Value-Based Cancer Care Issues

September 2010, Vol 1, No 4

Cost-Effectiveness in the New Comparative Effectiveness Landscape

ASCO Conference

Boston, MA—Cost-effectiveness can still add value in the comparative effectiveness landscape without it becoming woven into the politically caustic concept of healthcare allocation, according to 4 experts from academia, industry, and governmental agencies. The future of cost-effectiveness in the larger universe of comparative effectiveness research in a post–healthcare [ Read More ]

REMS Regulation Provokes Anger in Provider Community

Health Policy

Silver Spring, MD—Risk Evaluation and Mitigation Strategies (REMS) are required from some drug manufacturers as part of a new US Food and Drug Administration (FDA) regulation designed to draw the attention of sponsors, providers, and patients to the likelihood of severe adverse events accompanying certain drugs and [ Read More ]

Fostering Clinical Research in the Community Setting

ASCO Conference

Chicago, IL—Taking part in clinical research poses administrative, logistic, and financial challenges to community oncology practices, but also presents these organizations with opportunities for a more active role in shaping patient care. Therefore, community practices that venture into clinical research should strive to follow emerging guidelines aimed at establishing [ Read More ]

Value Propositions


Trastuzumab Extends Stomach Cancer Survival, But Is It Worth It? Adding trastuzumab to standard cisplatinum/fluoropyrimidine chemotherapy for patients with HER2-positive advanced gastric cancer results in a median survival of 13.8 months, compared with 11.1 months with chemotherapy alone, according to a new study (Lancet. [ Read More ]

Community Trials Essential to Broad Knowledge

Ed Pezalla, MD, MPH

VBCC Perspectives

Several sessions at the recent ASCO meeting considered new standards for community-based oncology research and the development of comparative effectiveness research (CER) methods. Community-based oncology trials play an important role in developing treatment strategies and options. In recent years, however, clinical trial participation in the United States has been on [ Read More ]

Active Surveillance Cost-Effective for Low-Risk Prostate Cancer

ASCO Conference

Chicago, IL—Active surveillance is a cost-effective option for low-risk clinically localized prostate cancer. The number of quality-adjusted lifeyears (QALYs) was highest with active surveillance compared with radical prostatectomy, radiation therapy, brachytherapy, and proton beam therapy, according to data presented by Julia H. Hayes, MD, instructor in medicine [ Read More ]

Bevacizumab Cost-Effectiveness “in Line” with Other Therapies

ASCO Conference

Chicago, IL—The cost-effectiveness of adding bevacizumab (Avastin) to first-line chemotherapy for the treatment of metastatic colorectal cancer is comparable to that of many other therapies for metastatic cancer. Although the acquisition cost of bevacizumab is high, it has improved the cost-effectiveness of systemic therapy (irinotecan [Camptosar]- or oxaliplatin-based [ Read More ]

Greater Role for Pharmacogenomics Ahead

ASCO Conference

Chicago, IL—Using genetic and pharmacogenomic information to treat patients with cancer in optimal fashion has advanced in the past several years, and the clinical utility of this approach should continue to improve as genetic research continues, said several panelists at a 2010 ASCO session on evaluating the evidence [ Read More ]

ASCO Weighs in on CER

ASCO Conference

The American Society of Clinical Oncology (ASCO) stated that comparative effectiveness research (CER) should draw on approaches currently used for clinical trials, highlighting its stake in the matter by pointing out that CER is integral to oncology research. ASCO’s statement came in response to a request from the [ Read More ]

Trial Participation Hampered by Costs

ASCO Conference

Cost-related factors are a chief reason for patients declining to participate in a clinical trial, a survey of 4 community oncology practices showed. Overall, 28% of patients cited cost as a factor in their refusal to participate in clinical trials, and 12% said cost was the primary [ Read More ]

Does Robotic Surgery Make the Cut?

Robertson Paton


Over the past decade, polarized opinion has abounded regarding robot-assisted laparoscopy. On one side, many of the surgeons who pioneered the use of the da Vinci surgical robot (Intuitive Surgical, Sunnyvale, CA) in Germany and the United States described it as “revolutionary,” heralding “a new era,” and creating [ Read More ]

Comparing VHA with Fee-for-Service Cancer Care

Cherie Dewar


Boston, MA—The work of 3 Harvard Medical School researchers presented at June’s AcademyHealth Conference provided a snapshot of how cancer care outcomes compare between the Veterans Health Administration (VHA) and the fee-for-service Medicare community. In this case, the notion of “you get what you pay for” may not [ Read More ]

New Compounds Hold Promise for Prostate Cancer

Prostate Cancer

Virtually all patients that succumb to prostate cancer die of metastatic castration-resistant disease (CRPC). Docetaxel, the standard of care for these patients, provides a modest prolongation of survival, but there is an urgent need for novel treatment strategies. Recently, the biological and molecular mechanisms driving prostate cancer growth and [ Read More ]

The $93,000 Question

Yu-Ning Wong, MD, MSCE

VBCC Perspectives

Sipuleucel-T (Provenge) and cabazitaxel (Jevtana) have drawn much attention both for being the first new treatments for advanced prostate cancer since docetaxel (Taxotere) was approved in 2004, and for their high costs. As described in Dr Newcomer’s accompanying piece, they will add significantly to the cost of care [ Read More ]