Chase Doyle

Authored Items

Regorafenib in Metastatic Colorectal Cancer: High Cost with Little Benefit

March 2015, Vol 6, No 2 - Economics of Cancer Care

San Francisco, CA—According to a recent cost-effectiveness analysis, third-line therapy with regorafenib (Stivarga) in patients with previously treated metastatic colorectal cancer (CRC) far ­exceeded accepted willingness-to-pay thresholds based on incremental cost-effectiveness ratio (ICER) and quality-adjusted life-years (QALYs). Presented at the 2015 Gastrointestinal Cancers Symposium, the results showed that regorafenib provided an additional 0.04 QALYs, at a cost of $39,391. [ Read More ]

Sunitinib Associated with Higher Costs Compared with Pazopanib in Patients with Renal-Cell Carcinoma

April 2015, Vol 6, No 3 - Economics of Cancer Care

Hollywood, FL—Sunitinib and pazopanib have long battled for supremacy in treating advanced renal-cell carcinoma (RCC). According to findings presented at the 2015 National Comprehensive Cancer Network (NCCN) conference, the newer drug, pazopanib, may have some advantage in terms of total cost of care, but survival outcomes were exactly the same. [ Read More ]

The Search for Value-Based Healthcare Delivery: The Agenda for Oncology

July 2015, Vol 6, No 6 - Value in Oncology

Chicago, IL—The presidential keynote address at the 2015 American Society of Clinical Oncology meeting was presented by Michael E. Porter, PhD, MBA, Bishop William Lawrence University Professor, Harvard Business School, Boston, who started the value discussions a decade ago. A strong proponent of changing the healthcare system to focus on value, Dr Porter suggests that the fundamental purpose of healthcare is to deliver great outcomes with increasing efficiency, but achieving this goal requires more holistic thinking about delivery care as science. [ Read More ]

Anthem’s Clinical Pathways Demonstrate Value: The Payer Perspective

July 2015, Vol 6, No 6 - Value in Oncology

Chicago, IL—At the special session on value during the 2015 American Society of Clinical Oncology meeting, Jennifer Malin, MD, PhD, Staff Vice President for Clinical Strategy, Anthem, Thousand Oaks, CA, presented the payer perspective on value in cancer care. The role of the payer, Dr Malin said, is to balance different stakeholders’ values and needs at various time points. [ Read More ]

Addressing Fertility Issues in Patients with Breast Cancer

December 2015, Vol 6, No 11 - Survivorship

Fertility and early menopause after cancer can pose challenging emotional and medical issues for patients and their clinicians. Survivors who become infertile because of their cancer treatment are at an increased risk for emotional distress and are often affected by unresolved grief and depression, according to Ann H. Partridge, MD, MPH, Medical Oncologist, Dana-Farber Cancer Institute, Boston. [ Read More ]

Clinical Pathways and the Oncology Medical Home: First Steps to Value-Based Patient Care

February 2016, Vol 7, No 1 - Value in Oncology

With $137 billion and growing spent on treatment in the US healthcare annually, cancer care delivery poses a significant challenge. At a special session at ASH 2015 on new payment models, Michael Kolodziej, MD, National Medical Director for Oncology Solutions at Aetna, discussed pathways and the medical home as transitional solutions to value in cancer care. [ Read More ]

Redesigning the Payment Model for Acute Leukemia: Benefits and Challenges of the Episode-of-Care Model

February 2016, Vol 7, No 1 - Value in Oncology

Given the high cost of care for acute leukemia, innovative payment strategies that reward longitudinal care and create economic incentives for data-driven care delivery are needed, according to Joseph Alvarnas, MD, Director of Value-Based Analytics, and Associate Clinical Professor of Hematology and Hematopoietic Cell Transplantation, City of Hope, Duarte, CA. [ Read More ]

Nilotinib Yields Better Rates of Molecular Response Than Imatinib in Frontline Setting

February 2016, Vol 7, No 1 - Leukemia

Dose-optimized nilotinib (Tasigna) increased the rates of major molecular response in patients with newly diagnosed chronic myeloid leukemia (CML) in the chronic phase (CP) in the Evaluating Nilotinib Efficacy and Safety in Clinical Trials-Extending Molecular Responses (ENESTxtnd) study. According to the final results of this study presented at ASH 2015, the cumulative major molecular response rates were 70.8% by 12 months and 81.0% by 24 months in patients managed with the dose optimization strategy. [ Read More ]

Immunotherapy with Blinatumomab Prolongs Survival in Acute Lymphoblastic Leukemia

February 2016, Vol 7, No 1 - Leukemia

Treatment with CD19-targeted immunotherapy blinatumomab (Blincyto) as a single agent showed antileukemic activity in patients with minimal residual disease (MRD) Philadelphia chromosome (Ph)-positive B-cell precursor acute lymphoblastic leukemia (ALL) whose disease progressed after or was intolerant to a second-generation or later tyrosine kinase inhibitor (TKI). The results were presented at ASH 2015. [ Read More ]

Anthem’s Response to Survivorship Medicine: Reimbursement Based on Care Coordination and Patient Outcomes

March 2016, Vol 7, No 2 - Survivorship

Survivorship medicine has never been in more demand, but questions regarding reimbursement remain. According to Jennifer Malin, MD, PhD, Medical Director, Oncology and Care Management, Anthem, if cancer survivorship models are to succeed, they will need to integrate into new healthcare delivery models, with less focus on cost and more on improving care coordination. [ Read More ]

A New Paradigm for Survivorship Care: Assessing the Patient’s Priorities

March 2016, Vol 7, No 2 - Survivorship

A new paradigm of survivorship care is needed that attempts to balance the patient’s total well-being against the often toxic treatment of the disease, suggests Deborah Korenstein, MD, Director of Clinical Effectiveness, Memorial Hospital, Memorial Sloan Kettering Cancer Center, NY. At the 2016 Cancer Survivorship Symposium, Dr Korenstein outlined a more personal approach to care: assessing the individual patient’s priorities and goals to balance long-term benefits and harms. [ Read More ]

New Survey: Physicians Are Not Addressing Financial Distress in Patients with Multiple Myeloma

March 2016, Vol 7, No 2 - Value in Oncology

Patients with multiple myeloma are making significant lifestyle trade-offs to manage the cost of healthcare, according to findings from the Cancer Experience Registry presented at ASH 2015. Joanne S. Buzaglo, PhD, Senior Vice President, Research and Training, Cancer Support Community, Philadelphia, PA, discussed survey results of patients with multiple myeloma who are assuming more costs, including direct costs (ie, copays and prescriptions) and indirect costs (ie, transportation costs and loss of income), which is leading to financial distress. [ Read More ]

Opportunities for Shared Decision-Making in Clinical Practice

July 2016, Vol 7, No 6 - Value in Oncology

The National Academy of Medicine recommends a shared decision-making approach when discussing medical treatments; however, an overview of evidence presented by Terrance Lynn Albrecht, PhD, Associate Center Director, Population Sciences, Karmanos Cancer Institute, and Chief of Oncology, Wayne State University School of Medicine, Detroit, at the 2016 American Society of Clinical Oncology annual meeting suggests that clinicians are not very effective in following this recommendation. [ Read More ]

Out-of-Pocket Costs Linked to Reduced Adherence to Oral Oncolytics

August 2016, Vol 7, No7, Special Issue: Payers’ Perspectives in Oncology - Value in Oncology

Access and adherence to long-term cancer therapies are emerging as major public health issues around the world, as high out-of-pocket costs for oral oncolytics are linked to nonadherence that can directly affect patient outcomes, said Dawn L. Hershman, MD, MS, Professor of Medicine and Epidemiology, Columbia University Medical Center, New York, NY, at ASCO 2016.

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Transition from Branded to Generic Cancer Drugs Significantly Increases Treatment Cost-Effectiveness

August 2016, Vol 7, No7, Special Issue: Payers’ Perspectives in Oncology - Value in Oncology

An economic analysis of oncology regimens that were previously evaluated in trials conducted by the Canadian Cancer Society Research Institute has shown that the transition from branded to generic drug costs has a considerable impact on the cost-effectiveness and cost-utility of treatment.

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Cost of Chemotherapy for Breast Cancer Varies Widely Across Regimens

August 2016, Vol 7, No7, Special Issue: Payers’ Perspectives in Oncology - Value in Oncology

The cost of care varies widely across breast cancer chemotherapy regimens, even among treatments of comparable efficacy, according to a retrospective study presented at ASCO 2016. Some of the most costly regimens, such as docetaxel plus doxorubicin and cyclophosphamide, were found to be the most expensive and were associated with the highest risk for hospitalization.

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Healthcare Resource Utilization High in Patients with Relapsed or Refractory Multiple Myeloma

August 2016, Vol 7, No7, Special Issue: Payers’ Perspectives in Oncology - Value in Oncology

A study evaluating the economic burden associated with multiple myeloma and its treatment has found that routine management and disease progression continues to drive healthcare resource utilization, regardless of the number of previous lines of therapy. Other key drivers of healthcare utilization in multiple myeloma are hospitalizations, transplantations, and concomitant medication use. The study was presented at ASCO 2016.

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Assessing the Cost–Benefit of Immune Checkpoint Inhibitors

September 2016, Vol 7, No 8 - Value in Oncology

Although immune checkpoint inhibitors can significantly extend survival of patients with metastatic disease, more than 50% of the patients who use them have serious, grade 3 to grade 5 adverse events. These toxicities comprise a considerable proportion of the total number of immune checkpoint inhibitors, especially those that target PD-1, said Neil T. Mason, MBA, Personalized Medicine Strategist, Moffitt Cancer Center, Tampa, FL, who presented his study results at a poster session at the 2016 American Society of Clinical Oncology annual meeting. [ Read More ]

Referring Radical Prostatectomies to High-Volume Providers Could Save Millions

September 2016, Vol 7, No 8 - Value in Oncology

A new study of the geographic distribution of cancer surgeries in the Medicare population has shown that performing radical prostatectomies in high-volume centers leads to improved outcomes and reduced costs of care. Referring patients to a high-volume provider within 100 miles could save >$20 million annually, according to data presented at the 2016 American Society of Clinical Oncology annual meeting and published just before the meeting. [ Read More ]

Clinical Pathways in Payment Reform Should Address Risk Adjustment

September 2016, Vol 7, No 8 - Clinical Pathways

It does not take a crystal ball, or even an economist, to foretell that disaster is imminent in the healthcare system if premiums and out-of-pocket costs continue to rise, along with the cost of cancer drugs. Although the government attempts to rectify the situation with Medicare payment reform, new payment and care delivery models, such as the Oncology Care Model (OCM) pilot, and laws, such as the 2015 Medicare Access and CHIP Reauthorization Act (MACRA), present financial challenges for oncologists. [ Read More ]

Palliative Care Program Eases Patient Symptoms and Hospital Costs

November 2016, Vol 7, No 10 - Value in Oncology

San Francisco, CA—In addition to improving quality of care and patient satisfaction, palliative care can also save hospitals millions of dollars, according to a study presented by lead investigator Sarina Isenberg, PhD candidate, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD. The study’s final analysis showed that expanded patient access to palliative care demonstrated substantial savings to the Johns Hopkins Hospital and Health System and could lead to approximately $20 million in savings in 5 years, said Ms Isenberg at the 2016 Palliative Care in Oncology Symposium. [ Read More ]

Out-of-Pocket Costs Are High for End-of-Life Care in Patients with Blood Cancers

November 2016, Vol 7, No 10 - Value in Oncology

San Francisco, CA—For patients with hematologic malignancies, end-of-life care varies but often involves high-intensity interventions as death approaches. According to a recent analysis by Cara L. McDermott, PharmD, PhD, MSc, Senior Fellow, Fred Hutchinson Cancer Research Center, Seattle, WA, and colleagues, these interventions can come with a hefty price tag, too. [ Read More ]

Disparities in Rehospitalization Rates Among Patients with Advanced Cancer

November 2016, Vol 7, No 10 - Palliative Care

San Francisco, CA—In addition to being costly for public and private payers, hospital readmissions can lead to increased risk for complications, hospital-acquired infections, and psychological distress in patients with advanced cancer. Although preventing readmissions would improve patient outcomes and decrease healthcare costs, the underlying causes of rehospitalization are not completely understood, suggested Robin L. Whitney, RN, PhD, Betty Irene Moore School of Nursing, University of California, Davis, and colleagues in a poster presentation at the 2016 Palliative Care in Oncology Symposium. [ Read More ]

Trajectory of Illness and Distress in Patients Undergoing Stem-Cell Transplantation

November 2016, Vol 7, No 10 - Palliative Care

San Francisco, CA—As a result of recent advances in therapy, indications for stem-cell transplant are expanding, along with the number of patients eligible for the procedure. However, the intense and cure-oriented nature of transplants can lead to various forms of distress in patients who undergo this treatment, said Christina K. Ullrich, MD, MPH, Pediatric Oncology, Dana-Farber Cancer Institute, Boston, MA, at the 2016 Palliative Care in Oncology Symposium. [ Read More ]

New Value Model Incorporates Long-Term Adverse Effects of Cancer Drugs

February 2017, Vol 8, No 1 - Value-Based Care

A new economic model suggests that overall survival and drug toxicity profiles are insufficient for assessing the value of a drug. According to a study that incorporated late adverse events in advanced Hodgkin lymphoma, a more comprehensive benefit-to-risk ratio of a drug requires an understanding of its long-term health implications, said Ohad Oren, MD, Pennsylvania Hospital, University of Pennsylvania, Philadelphia, at the 2016 American Society of Hematology meeting. [ Read More ]

ASCO Value Framework Ill-Equipped to Assess Value of Therapies in Chronic Lymphocytic Leukemia

February 2017, Vol 8, No 1 - Value-Based Care

San Diego, CA—A study examining the feasibility and applicability of the American Society of Clinical Oncology (ASCO) Value Framework in chronic lymphocytic leukemia (CLL) suggests that the tool, although useful in assessing a small percentage of drug regimens, may need to be amended to be useful in CLL, reported Erlene K. Seymour, MD, Assistant Professor, Department of Oncology, Karmanos Cancer Institute, Wayne State University, Detroit, MI, at the 2016 American Society of Hematology meeting. [ Read More ]

Value Frameworks Unreliable in Assessing Novel Hematologic Therapies

February 2017, Vol 8, No 1 - Value-Based Care

San Diego, CA—The American Society of Clinical Oncology (ASCO) and the European Society for Medical Oncology (ESMO) developed frameworks to determine the relative value of novel therapeutic agents. These value frameworks, however, may need to be modified to assess treatments for hematologic malignancies, suggested Matthew C. Cheung, MD, SM, FRCPC, Clinical Hematologist, Odette Cancer Centre, Toronto, Ontario, Canada, at the 2016 American Society of Hematology meeting. [ Read More ]

Increased Utilization of Biosimilars in Oncology Could Save Payers Millions

February 2017, Vol 8, No 1 - Economics & Value, Value-Based Care

San Diego, CA—Filgrastim (Neupogen), a short-acting granulocyte colony-stimulating factor (G-CSF), has helped to manage chemotherapy-induced neutropenia in patients with nonmyeloid malignancies, but it comes with a hefty price tag. According to a recent study, biosimilars of filgrastim may provide a more affordable option for US payers, suggested Susan Gabriel, Director of Global Health Economics and Outcomes Research, Teva Pharmaceuticals, Frazer, PA, at the 2016 American Society of Hematology meeting. [ Read More ]

BEACOPP Regimen Superior to ABVD in Newly Diagnosed, Advanced Hodgkin Lymphoma

February 2017, Vol 8, No 1 - Value-Based Care

San Diego, CA—In transplant-eligible patients with newly diagnosed, advanced-stage Hodgkin lymphoma, a decision-analytic model showed that chemotherapy with bleomycin, plus etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone (BEACOPP) maximized life-expectancy and quality-adjusted life expectancy compared with doxorubicin plus bleomycin, vinblastine, and dacarbazine (ABVD) therapy in the first-line setting, reported Abi Vijenthira, MD, Princess Margaret Cancer Centre, University of Toronto, Canada, at the 2016 American Society of Hematology meeting. [ Read More ]

Oncologists Must Begin to Discuss Financial Toxicity with Patients

August 2017, Vol 8, No 4 | Payers’ Perspectives In Oncology: ASCO 2017 Highlights - Value-Based Care

Chicago, IL—The issues underlying financial toxicity are undoubtedly complex, but for oncologists looking to help their patients cope, simply noting the cost of treatment from the outset may be the best place to start. As the cost of cancer care continues to rise, greater transparency throughout the process of drug pricing and drug payment needs to become part of the clinical discussion, said Leonard Saltz, MD, Chief, Gastrointestinal Oncology Service, Memorial Sloan Kettering Cancer Center, New York City, at the 2017 ASCO annual meeting. [ Read More ]

Adoptive T-Cell Therapy: Ready for Prime Time

August 2017, Vol 8, No 4 | Payers’ Perspectives In Oncology: ASCO 2017 Highlights - Immunotherapy

Chicago, IL—Chimeric antigen receptor (CAR) T-cell therapy is changing cancer care. In 2010, there were just 3 CAR T-cell clinical trials. As of May 2017, 183 clinical trials are underway, and for the first time, there are more clinical trials in China than in the United States, according to Carl H. June, MD, Director, Translational Research Program, University of Penn­­sylvania, Philadelphia, at the 2017 ASCO annual meeting. Dr June discussed how this rapidly evolving technology is taking immuno-oncology to the “next level” of precision medicine. [ Read More ]

Daratumumab Added to Carfilzomib, Lenalidomide, and Dexamethasone: Safe and Tolerable in Patients with Newly Diagnosed Multiple Myeloma

August 2017, Vol 8, No 4 | Payers’ Perspectives In Oncology: ASCO 2017 Highlights - Multiple Myeloma

Chicago, IL—In patients with newly diagnosed multiple myeloma, the addition of daratumumab to carfilzomib (Kyprolis), lenalidomide (Revlimid), and dexamethasone (ie, the KRd regimen) is showing promise as a frontline treatment regimen. According to the results of an open-label, phase 1b study presented at ASCO 2017, induction therapy with the KRd regimen was well-tolerated, and the overall safety profile was consistent with previous reports for KRd, with no additional toxicity observed with the addition of daratumumab. Moreover, the study investigators reported that the regimen was very effective, with 100% overall response rate observed. [ Read More ]

Rapid Adoption of Oncology Drugs Improves Survival

December 2017, Vol 8, No 5 - Value in Oncology

Innovation takes time, especially when it comes to cancer research. However, delays in the adoption of novel oncology treatments can have a significant impact on patient health, reported Jason Shafrin, PhD, Director of Healthcare Quality and Value-Based Research Methods, and Senior Research Economist, Precision Health Economics, Los Angeles, CA, who presented the results of a geographic-based analysis of claims data at the 2017 Cancer Survivorship Symposium. [ Read More ]

Oral Multiple Myeloma Medication Linked to Decreased Productivity Loss

February 2018, Vol 9, No 1 | Payers’ Perspectives In Oncology: ASH 2017 Highlights - Multiple Myeloma, Value-Based Care

Atlanta, GA—A recent analysis of a commercial claims database suggests that oral therapy for multiple myeloma may help decrease the economic burden for patients and healthcare systems. According to data presented at ASH 2017, patients with multiple myeloma who received injectable therapy used significantly more disability benefits and incurred higher productivity costs than patients who received oral medications. [ Read More ]

Acute Myeloid Leukemia Treatment Episodes Linked to Significant Economic Burden

February 2018, Vol 9, No 1 | Payers’ Perspectives In Oncology: ASH 2017 Highlights - Value-Based Care

Atlanta, GA—A retrospective analysis of a large commercial payer database has demonstrated a link between various treatment episodes of acute myeloid leukemia and substantial economic burden. According to data presented at ASH 2017, healthcare resource use and direct healthcare costs were associated with high-intensity chemotherapy induction, hematopoietic stem-cell transplantation (HSCT), and episodes of relapsed or refractory disease in a US commercially insured population. [ Read More ]

Profound Symptom Burden of Myeloproliferative Neoplasms Highlighted in New Studies

February 2018, Vol 9, No 1 | Payers’ Perspectives In Oncology: ASH 2017 Highlights - ASH 2017, Conference Correspondent

Atlanta, GA—A pair of recent studies from the Mayo Clinic underscore the serious symptom burden experienced by patients diagnosed with myeloproliferative neoplasms (MPNs), according to data presented at ASH 2017. Specifically, patients with MPNs are at high risk for depression, and those with Philadelphia chromosome–negative disease are afflicted with sleep and psychiatric disturbance as well. [ Read More ]

Recent FDA Approvals for ALL a “Watershed” Moment

February 2018, Vol 9, No 1 | Payers’ Perspectives In Oncology: ASH 2017 Highlights - Leukemia

Atlanta, GA—The past few years have witnessed significant progress in the treatment of several hematologic malignancies, and truly paradigm-changing therapies have recently emerged in acute lymphoblastic leukemia (ALL). At ASH 2017, Crystal L. Mackall, MD, Co-Director, Immunology & Immunotherapy of Cancer Program, Stanford University, CA, discussed the FDA approvals of 2 important treatments for patients with B-cell precursor ALL. [ Read More ]

Brentuximab Vedotin plus Nivolumab Yields High Complete Responses in Relapsed or Refractory Hodgkin Lymphoma

February 2018, Vol 9, No 1 | Payers’ Perspectives In Oncology: ASH 2017 Highlights - Lymphoma

Atlanta, GA—Interim results from a phase 1/2 study of the combination of brentuximab vedotin (Adcetris) and nivolumab (Opdivo) have demonstrated a high overall response rate (ORR) in patients with relapsed or refractory Hodgkin lymphoma. According to data presented at ASH 2017, 83% of patients responded to the combination, which included a 62% rate among efficacy-evaluable patients. [ Read More ]

First-in-Class Antibody-Drug Conjugate Effective in HER2-Negative Metastatic Breast Cancer

August 2018, Vol 9, No 2 | Payers’ Perspectives In Oncology: ASCO 2018 Highlights - Breast Cancer

Chicago, IL—A novel drug is showing significant promise in metastatic breast cancers, offering renewed hope to patients with late-stage, difficult-to-treat solid tumors. According to data presented at ASCO 2018, sacituzumab govitecan demonstrated significant clinical activity as a single agent in [ Read More ]

Timing of Palliative Care Consults Affects Healthcare Utilization in Elderly Patients with Pancreatic Cancer

August 2018, Vol 9, No 2 | Payers’ Perspectives In Oncology: ASCO 2018 Highlights - Pancreatic Cancer

Chicago, IL—A claims analysis of elderly patients with pancreatic cancer has shown that those receiving early palliative care consultations had lower healthcare utilization than patients who received late palliative care. Data presented at ASCO 2018 showed that patients who received [ Read More ]

Do No Financial Harm: How to Improve Cost Transparency in Cancer Care

December 2018, Vol 9, No 4 - Value-Based Care

San Diego, CA—We’ve heard the figures before: the price of cancer drugs has risen by orders of magnitude per month over the past decades, deductibles have tripled in the past 6 years, and employer contribution to premiums has increased by nearly 300% over the past 15 years. In addition to cancer treatment becoming more expensive, insurance design and drug formularies have changed, resulting in a greater financial burden for patients. [ Read More ]