?Houston, TX—Delta Air Lines has a commitment to preventive health and comprehensive cancer care for its 140,000 health plan members; the company is piloting a “high-performance cancer network,” said Lynn Zonakis, Managing Director of Health Strategy and Resources, Delta Air Lines, Atlanta, GA, at the 2012 Second Annual Conference of the Association for Value-Based Cancer Care. Ms Zonakis was part of the employers’ panel at the conference who presented perspectives from different employer groups related to cancer care.[ Read More ]
November 2012, Vol 3, No 8
?We should all read with great interest the New York Times opinion piece by Peter B. Bach, MD, and colleagues from Memorial Sloan-Kettering Cancer Center on their rationale for not including ziv-aflibercept (Zaltrap) in its formulary for patients with metastatic or advanced colorectal cancer.[ Read More ]
?San Francisco, CA—The Oncotype DX Recurrence Score (the 21-gene) test can help identify patients with estrogen receptor (ER)-positive breast cancer with any number of positive lymph nodes who will have residual disease after adjuvant chemotherapy, and who may benefit from additional treatment, reported Eleftherios P. Mamounas, MD, Medical Director, Aultman Hospital Cancer Center, Canton, OH, at the 2012 Breast Cancer Symposium.
This new retrospective analysis was conducted by investigators from the National Surgical Adjuvant Breast and Bowel Project (NSABP).[ Read More ]
?Boston, MA—In the United States right now, intensity modulated radiation therapy (IMRT) has largely replaced 3-dimensional conformal radiation therapy as the technique of choice for most patients with organ-confined prostate cancer that is being treated with radiation as the primary therapy.
Another technique in use is brachytherapy, and, at some centers, proton beam therapy is being studied.[ Read More ]
?Synribo Approved for Chronic Myelogenous Leukemia
The US Food and Drug Administration (FDA) approved omacetaxine mepesuccinate (Synribo; Teva Pharmaceutical) to treat adults with chronic myelogenous leukemia (CML), a hematologic disease. An estimated 5430 Americans will be diagnosed with CML in 2012, according to the National Institutes of Health.
It is well understood that cancer-cell proliferation encourages tumor growth and metastasis. It is also known that the use of statins blocks the production of cholesterol, and endogenous cholesterol is crucial for human cell proliferation. Linking these 2 disparate mechanisms, researchers in Denmark set out to investigate whether statin therapy can help to reduce cancer-related mortality by limiting cancer-cell proliferation in patients who have used statins before they were diagnosed with cancer (Nielsen SF, et al. N Engl J Med. 2012;367:1792-1802).[ Read More ]
?Boston, MA—The use of proton beam radiation therapy (PBRT) for the treatment of prostate cancer is increasing across the United States, but there is no evidence from randomized, controlled trials to suggest that PBRT is more effective than intensity modulated radiation therapy (IMRT), which is the current standard of care. A study presented at the 2012 American Society for Radiation Oncology annual meeting found few differences in toxicity between the 2 techniques, but demonstrated that PBRT was associated with a 57% increase in median cost per patient.[ Read More ]
?The cost of cancer care matters; in fact, it matters so much that Memorial Sloan-Kettering Cancer Center (MSKCC) in New York City has decided not to include in its formulary the newly approved drug ziv-aflibercept (Zaltrap), which was recently approved for use in patients with progressive metastatic colorectal cancer. The decision is based on considering cost versus benefit rather than on “newer is better.”[ Read More ]
Cumulative Financial Impact of Skeletal-Related Events on Patients with Breast Cancer Is Significant
?San Francisco, CA—In patients with breast cancer with bone metastases, skeletal-related events (SREs) are associated with high treatment costs. For example, the cumulative cost of treating 1 spinal cord compression exceeds $100,000, according to a new cost analysis presented at the 2012 Breast Cancer Symposium.[ Read More ]
Payers’ Support of Clinical Decisions Allows Providers to Choose Most Effective, Cost-Saving Therapies
?The cost of cancer care is staggering. Global sales of cancer drugs alone are forecast to grow at a rate of 12% to 15% annually, reaching $75 billion to $80 billion by the end of this year, according to IMS Health.1
Clinical leadership is one of the critical keys to controlling quality and costs in healthcare. Every other segment of the healthcare system also has a role to play. At Aetna, we work to influence the creation of safer, more effective, and more affordable healthcare through clinical evidence and unprecedented collaboration.[ Read More ]
?With the fanfare of a New York Times Op-Ed piece by Peter B. Bach, MD, and colleagues, the announcement was made that Memorial Sloan-Kettering Cancer Center (MSKCC) would exclude the new colorectal cancer drug ziv-aflibercept (Zaltrap) from its formulary. Regardless of questions raised about the accuracy of the cost and the dosing comparisons and certain conflicts, the question is—Will the MSKCC decision influence community oncology clinics to consider a similar restriction?[ Read More ]
?Phoenix, AZ—Using the paradigm of individualizing drug therapy based on a patient’s genetics, a group of oncologists and genomic experts have designed a genomic prescribing system that they hope will significantly reduce the staggeringly high rate of adverse drug reactions associated with prescription drugs in the United States. Principal investigator Peter H. [ Read More ]
?Vienna, Austria—The identification of genetic mutations and tumor biomarkers to select the right drug for the right patient are not enough to satisfy the need for personalized cancer care, according to Kathy Redmond, MSc, RN, Editor of Cancer World magazine, a publication of the European School of Oncology and former president of the European Oncology Nursing Society, who addressed the topic of personalized medicine at the 2012 European Society for Medical Oncology Congress.[ Read More ]
?In this article we address the final payment rules issued on November 1, 2012, by the Centers for Medicare & Medicaid Services (CMS), the Physician Fee Schedule (PFS), and the Hospital Outpatient Prospective Payment System. These annual updates to Medicare payment rates for physicians and hospitals can have a dramatic impact on reimbursement and incentives within the Medicare program, but they also tend to impact trends in the commercial insurance market.[ Read More ]
Abraxane Receives New Indication for Locally Advanced or Metastatic Non–Small-Cell Lung Cancer, in Combination with Carboplatin, in Patients Who Are Not Candidates for Curative Surgery or Radiation Therapy
?For the purposes of treatment, lung cancer is classified as non–small cell, which accounts for approximately 85% of cases, or as small cell, representing 14% of cases.1 Non–small-cell lung cancer (NSCLC) is the leading cause of death worldwide.2 The greatest risk factor for lung cancer is cigarette smoking. Other risk factors include smoking pipes or cigars and exposure to agents such as radon gas, secondhand smoke, asbestos, chromium, cadmium, arsenic, some organic chemicals, radiation, and air pollution. [ Read More ]
?Boston, MA—The patterns of use of radiotherapy have changed over time in elderly patients with stage I breast cancer, and these changes have financial implications for the healthcare system. In elderly patients with favorable-risk breast cancer, the use of intensity modulated radiation therapy (IMRT) and brachytherapy steadily increased from 2001 to 2007, while the use of standard external beam radiation therapy (EBRT) decreased. Data are lacking on whether the newer technologies improve outcomes in this patient population. [ Read More ]
?San Francisco, CA—Three frequently used radiologic tests rarely detect metastases in patients with a new diagnosis of breast cancer and should not be routinely performed, according to a comprehensive literature review presented at the 2012 Breast Cancer Symposium.[ Read More ]
?San Francisco, CA—Acute care utilization, namely, emergency department visits and hospitalizations, are surprisingly common among patients with early breast cancer, according to a retrospective study using an administrative database in Ontario, Canada.
The findings coincide with current efforts, at least in the United States, to reduce acute care utilization as a chief means of reducing the cost of treating cancer. In fact, keeping patients with cancer away from emergency departments and hospitals has become a quality measure in many healthcare systems.[ Read More ]
?San Francisco, CA—According to a study from the US Oncology Network, patients with breast cancer who are treated with adjuvant chemotherapy have no increased risk for acute myeloid leukemia (AML) or myelodysplastic syndromes (MDS), at least within the first 3 years of treatment.
“The rates of AML/MDS were found to be low after adjuvant chemotherapy, and similar to those noted in nonchemotherapy-treated patients,” reported Neelima Denduluri, MD, a medical oncologist at Virginia Cancer Specialists, Arlington, during the 2012 Breast Cancer Symposium.[ Read More ]
?Houston, TX—Employers’ health plan managers must “balance members’ access to new treatments with the fiscal responsibility of managing the healthcare financial resources wisely,” said Bridget Eber, PharmD, Senior Consultant and Clinical Lead of Rx Group Purchasing, Towers Watson, at the 2012 Second Annual Association for Value-Based Cancer Care Conference. Towers Watson’s clients include 175 employers with self-funded benefits programs totaling $3 billion in annual drug spending.[ Read More ]
?Houston, TX—Most employers do not understand biologics and specialty pharmacy well enough to use services appropriately and to take advantage of their benefits, said F. Randy Vogenberg, RPh, PhD, Principal, Institute for Integrated Healthcare, Sharon, MA, an employer benefit consulting company.
Speaking at the Second Annual Association for Value-Based Cancer Care Conference, Dr Vogenberg drew from a recent survey of employers to suggest actions that need to be taken to better integrate healthcare stakeholders.[ Read More ]
?Vienna, Austria—Adding bevacizumab (Avastin) to chemotherapy improves outcomes in patients with platinum-resistant recurrent ovarian cancer, according to results of the phase 3 clinical trial AURELIA, which was presented at the 2012 European Society for Medical Oncology Congress. Bevacizumab improved progression-free survival (PFS) and overall response rate (ORR) with any of the 3 chemotherapy regimens in the study, but adding bevacizumab to weekly paclitaxel was the most active combination in an exploratory analysis of the trial.[ Read More ]
?Vienna, Austria—Costs associated with first-line pemetrexed/cisplatin are significantly lower than those of carboplatin/paclitaxel/bevacizumab for the treatment of advanced non–small-cell lung cancer (NSCLC), according to an analysis presented at the 2012 European Society for Medical Oncology Congress.[ Read More ]