-AACR San Antonio Breast Cancer Symposium.[ Read More ]
San Diego, CA—Adherence to several quality care standards markedly improved in practices participating in ASCO’s Quality Oncology Practice Initiative (QOPI) over a 4-year period, according to a study presented at ASCO’s inaugural 2012 Quality Care Symposium.
QOPI Participation Enhances Performance
The findings indicate that the oncology practices that participate in the QOPI are able to document significant and rapid improvement in their overall performance. Approximately 15% of US oncology practices are now participating in the QOPI.[ Read More ]
A study using real-world data for patients with tumor lysis syndrome (TLS) showed that treatment with rasburicase (Elitek) was associated with significantly greater reductions in uric acid, length of hospital stay, and total hospitalization costs per patient compared with allopurinol (Zyloprim).
TLS, which is a consequence of either tumor treatment or spontaneous tumor death, is an oncologic emergency. TLS can lead to renal failure, seizures, severe muscle weakness, tetany, cardiac arrhythmias, and death. The treatment options for TLS include allopurinol and rasburicase.[ Read More ]
Atlanta, GA—MLN9708, an investigational oral proteasome inhibitor, produced impressive results in a phase 1/2 clinical trial of treatment-naïve patients with multiple myeloma that was featured in a press briefing at the 2012 American Society of Hematology (ASH) meeting.
Used in combination with lenalidomide, MLN9708 achieved an overall response rate exceeding 90%, and complete responses were seen in 25% of patients, reported Shaji K. Kumar, MD, Professor of Medicine at the Mayo Clinic, Rochester, MN.[ Read More ]
Atlanta, GA—Support for the oral immunomodulatory agent pomalidomide for the treatment of multiple myeloma took a giant step forward when new data from the phase 3 MM-003 trial showed a survival advantage in patients with advanced disease.
The data were reported at the 2012 American Society of Hematology meeting by Meletios Dimopoulos, MD, Professor and Chairman of the Department of Clinical Therapeutics at Alexandra Hospital in Athens, Greece.[ Read More ]
For the prevention of recurrent venous thromboembolism (VTE), rivaroxaban (Xarelto) appears to be more cost-effective than warfarin (Coumadin), an independent analysis undertaken by the University of Pittsburgh School of Medicine showed.[ Read More ]
Vienna, Austria—Several studies presented at the 2012 European Society for Medical Oncology Congress offered a look into what many believe will lead to the application of genome-based biomarker information into clinical use based on the concept of personalized medicine, although not all of the results were unconditionally encouraging.[ Read More ]
Atlanta, GA—The use of azacitidine (Vidaza) in patients with high-risk myelodysplastic syndrome (MDS) is associated with the reduced need for red blood cell (RBC) transfusion and transfusion dependence, a report from the 2012 American Society of Hematology meeting showed.
“At 12 and 18 months after azacitidine treatment, there were 26% and 38% reductions in RBC transfusion costs, respectively, per patient compared with the 6 months before therapy,” said Eric Tseng, MD, Department of Hematology, University of Toronto, Ontario, Canada.[ Read More ]
San Diego, CA—A multidisciplinary team approach for discussing end-of-life issues with patients reduces the use of the intensive care unit (ICU) without shortening survival time, researchers from the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University said at ASCO’s inaugural 2012 Quality Care Symposium.
Multidisciplinary Support in End-of-Life Decisions[ Read More ]
San Diego, CA—A real-time performance tracking system that monitors adherence to quality care metrics significantly improved adherence to quality standards over a 4-year period for 64 cancer centers participating in the Rapid Quality Reporting System (RQRS) “beta test,” according to researchers who are pioneering the program.[ Read More ]