Value-Based Cancer Care Issues

May 2010, Vol 1, No 1

Breast Cancer Survival Improves, Thanks to New Therapies


Barcelona—Survival for patients with metastatic breast cancer has improved dramatically in the last 20 years, especially in the subgroup of patients with HER2-positive tumors, according to research presented at the 7th European Breast Cancer Confer ence (EBCC7). This improvement, the researchers suggest, is due to in creased [ Read More ]

Foreign Cancer Care Offers a Mirror to Our Own

ACCC Conference

Baltimore, MD—In light of ongoing discussions on healthcare and its reform in the United States, an examination of how care is financed and delivered in other parts of the world could provide a useful contrast for our own national deliberations. That was the premise behind a [ Read More ]

Radiation and Reimbursement Concerns Dog Diagnostic Imaging

ACCC Conference

Baltimore, MD—Although major technological advances continue in the diagnostic imaging arena, heightened concern over radiation overdoses, steep prices for equipment, and questions about whether the new technologies will be reimbursed pose challenges for the field. So said Jason Launders, MSc, a medical physicist and expert on computed tomography [ Read More ]

Get Ready for Comparative Effectiveness Research

ACCC Conference

Baltimore, MD—Comparative effectiveness research (CER) is at the forefront of new cost-control efforts, according to experts speaking at a panel discussion at the Asso ciation of Community Cancer Centers’ (ACCC) 36th Annual National Meeting. Unlike traditional drug evaluations conducted by the US Food and Drug Administration, CER aims [ Read More ]

Community Cancer Centers Face Economy’s Impact

ACCC Conference

Baltimore, MD—The preliminary results of a 2009 survey on cancer care trends among community hospital cancer centers indicates the growing impact of the recession, with data showing a greater inability of patients to pay for cancer care and a freezing of plans to purchase new equipment. [ Read More ]

Healthcare Reform Through the Eyes of Joseph S. Bailes, MD

HOPA Conference

New Orleans, LA—The Patient Protection and Affordable Care Act, ie, “health care reform,” was recently passed, but oncologists and those who pay for their services are still wondering what’s in store for them. In a keynote address delivered at the annual conference of the Hematology/Oncology Pharmacy Association (HOPA), Joseph [ Read More ]

Oncology Pharmacy Reimbursement Issues in 2010

HOPA Conference

New Orleans, LA—As reimbursement for services continues to decline, oncology pharmacists must be proactive and develop a strategy to minimize losses, said Steven L. D’Amato, RPh, a clinical pharmacy specialist with the Maine Center for Cancer Medicine, Scarborough, Me, at a presentation at the annual meeting of [ Read More ]

Compendia: Powerful Tools, Wrong Job

Lynn Nishida, RPh

VBCC Perspectives

At the most basic level, compendia are drug information resources intended to aid clinicians in making “informed treatment decisions, especially in difficult and complex cases.”1 They were not intended for use in determining reimbursement of medications for the public and private healthcare insurance sectors. Nevertheless, this responsibility was assigned by [ Read More ]

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

Rosemary Frei, MSc

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

Rosemary Frei, MSc

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 ]

Radical Treatment Not Best Course for BRCA Mutations

EBCC7 Conference

Barcelona—For women with the BRCA1 or 2 genetic mutation that predisposes them to breast cancer, the option to undergo prophylactic mastectomy of the other, noncancerous breast following their initial breast cancer treatment does not improve disease-free survival or overall survival, said researchers at the EBCC7 meeting. Annette [ Read More ]

Collaboration Needed to Maximize Tamoxifen’s Benefit

EBCC7 Conference

Barcelona—An effort to monitor and modify prescription drug use in breast cancer patients prescribed tamoxifen can help prevent the polypharmacy that lessens tamoxifen’s effectiveness. Drugs including bupropion, fluoxetine, and paroxetine can inhibit the action of the CYP2D6 enzyme, which is crucial to the metabolism of tamoxifen for breast cancer. [ Read More ]

Protein Offers Expanded Predictive Significance in Early Breast Cancer


Barcelona—A protein previously thought to exist only in a limited number of tumors in fact exists across all breast cancer subtypes, a finding that can help predict the tumor’s response to chemotherapy and guide treatment decisions. These results are from a study, led by first author Gunter [ Read More ]

Existing Test May Have New Use in Anthracycline Targeting

EBCC7 Conference

Barcelona—A meta-analysis of 4 large breast cancer trials reveals that a particular chromosome abnormality is a highly significant indicator that a patient’s breast cancer will respond to anthracycline therapy, announced an international team of researchers at the EBCC7 meeting. According to the lead author on the current study, [ Read More ]

For Dying Patients, Emergency Care Is Less than Ideal

End-of-Life Care

A Canadian study examining the reasons why a patient with cancer will visit the emergency department near the end of life points out shortcomings in current care delivery systems and suggests a greater role for more effective palliative care, say the authors. The study, a retrospective examination of [ Read More ]

New Colorectal Cancer Therapies Foster New Discussions on the Value of Medications

Colorectal Cancer

New chemotherapies for metastatic colon cancer have improved life expectancy, but at a significant cost, say the authors of a study that explores the value of medications including bevacizumab (Avastin, Genentech), capecitabine (Xeloda, Roche Laboratories), cetuximab (Erbitux, Bristol-Myers Squibb), irinotecan hydrochloride (Camptosar, Pfizer, Inc), and oxaliplatin (Eloxatin, Sanofi-Aventis LLC). [ Read More ]

Oncology-related Updates from the US Food and Drug Administration


Cellular Immunotherapy Approved in Advanced Prostate Cancer The FDA approved Provenge (sipuleucel-T), a new therapy for certain men with advanced prostate cancer that uses the patient’s own immune system to fight the disease. Provenge is indicated for the treatment of asymptomatic or minimally symptomatic prostate cancer that [ Read More ]

Evolution in Oncology Practice Management: Part 1


As health plans grapple with the rapidly rising cost of oncology medications and a “buy and bill” system that does not work for physicians or for the plans, they are seeking new strategies for providing these life-saving drugs to their [ Read More ]