Rosemary Frei, MSc

Authored Items

Better Diagnostic Accuracy Through More Testing? Not Necessarily When It Comes to Bladder Cancer

May 2010, Vol 1, No 1 - Genitourinary Cancers Symposium

San Francisco, CA—A new study challenges the notion that more testing leads to greater accuracy in detection of non–muscle-invasive bladder cancer (NMIBC). Results presented at the ASCO 2010 Genitourinary Cancers Symposium indicate that cystoscopy alone costs $7692 per tumor detected and has a low false-positive rate. Adding cytology, nuclear [ Read More ]

Researchers Probe Concurrent Timing of ADT Use Drop and Medicare Reimbursement Policy Change

May 2010, Vol 1, No 1 - Genitourinary Cancers Symposium

San Francisco, CA—By mining the Surveillance, Epidemiology and End Results-Medicare Database, researchers have documented a significant de cline in nonevidence-based use of androgen deprivation therapy (ADT) for prostate cancer between 2003 and 2005. This coincides with a significant drop in Medicare reimbursement in 2004 for the form of [ Read More ]

Recent Ruling on Genetic Patents Leaves Many Questions

October 2011, Vol 2, No 6 - Health Policy

On July 29, 2011, a 3-judge panel from the US Court of Appeals for the Federal Circuit invalidated some patents held by Myriad Genetics and the University of Utah Research Foundation for methods of analyzing individuals’ gene sequences for the presence of BRCA1 and BRCA2 mutations, but upheld other related patents in a reversal of a lower court ruling. The decision has left the door open to many questions.

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Is Sentinel Lymph Node Biopsy Truly the Standard of Care in Melanoma?

December 2011, Vol 2, No 7 - American Pathologists Meeting

Grapevine, TX—Two expert oncologists presented the clinical data in support for and against the use of sentinel lymph node biopsy (SLNB) in melanoma as the standard of care during the 2011 College of American Pathologists annual meeting.

Vernon Sondak, MD, Chair, De - partment of Cutaneous Oncology, Moffitt Cancer Center, Tampa, FL, supported the use of SLNB as the standard of care in melanoma.

J. Meirion Thomas, MD, attending oncologist, Royal Marsden Hospital and Imperial College, London, said that routine SLNB in melanoma is unwarranted.
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Americans Willing to Pay Hundreds of Dollars Out of Pocket for Cancer Risk Tests

February 2012, Vol 3, No 1 - Health Policy

American adults would be willing to pay a median of $263 for a perfect prostate cancer prediction test and $232 for a perfect breast cancer prediction test, according to a recent survey (Neumann PJ, et al. Health Econ. 2012;21:238-251). This is even when—according to this hypothetical scenario presented to participants in the survey—respondents were told that if the test results were positive the disease could not be prevented, but the person could access treatments when the disease occurred.

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New Data Suggest Oncotype DX Unnecessary in Some Cases of Low-Grade Cancer

March 2012, Vol 3, No 2 - Breast Cancer

Grapevine, TX—A New Jersey research team is making the case for relying less on the Oncotype DX test for breast-cancer prognosis and instead focusing on conventional pathological analyses. Pathologists at Saint Barnabas Medical Center, Livingston, NJ, and Monmouth Medical Center, Long Branch, NJ, found that in a retrospective review of 90 cases, 88% of those who had the following 3 characteristics were in the Oncotype DX low-risk category:

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New Calculator Shows Financial Impact of Poor Quality of Care to an Institution, and How to Correct It

September 2012, Vol 3, No 6 - Head and Neck Cancer

Toronto, Canada—A Healthcare Qual­ity Calculator (HQCal) created by re­searchers at Vanderbilt University School of Medicine, Nashville, TN, allows decision makers to determine which investments are the most cost-efficient for improving quality of care, according to a new study presented at the 2012 International Conference on Head and Neck Cancer.

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Integrative Medicine Cuts Inpatient Costs in Oncology Care Unit

October 2012, Vol 3, No 7 - Economics of Cancer Care

Albuquerque, NM—Using yoga and other integrative medicine and complementary therapies can cut oncology-related inpatient costs by more than $150 per day as a result of the reduced need for pain medications, anxiolytics, and antiemetics, according to a recent study conducted at the Beth Israel Medical Center in New York City; this daily reduction adds up to nearly $1 million annually when the savings are extrapolated to a 24-bed oncology unit in the hospital.

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Marker Helps Identify Most Aggressive Metastasized Breast Tumors

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

Boston, MA—Researchers believe they are closing in on a better way to identify breast cancers that are particularly dangerous and therefore require more aggressive therapy.

High levels of the proliferation marker Ki-67 in axillary lymph node metastases from a primary breast tumor are associated with reduced survival, according to a study presented at the American Society for Clinical Pathology’s 2012 meeting.

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Marker Helps Identify Most Aggressive Metastasized Breast Tumors

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

Boston, MA—Researchers believe they are closing in on a better way to identify breast cancers that are particularly dangerous and therefore require more aggressive therapy.

High levels of the proliferation marker Ki-67 in axillary lymph node metastases from a primary breast tumor are associated with reduced survival, according to a study presented at the American Society for Clinical Pathology’s 2012 meeting.

[ Read More ]

Axillary Ultrasound versus Sentinel Lymph Node Biopsy in Invasive Breast Cancer

January 2013, Vol 4, No 1 - Breast Cancer

Vancouver, BC—In the aftermath of the Z0011 study from the American College of Surgeons Oncology Group, oncology centers across the United States are reexamining their approach to axillary management in breast cancer.

The Z0011 researchers determined that axillary lymph node dissection (ALND) is not beneficial in patients with T1 or T2 invasive breast cancer, 1 or 2 positive sentinel nodes, and breast-conserving therapy followed by whole-breast irradiation (Giuliano AE, et al. JAMA. 2011;305:569-575).

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CMS’s Proposal to Severely Limit FDG-PET Use for Patients with Cancer Elicits Concern

May 2013, Vol 4, No 4 - Health Policy

US oncologists and radiologists are waiting to see whether the Centers for Medicare & Medicaid Services (CMS) will reconsider its proposal to limit the use of and reimbursement for fluorodeoxy­glucose-positron emission tomography (FDG-PET) scan after initial anti­cancer therapy to 1 scan in patients with solid tumors (with the exception of patients with prostate cancer, who will not be reimbursed for any FDG-PET scans).

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Comparing the Impact of ADT Agents on Cardiovascular Events and Death in Men with Prostate Cancer

July 2013, Vol 4, No 6 - Prostate Cancer

Niagara Falls, Ontario—Among men with prostate cancer and preexisting cardiovascular (CV) disease, the risk of CV events or CV-related death is cut in half when they receive androgen-deprivation therapy (ADT) with degarelix (Firmagon) instead of the luetinizing hormone–releasing hormone (LHRH) agonists goserelin (Zoladex) or leuprolide (Lupron), according to results of a new analysis presented at the 2013 Canadian Urological Association annual meeting.

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Physician-Focused Improvement in Patient Satisfaction at the Cleveland Clinic

November 2013, Vol 4, No 9 - Patient Communication

Phoenix, AZ—The degree of patient satisfaction with healthcare is becoming paramount in the new era of value-based care, according to James Merlino, MD, Chief Experience Officer, and Associate Chief of Staff, Patient Experience Office, Cleveland Clinic Health System (CCHS), OH, who discussed high-value healthcare at the American Medical Group Association 2013 Institute for Quality Leadership conference.

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Ten Steps to Achieving Value-Based Care at the Mayo Clinic

November 2013, Vol 4, No 9 - Value in Oncology

Phoenix, AZ—The staff at the Mayo Clinic are working to “bend the cost curve” and optimize resource utilization efficiency while continuing to provide high-quality care to their large population of patients, said Kari Bunkers, MD, Chief Medical Information Officer, Mayo Clinic Health System, and Medical Director, Mayo Clinic Office of Population Health Management (OPHM) at the American Medical Group Association 2013 Institute for Quality Leadership conference.

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Hispanics More Likely than Caucasians to Develop Major Complications after Radical Cystectomy

November 2013, Vol 4, No 9 - Bladder Cancer

Vancouver, Canada—The odds of having a major complication after a radical cystectomy, which is performed as part of the treatment for bladder cancer, are higher for Hispanics than for Caucasians, researchers have found. They calculated that the rate of such complications was 23.53%  for Hispanic Americans compared with 16.09% for Caucasian Americans.

[ Read More ]

Oncotype DX May Not Be Necessary to Predict Recurrence in Low-Grade Breast Cancer

April 2014, Vol 5, No 3 - Personalized Medicine

San Diego, CA—Results of a new small study have shown that histology without the use of Oncotype DX Breast Cancer assay accurately predicts the risk for recurrence in low-grade breast carcinoma. Although Oncotype DX is useful in predicting recurrence in high-grade breast cancer, this study suggests that low-grade tumors may be adequately assessed for recurrence by histology only. [ Read More ]

Frequent Mammography Screening for Breast Cancer Adds Billions to Cost

May 2014, Vol 5, No 4 - Economics of Cancer Care

The total annual cost of mammography screening for women aged 40 to 85 years in the United States is estimated to be $7.8 billion, according to a new analysis (O’Donoghue C, et al. Ann Intern Med. 2014;160:145-153). That is $4.3 billion more than the cost would be if mammography intervals were lowered to fall in line with the recommendations of the US Preventive Services Task Force (USPSTF), the study researchers calculated. [ Read More ]

Survivorship Care Plan Use Lagging

May 2014, Vol 5, No 4 - Survivorship

Cancer centers are ramping up their efforts to create survivorship care plans (SCPs) for all of their patients. However, according to a new survey conducted in 2013, they still have far to go before January 1, 2015, when the American College of Surgeons Commission on Cancer (CoC) accreditation requirement of creating SCPs for all patients comes into effect (Birken SA, et al. J Cancer Educ. 2014 April 6. Epub ahead of print) [ Read More ]

Aetna’s Model of Value-Based, Financially Viable Accountable Care Improves Health Outcomes

June 2014, Vol 5, No 5 - Economics of Cancer Care

Charles Kennedy, MD, Chief Executive Officer of Aetna’s Accountable Care Solutions, is responsible for leading Aetna’s accountable care partnerships with healthcare providers. Dr Kennedy also serves as the health insurance industry representative on the Health IT Policy Committee, a federal advisory committee that makes recommendations to the National Coordinator for Health IT on a policy framework for the development and adoption of a nationwide health information infrastructure. [ Read More ]

HHS Relaxes Electronic Health Record Certification Criteria

October 2014, Vol 5 , No 8 - Health Policy

The US Department of Health and Human Services (HHS) has responded to the chorus of voices calling for less complex rules governing electronic health records (EHRs) by not adopting the Voluntary 2015 Edition Electronic Health Record Certification Criteria. In its final rule, released in September 2014, the Office of the National Coordinator for Health Information Technology has instead included 10 optional and 2 revised certification criteria. [ Read More ]

Multigene Test Stratifies Prostate Cancer Aggressiveness

October 2014, Vol 5 , No 8 - Prostate Cancer

Chicago, IL—The commercially available cell-cycle progression test known as Prolaris is helpful for stratifying risk for men with clinically localized prostate cancer and can help to modify treatment decisions for men with prostate cancer based on the aggressive nature of their tumor, according to a poster presented at the 2014 College of American Pathologists annual meeting by Michael K. Brawer, MD, Vice President of Medical Affairs, Urology, Myriad Genetic Laboratories, Inc, Salt Lake City, UT, and colleagues. [ Read More ]

Postresection Routine Surveillance with CT Instead of Chest X-Ray Does Not Improve Survival in Early-Stage Lung Cancer

October 2014, Vol 5 , No 8 - Lung Cancer

Toronto, Canada—Survival is not improved with routine surveillance using computed tomography (CT) versus chest x-ray in patients who have undergone resection for stage I non–small-cell lung cancer (NSCLC), according to the results of a new analysis presented at the 2014 American Association for Thoracic Surgery meeting. [ Read More ]

Medicaid Reimbursement Rate Has Direct Impact on Cancer Screening Rates

October 2014, Vol 5 , No 8 - Economics of Cancer Care

Although increasing the reimbursement rate for cancer screening tests does not consistently improve the likelihood of Medicaid beneficiaries being screened for cancer, raising the rate of reimbursement for office visits does consistently increase the likelihood that they will be screened for cancer, including breast or prostate cancer, according to results of a new analysis of Medicaid claims and enrollment data. [ Read More ]

High-Quality Cancer Care Focus of ASCO’s Medicaid Reform Recommendations

March 2015, Vol 6, No 2 - Health Policy

Late last year, the American ­Society of Clinical Oncology (ASCO) issued a policy statement on Medicaid reform, with recommendations on ensuring quality of care for all patients with cancer, including the underserved population, while also improving provider reimbursement to ensure value-based care. ASCO’s poicy statement advocates for the expansion of Medicaid coverage to all Americans with cancer, an increase in Medicaid pay­­ment rates to reach those of Medicare, and a greater emphasis on rewarding providers for the delivery of quality care. [ Read More ]

Foreign-Trained Physicians Less Likely to Screen for Cancer, Especially Among Immigrant Populations

March 2015, Vol 6, No 2 - Quality Care

Screening for cancer is suboptimal among some immigrant populations, especially those whose primary care physicians are trained in foreign countries, according to results of a new study of primary care practices in Canada; specifically, women from South Asia whose family physicians were trained in South Asia were less likely to be screened for cervical cancer than nonimmigrant women whose physicians were not immigrants. [ Read More ]

Value of Cancer Care for Most Tumors Lower in United States than in Western Europe

May 2015, Vol 6, No 4 - Economics of Cancer Care

A reevaluation of the value of cancer care between 1982 and 2010 in the United States versus Western Europe (Soneji S, Yang JW. Health Aff [Millwood]. 2015;34:390-397) paints an entirely different picture from a similar analysis published in 2012 (Philipson T, et­ al. Health Aff [Millwood]. 2012;­­31:667-675). The earlier study found significant improvements in breast and prostate cancer survival in the United States relative to Western Europe, concluding that the high costs in the United States were worth it. [ Read More ]

US Oncologists Favor Establishment of NICE-Like Body to Determine Medicare Cancer Drugs Reimbursement

May 2015, Vol 6, No 4 - Economics of Cancer Care

According to a recent study, 63.6% of oncologists surveyed favor the establishment of an independent panel of health experts to decide which treatments Medicare will pay for based on a cost-benefit analysis (Gogineni K, et al. J Clin Oncol. 2015;­33:846-853). Less than 50% of patients and members of the general public think this is a good idea. The United Kingdom’s National Institute for Health and Care Excellence (NICE) is one model for such a panel. [ Read More ]

Screening in Younger First-Degree Relatives of Patients with CRC

November 2015, Vol 6, No 10 - Cancer Screening

A study from the Centers for Disease Control and Prevention documented an average 38% colorectal cancer (CRC) screening rate among people aged 40 to 49 years, and a 69.7% rate in those aged ?50 years with a first-degree relative with CRC. An earlier analysis of National Health Interview Survey (NHIS) data from 2005 and 2010 showed that first-degree relatives of patients with CRC were 70% more likely to have a colonoscopy than their counterparts. [ Read More ]