Conference Promises Valuable Perspectives

February 2011, Vol 2, No 1 - AVBCC Preview

The Association for Value-Based Cancer Care’s First Annual Stakeholder Integration Conference will be held in Philadelphia on March 29- 30, 2011 (see full agenda below). To help set the stage for this meeting, Value- Based Cancer Care (VBCC) interviewed Gary Owens, MD, one of the cochairs of the meeting. Dr Owens is president of Gary Owens Associates, a medical management and pharmaceutical consulting firm in the Philadelphia area. Dr Owens is a primary care physician who has spent 20 years in health plans, and one of his major areas of focus during that time has been oncology.

VBCC: Why this meeting now?
Gary Owens, MD: A number of reasons, the first being the obvious rapid growth of spending that the players in the oncology world—including the federal government, health plans, and the public—is seeing. As Peter Bach noted several years ago in the New England Journal of Medicine (2009;360: 626-633), the cost of cancer care agents has risen dramatically over the years, and the ability to control those costs has been limited. Baby boomers are aging, and people are living longer with cancer. It is an almost-perfect storm. Ultimately, the goal is to provide the best care possible for patients with malignant disorders but to spend those care resources wisely. We don’t want to withhold treatment from those who need it, but we don’t want to waste treatment in those for whom it is ineffective or unproven. This meeting will examine all these topics.

VBCC: Who will be presenting at this meeting, and what topics can we expect to be covered?
Dr Owens: We have some key thought leaders. On the clinical side, Al Benson, MD, the current president of the Association of Community Cancer Centers, and A. Mark Fendrick, MD, from the University of Michigan, will both present. Dr Fendrick is a driving force behind the value-based benefit movement, and it will be interesting to hear his perspective.

Along the lines of targeted therapy, we have a session on the age of personalized oncology therapy that promises to be a very cogent topic. Right now, these offer more promise than reality. Although there are a few successful examples of this so far—KRAS testing and colorectal cancer, HER2/neu testing and breast cancer, and ABR-BCL mutations in chronic myelogenous leukemia—this is an area that will continue to grow, so it was essential that we cover this.

In the future, I suspect that drugs will come to market with companion diagnostics attached to them. I’m not sure that health plans, providers, or anyone else is tuned in as to how to manage these situations effectively.

Other areas to be covered will include clinical treatment of cancer patients, the use of guidelines, and patient navigators and patient-assistance programs. With the growing number of uninsured and underinsured patients, we can’t forget about the difficulties these individuals face in accessing treatment, so these latter sessions will be important.

VBCC: What’s different about this meeting? Dr Owens: A big plus is that it brings together different viewpoints from various stakeholders, including health plans, pharmacy benefit managers, providers, patients, government, manufacturers, and the National Com pre hensive Cancer Network. We’re attempting to bring together a group that owns different pieces of the cancer care equation, and to hear about the world of oncology through their eyes. We hope to identify common issues and understand how we might integrate these. The current situation with Avastin provides an excellent example of the interconnected nature of cancer care today. The US Food and Drug Admin – istration (FDA)’s accelerated approval was based on the requirement of further data on patients with metastatic breast cancer. Compendia, however, continue to advocate coverage for this condition as do some patient groups. So we have a situation where the FDA is taking one action and the real world another. Some patients are benefiting but many are probably not. Con – ferences such as these can be helpful in shedding light on the issues behind these situations. We’re trying to open up the lines of communication between these various groups. Currently, stakeholders may not have a chance to “cross-pollinate,” as we’re hoping to do here. I may have seen only 1 or 2 other meetings that have even tried to bring together this many stakeholders. We tend to live in our own world and often only see our own points of view, so it can be eyeopening to see those other viewpoints. We will feature multiple presenters, with interactivity not only among presenters but with members of the audience. We believe that this audience is going to have as much expertise as the people behind the podium, which should make for excellent interactions.