Houston, TX—On March 29-31, 2012, approximately 200 oncologists, payers, employers, managed care executives, pharmacy benefit managers, and other stakeholders convened for the Second Annual Stakeholder Integration Conference of the Association for Value-Based Cancer Care (AVBCC). The mission of the conference was to align the various perspectives around the central needs of defining value in cancer care and developing strategies for enhancing patient outcomes.[ Read More ]
May 2012, Vol 3, No 3
Hollywood, FL—Cancer care today is influenced by an ever-broadening array of players, and what was once an intimate relationship between patient and physician now involves multiple decision makers. At the 2012 National Comprehensive Cancer Network (NCCN) meeting, a panel of various stakeholder groups addressed the questions of what and who defines “optimal care” for today’s patient. [ Read More ]
Baltimore, MD—It has been said that a journey of a thousand miles begins with a single step. It is with this sensibility that Donald P. Howard of the Centers for Medicare & Medicaid Services (CMS) began his presentation at the 2012 Association of Community Cancer Centers (ACCC) meeting, detailing the current state of the hospital value-based purchasing (VBP) program.[ Read More ]
Houston, TX—The need to optimize the treatment of patients with cancer while using healthcare resources wisely—in other words, providing “value-based cancer care”—is not a topic of debate, but how to achieve this pressing goal is far from clear. In a panel discussion during the Association for Value-Based Cancer Care’s Second Annual Conference, strategists from the payer side of the issue discussed the current trends and the challenges they are facing.[ Read More ]
The US Food and Drug Administration (FDA) approved the oral agent pazopanib (Votrient; GlaxoSmith-Kline) for the treatment of patients with advanced soft-tissue sarcoma who have previously received chemotherapy. Pazopanib received orphan drug designation for this indication and is the first agent to receive approval for this indication in many years. Votrient works by interfering with the angiogenesis process (ie, the growth of new blood vessels that feed the growth/survival of solid tumors).[ Read More ]
The FDA accelerated the approval of the oral mTOR kinase inhibitor everolimus (Afinitor; Novartis) for the treatment of kidney tumors (ie, renal angiomyolipomas) not requiring immediate surgery in patients with tuberous sclerosis complex (TSC). This is the first drug approved specifically by the FDA for this patient population.
TSC is a rare genetic disease causing noncancerous tumors in the kidney, brain, and other organs. There are approximately 40,000 patients with TSC in the United States, of whom 70% or 80% develop kidney problems.[ Read More ]
The United States spends more on cancer care than European countries. Some people have argued that this extra expense is unwarranted, because US patients with cancer have similar or worse outcomes despite this increased spending. However, data from a new study suggest that the higher spending for cancer in the United States than in 10 European countries may be worth the additional expense (Philipson T, et al. Health Aff [Millwood]. 2012;31:667-675).[ Read More ]
Cancer is the most dreaded of all diseases, the authors of a new study suggest, which may explain why policymakers have sometimes given cancer therapies preferential status over therapies for other conditions (Neumann PJ, et al. Health Aff [Millwood]. 2012;31:700-708). However, some oncologists and health economists believe that pharmacoeconomic evaluations and reimbursement decision makers should judge cancer interventions by the same standards as those used for all other medical conditions. [ Read More ]
Controversy abounds regarding the question of whether routine prostate-specific antigen (PSA) testing reduces mortality from prostate cancer. That controversy became more intense after a recent analysis of benefits and harms of PSA screening, conducted by the US Preventive Services Task Force, recommended against routine PSA screening in asymptomatic men. [ Read More ]
Although most PSA-detected cancers are slow-growing and unlikely to cause death, most men opt to undergo immediate treatment in the form of surgery or radiation.[ Read More ]
A recent survey of US and Canadian oncologists explored how they perceive cost-effectiveness of the new and costly cancer treatments, and whether providers are considering value questions of quality versus cost in their clinical decisions.[ Read More ]
Genomic Health announced it has formed an alliance with OncoMed Pharmaceuticals to support the development of DNA-sequencing technologies in the search for diagnostic biomarkers that could identify patients who will best benefit from targeted drugs currently in development by OncoMed. These drugs are designed to block specific pathways believed to play a role in cancer-cell growth after chemotherapy.[ Read More ]
The National Human Genome Research Institute (NHGRI), part of the National Institutes of Health (NIH), has awarded $10.5 million to 10 researchers to develop technologies that will assist research on millions of genomic elements that play a role in determining what genes are expressed, and at what levels in different cells. This has particular implications for cancer therapies.
These multiyear grants are part of the Encyclopedia of DNA Elements (ENCODE) project, which promotes research on the role that the human genome plays in health and disease.[ Read More ]
Injecting antibodies and T cells with cancer stem cells may signal a new paradigm for anticancer immunotherapy, according to a recent study.
“This is a major breakthrough in immunotherapy research, because we were able to use purified cancer stem cells to generate a vaccine, which strengthened the potency of antibodies and T cells that selectively targeted cancer stem cells,” said lead investigator Qiao Li, PhD, Research Assistant Professor, Department of Surgery, University of Michigan, Ann Arbor.[ Read More ]
The Mevion S250 Proton Therapy System has received marketing approval in Europe but is still pending clearance by the US Food and Drug Administration.
Proton-beam radiation therapy is most often used for cancer therapy, but it is not widely used and is very expensive. Several studies have shown promising results for this type of therapy for the treatment of locally advanced sinonasal malignancies; it has also been used to treat patients with unresectable hepatocellular carcinoma.[ Read More ]
Houston, TX—In Michigan, 7 oncology practices are now participating in Priority Health’s oncology medical home. At the Association for Value-Based Cancer Care second annual conference, John Fox, MD, MHA, Associate Vice President for Medical Affairs, Priority Health, Grand Rapids, MI, described the key components and goals of this model.[ Read More ]
Houston, TX—Defining value in cancer care is like a group of blind men trying to define what an elephant is, by touch: it is described according to one’s own experience and perceptions, said Mark Zitter, MBA, Founder and Chief Executive Officer, The Zitter Group, San Francisco, CA.[ Read More ]
At the Association for Value-Based Cancer Care (AVBCC) second annual meeting, Ira M. Klein, MD, MBA, maintained that establishing value in cancer care is not just up to healthcare strategists. AVBCC asked Dr Klein to elaborate on this idea in the following interview.
AVBCC: You mentioned that society and the individual are important components of any effort to lower cost and establish value in cancer care. How so?[ Read More ]
Houston, TX—Jennifer Malin, MD, PhD, Manager and Medical Director of Oncology at WellPoint, described new approaches that can help to align reimbursement in oncology to enhance value and patient outcomes by focusing on episode of care rather than on the drugs, by shifting physicians’ incentives to support patient-centered decision-making.
Dr Malin described WellPoint’s new reimbursement programs in oncology at the 2nd Annual Conference of the Association for Value-Based Cancer Care.[ Read More ]
At the Association for Value-Based Cancer Care (AVBCC) second annual meeting, Winston Wong, PharmD, expressed concerns that the site of delivery of cancer care affects efforts to rein in costs and provide value in cancer care. Wong expanded on this issue in the following interview.
AVBCC: Why do you believe that the site of delivery of cancer care can impact the attempt to rein in costs of cancer care and provide value?[ Read More ]
Houston, TX—In the past 2 decades, community oncologists have experienced an era of stability (1991-2003) and a time of adaptation (2004-2006), and are now practicing in an era that may best be described as feeling the “squeeze” (2007-present), said Thomas A. Marsland, MD, President of Cancer Specialists of North Florida, Jacksonville, who discussed the current crisis in the community oncology setting at the Association for Value-Based Cancer Care second annual conference.[ Read More ]
The 2012 updates to the National Comprehensive Cancer Network (NCCN) Clinical Practice Guidelines in Oncology™ have elevated several drugs to category 1 recommendation and have changed the algorithm for work-up in some tumors. A synopsis of the key updates presented at the 2012 annual conference is reported here.
The breast cancer panel recommended a more conservative use of imaging modalities for assessing, staging, and conservative management of the axillae in selected patients.[ Read More ]
Patients receiving a diagnosis of cancer are at increased risk for suicide and other adverse health effects that are triggered by the trauma associated with such a diagnosis, according to results of a recent study (Fang F, et al. N Engl J Med. 2012;366:1310-1318).
It has previously been shown that receiving a diagnosis of cancer is associated with a high level of psychological stress, but that has often been attributed to the stress associated with the treatment itself or to the burden of living with cancer.[ Read More ]
The National Comprehensive Cancer Network (NCCN) introduced 3 new panels to its Clinical Practice Guidelines in Oncology™ at its 2012 annual conference. The key components of these new guidelines are described below.
New Panel on Lung Cancer Screening
The new Lung Cancer Screening Panel recommended that persons at risk for lung cancer be screened regularly (in some cases, annually) with helical low-dose computed tomography (LDCT) in an effort to detect cancer at its earliest stage.[ Read More ]
An independent health information technology company, eviti, Inc, provides a suite of web-based decision-support services that connects and delivers value to all parties in the care process—patients receive quality care, physicians are assured payment, insurers pay for quality care only, and pharmacy benefit managers (PBMs) or specialty pharmacy improve adherence. This decision support platform is a transformative solution that reduces variability in care, improves quality, and enables realignment of provider incentives.[ Read More ]
Baltimore, MD—Results from the latest survey of the Association of Community Cancer Centers (ACCC) membership suggest that although cancer centers have stepped up their efforts to introduce cost-reduction and revenue-enhancing initiatives, the rising tide of underinsured or uninsured patients with cancer is straining even the most optimistic of business plans.
The survey, Cancer Care Trends in Community Cancer Centers, has been conducted annually for the past 3 years. A total of 59 community cancer programs participated in this survey.[ Read More ]
Chicago, IL—Targeting prostate cancer with extreme accuracy, using tissue oxygen content to predict its recurrence, and using breast cancer drugs on brain tumors were a few highlights of a news conference on advances in personalized medicine at the 2012 American Association for Cancer Research meeting.
Prostate Cancer[ Read More ]
Chicago, IL—Metformin cannot seem to stay out of the news. This antidiabetes drug that is derived from the French lilac is now also thought to possibly protect against liver cancer, lower the risk for oral cancer, improve prognosis of pancreatic cancer in diabetic patients, and increase response to melanoma tumors with BRAF mutations when used in combination with a common cancer drug, according to several studies presented at the 2012 American Association for Cancer Research meeting.[ Read More ]
Chicago, IL—For the individual at average risk for disease, whole-genome sequencing (WGS)—mapping the sequence of one’s full set of genetic material—is not a crystal ball to reliably predict future health, according to a study presented at the 2012 American Association for Cancer Research meeting.[ Read More ]
What is the most important challenge faced by a person who is diagnosed with cancer today? Opinions will differ, but most patients want to be assured that they will work with a group of multispecialty physicians who will provide recommendations for care that provide the best possible outcomes, that all options for effective treatment will be available to them, that care will be provided in a safe and comfortable hospital or other facility, and that the healthcare staff will care about their problems and concerns with managing treatment, professional issues, and family issues.[ Read More ]