Caroline Helwick


Authored Items

Genome-Forward Medicine in Lung Cancer

August 2011, Vol 2, No 5 - ASCO Annual Meeting

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.

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Dose-Monitoring, Split-Fill Programs Reduce Oral Chemotherapy Waste, Save Costs

August 2011, Vol 2, No 5 - Oncology

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.

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Post-ASCO Survey: Oncologists’ and Payers’ Treatment and Coverage Decisions

August 2011, Vol 2, No 5 - Reimbursement

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).

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Screening for Pancreatic Cancer Is Effective, Has Value— at Least in High-Risk Individuals

August 2011, Vol 2, No 5 - Cancer Care

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).

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Therapy-Associated Complications Significantly Increase Cost of Cancer Care

October 2011, Vol 2, No 6 - ESMO 2011 Conference

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.

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Value of Bevacizumab in Ovarian Cancer Got a Boost in a New Analysis

October 2011, Vol 2, No 6 - ESMO 2011 Conference

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%.

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Positive Data Continue to Accrue for Crizotinib in ALK-Positive NSCLC

October 2011, Vol 2, No 6 - ESMO 2011 Conference

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.

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Everolimus-Exemestane Combination Prolongs Remission by 4 Months in Metastatic Breast Cancer

October 2011, Vol 2, No 6 - ESMO 2011 Conference

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 ]

New T-DM1 Reduces Disease Progression by 40% in Advanced Breast Cancer, with Low Toxicity

October 2011, Vol 2, No 6 - ESMO 2011 Conference

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.

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Targeted Radiation Therapy Gaining Momentum

October 2011, Vol 2, No 6 - Breast Cancer Symposium

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.

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Survivorship Programs an Emerging Need, But Are They Cost-Effective?

October 2011, Vol 2, No 6 - Survivorship Care

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).

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Dual HER2 Blockade with Pertuzumab Substantially Delays Disease Progression

December 2011, Vol 2, No 7 - CTRC-AACR SABCS Annual Meeting

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.

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Adding Everolimus to Exemestane Significantly Prolongs Remission in Patients with Breast Cancer

December 2011, Vol 2, No 7 - CTRC-AACR SABCS Annual Meeting

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.

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New Prognostic Tool to Guide Treatment of Ductal Carcinoma In Situ

December 2011, Vol 2, No 7 - CTRC-AACR SABCS Annual Meeting

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.

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Medical Staff Members Spend Many Hours Dealing with Insurance Companies

December 2011, Vol 2, No 7 - Health Policy

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.

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Delivering Affordable, Evidence-Based Cancer Care in High-Income Countries

December 2011, Vol 2, No 7 - ESMO 2011 Conference

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.

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Young Patients Are Served Equally Well by Lumpectomy or Mastectomy

December 2011, Vol 2, No 7 - ASCO Breast Cancer Symposium

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.

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The Cost of Cancer Care: How Can We Spend Better?

February 2012, Vol 3, No 1 - Breast Cancer

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.

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The Promise of Molecular Profiling

February 2012, Vol 3, No 1 - VBCC Perspectives

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?

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Next-Generation Proteasome Inhibitors Cause Less Peripheral Neuropathy

February 2012, Vol 3, No 1 - ASH Annual Meeting

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.

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Direct-to-Consumer Genetic Testing: Concerns Trump Benefits at This Point

February 2012, Vol 3, No 1 - Health Policy

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.

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Physician-Led Approach Can Cut Unnecessary Testing in Prostate Cancer

February 2012, Vol 3, No 1 - Prostate Cancer

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.

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Everolimus Has Minimal Economic Impact on Treatment of Pancreatic NETs

March 2012, Vol 3, No 2 - Gasterol Intestinal Symposium

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 ]

AMA Delegates and Oncologists Balk at ICD-10 Implementation

March 2012, Vol 3, No 2 - Health Policy

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 ]

For Metastatic Breast Cancer, Nab-Paclitaxel Requires Less Growth Factor Support

March 2012, Vol 3, No 2 - Breast Cancer

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 ]

Dose-Dense Chemotherapy plus Growth Factors in Elderly ER-Positive Patients Unnecessary, Costly

March 2012, Vol 3, No 2 - Breast Cancer

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 ]

For Pancreatic Cancer, Neoadjuvant Chemoradiation Cost-Effective Compared with Surgery First

March 2012, Vol 3, No 2 - Gasterol Intestinal Symposium

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 ]

Economic Burden of Febrile Neutropenia in NHL Exceeds $11,000 per Episode

March 2012, Vol 3, No 2 - ASH Annual Meeting

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 ]

Novel Oral B-Cell Receptor Inhibitor Very Effective in Chronic Lymphocytic Leukemia

March 2012, Vol 3, No 2 - ASH Annual Meeting

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 ]

Confusion Still Surrounds Prophylaxis for Venous Thromboembolism

March 2012, Vol 3, No 2 - ASH Annual Meeting

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 ]

High-Risk Myelodysplastic Syndrome: First-Line Treatment Choices Often Not Supported by Evidence

March 2012, Vol 3, No 2 - ASH Annual Meeting

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 ]

Payer Trends in Oncology: Challenges and Solutions

May 2012, Vol 3, No 3 - AVBCC Annual Conference

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.

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WellPoint: Aligning Reimbursement with Value-Based, Patient-Centered Outcomes

May 2012, Vol 3, No 3 - AVBCC Annual Conference

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.

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Community Oncology in Crisis

May 2012, Vol 3, No 3 - AVBCC Annual Conference

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.

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The Value of Level I Pathways at US Oncology

June 2012, Vol 3, No 4 - AVBCC Annual Conference

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.

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CareFirst Oncology Management Program Aims to Manage the “Entire Oncology Patient”

June 2012, Vol 3, No 4 - AVBCC Annual Conference

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.

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Defining the Roles of Patient Navigation Can Remove Barriers to Quality Care

July 2012, Vol 3, No 5 - AVBCC Annual Conference

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.

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Endocrine Therapy Substantially Underutilized Among Low-Income Patients with Breast Cancer

July 2012, Vol 3, No 5 - ASCO Annual Meeting

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.

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Chemotherapy-Related Toxicity Adds to Economic Burden in Metastatic Breast Cancer

July 2012, Vol 3, No 5 - ASCO Annual Meeting

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.

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Evidence-Based Guidelines/Pathways Critical for Value-Based Benefit Design in Oncology

July 2012, Vol 3, No 5 - AVBCC Annual Conference

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:

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Involving the Patient in End-of-Life Care Decisions: Aetna’s Oncology Strategy

July 2012, Vol 3, No 5 - AVBCC Annual Conference

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.”

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Tough Times for Small Oncology Practices

July 2012, Vol 3, No 5 - AVBCC Annual Conference

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:

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Pathways Offer Providers a True Value Proposition

July 2012, Vol 3, No 5 - AVBCC Annual Conference

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:

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Vemurafenib Does Not Impact Health Plan Budget

July 2012, Vol 3, No 5 - AMCP Annual Meeting

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.

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In Colorectal Cancer, Treatment Efficacy Is High Among the Elderly

July 2012, Vol 3, No 5 - AMCP Annual Meeting

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.

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Many Emerging Biomarkers, but Few Are Clinically Applicable

October 2012, Vol 3, No 7 - AVBCC Annual Conference

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.

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Indirect Costs of Metastatic Breast Cancer Are Substantial

October 2012, Vol 3, No 7 - Breast Cancer Symposium

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.

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Head-to-Head Comparison: Pazopanib versus Sunitinib in Metastatic Renal-Cell Carcinoma

October 2012, Vol 3, No 7 - ESMO 2012 Conference

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 ]

ESMO Theme: Personalized (“Precision”) Oncology Care Marches Forward

October 2012, Vol 3, No 7 - Personalized Medicine

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.

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Is Personalized Cancer Care Affordable?

October 2012, Vol 3, No 7 - Personalized Medicine

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.

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An Underappreciated Cause of Cancer Death: Disparities in Treatment

October 2012, Vol 3, No 7 - Breast Cancer Symposium

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.

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Health Plans Need Policies for Dealing with Off-Label Drug Use

October 2012, Vol 3, No 7 - AVBCC Annual Conference

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.

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Companion Drug Testing Is Becoming Critical to Pharmacy Benefits Management

October 2012, Vol 3, No 7 - AVBCC Annual Conference

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.

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Delta Air Lines’ Approach to Patient Care: High-Performance Cancer Networks

November 2012, Vol 3, No 8 - AVBCC Annual Conference

?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.

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The Missing Perspective in Personalized Cancer Care

November 2012, Vol 3, No 8 - Personalized Medicine

?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.

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Employers’ Challenge: Cut Healthcare Costs Without Limiting Employees’ Benefits

November 2012, Vol 3, No 8 - AVBCC Annual Conference

?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.

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To Many Employers, Specialty Pharmacy Is a Vague Concept

November 2012, Vol 3, No 8 - AVBCC Annual Conference

?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.

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Quality Oncology Practice Initiative Shows Strong Improvement in Some Care Measures

January 2013, Vol 4, No 1 - ASCO’s 1st Quality Care Symposium

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.

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Rasburicase Cost-Effective for Tumor Lysis Syndrome

January 2013, Vol 4, No 1 - ASH Annual Meeting

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.

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Oral Proteasome Inhibitor MLN9708 a News Maker at ASH 2012

January 2013, Vol 4, No 1 - ASH Annual Meeting

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.

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New Data Demonstrate Overall Survival Benefit with Pomalidomide in Advanced Myeloma

January 2013, Vol 4, No 1 - ASH Annual Meeting

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.

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Azacitidine Reduces Transfusions and Costs for Patients with High-Risk MDS

January 2013, Vol 4, No 1 - Health Economics

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.

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Multidisciplinary Palliative Care Team at Johns Hopkins Achieves Reduction in ICU Utilization, Cost

January 2013, Vol 4, No 1 - ASCO’s 1st Quality Care Symposium

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

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