Value-Based Cancer Care Issues


July 2015, Vol 6, No 6

ASCO Develops New Framework to Evaluate the Value of Cancer Therapies

Laura Morgan

ASCO’s Value Framework

Cancer care is one of the fastest growing components of US healthcare costs and is estimated to reach $158 billion by 2020. The American Society of Clinical Oncology (ASCO) Value in Cancer Care Task Force attributes the rising cost of cancer care to several factors, including the overall aging of the population, the introduction of costly new drugs and innovative surgery and radiation techniques, and the adoption of more expensive diagnostic tests. [ Read More ]

ASCO’s Value Framework Abandons the Hippocratic Oath

Robert Goldberg, PhD

VBCC Perspectives

The American Society of Clinical Oncology (ASCO) new value framework abandons the Hippocratic Oath. No longer is the doctor’s first obligation to “apply, for the benefit of the sick, all measures which are required.” Instead, ASCO’s value framework has the potential to help insurers “evaluate the relative value of new treatments” as they develop “benefit structures, adjustment of insurance premiums, and implementation of clinical pathways and administrative controls." [ Read More ]

FDA News – July 2015

FDA Approvals, News & Updates

The FDA’s Oncologic Drug Advisory Committee (ODAC) reviewed necitumumab (Eli Lilly & Co) for use in patients with metastatic squamous non–small-cell lung cancer (NSCLC). Necitumumab is an immunoglobulin G1 monoclonal antibody that inhibits the interaction between the human epidermal growth factor receptor (EGFR) and its ligands. EGFR expression is elevated in NSCLC and affects >95% of squamous NSCLC tumors. [ Read More ]

Oncology News – July 2015

Oncology News

  • Eli Lilly and Immunocore Launch New Collaboration to Develop Next-Generation Immuno-oncology Therapies
  • Biosimilars Focus on Oncology, Could Reach $55 Billion by 2020
  • ImmunoCellular Therapeutics and Novella Clinical to Collaborate on a Phase 3 Trial in Glioblastoma
  • House Passes New Medicare Bill That Includes a Value-Based Insurance Design Pilot Project
[ Read More ]

The ASCO Value Framework: To What End?

Edward C. Li, PharmD, MPH, BCOP

VBCC Perspectives

In the modern era of increasing healthcare costs, and with prescription drug expenditures forecasted to increase by 7% to 9% in the next year, a focused discussion on the value proposition of cancer care is warranted. The American Society of Clinical Oncology (ASCO) Value in Cancer Care Task Force should be commended for igniting the conversation about the value of chemotherapy regimens. We live in a society with a limited amount of resources, and, therefore, resources such as treatment options must be allocated appropriately to maximize the benefits to society. [ Read More ]

Patient-Centric Cancer Care

Rick Lee

VBCC Perspectives

Rising to a level of equal status with cancer providers is a tall order for patients with cancer, yet it is precisely the intent of the Meaningful Use Stage 3 proposed standards that are set to take effect in 2018 (ie, patient-reported outcomes), as well as the value-based care initiatives. Providers need to drop their resistance and contemplate the following benefits of patient centricity. [ Read More ]

The Rush to Value

William McGivney, PhD

VBCC Perspectives

The American Society of Clinical Oncology (ASCO) has introduced its conceptual framework to “Assess the Value of Cancer Treatment Options,” with the laudable objective to “assist physicians and patients in assessing the values of a new drug treatment.” As released, the ASCO framework has the potential to confound oncologists, in some instances, as follows. [ Read More ]

ASCO’s and MSKCC’s Efforts to Address the Cost of New Cancer Treatments

Dan McCrone, MD

VBCC Perspectives

In 2012 and 2013, the American Society of Clinical Oncology (ASCO) published 2 sets of 5 key opportunities to improve value in cancer care as part of a multispecialty project, called Choosing Wisely. As a supervisor for a process that reviewed more than 15,000 hematology and oncology treatment requests in 2013, we were able to observe oncologists who followed ASCO’s advice, and those who were either unaware of Choosing Wisely or who chose to disregard it. Although the recommendations were not universally followed, they were a tremendous step forward in advancing value-based oncology treatments. [ Read More ]

In the Literature – July 2015

In the Literature

  • Nivolumab Superior to Docetaxel in Patients with Previously Treated Squamous-Cell NSCLC
  • Glembatumumab Vedotin Well Tolerated in Patients with Advanced Glycoprotein NMB-Expressing Breast Cancer
  • Standardized Methods to Assess Response in Pediatric NHL
[ Read More ]

Implications of the New Provider-Driven Value-Assessment Tools in Oncology

Larry Blandford, PharmD; Dan Renick, RPh

VBCC Perspectives

Given the number of oncology agents introduced over the past 5 years, and the corresponding rise in costs, it is little surprise that multiple organizations are reacting with methods to assess value. Although payers have historically been the default for assessing value to determine formulary coverage, the most recent entrants of the American Society of Clinical Oncology (ASCO), with its value framework, and Memorial Sloan Kettering Cancer Center (MSKCC), with its DrugAbacus, into this arena represent providers of oncology care. Historically pegged as solely focused on clinical evidence and seeking effective therapy at all costs, the focus by providers on the value of cancer care is increasing. [ Read More ]

Who Defines Value?

Art Wood

VBCC Perspectives

The relative value of cancer care has become the major debate in oncology over the past few years. The rising costs of treatment, along with increasing out-of-pocket costs for patients, have sparked a debate about what is “reasonable” treatment for all involved. As a nonprofit patient assistance foundation, Patient Services provides financial assistance to patients who have great challenges in accessing their treatments because of the high costs. Of note, most of those who receive assistance from our foundation are insured. [ Read More ]

Value-Based Tools Should Complement Clinicians’ Perspectives to Inform Best Treatment Decisions for the Individual Patient

Amy Grogg, PharmD

VBCC Perspectives

The American Society of Clinical Oncology (ASCO) value framework and Memorial Sloan Kettering Cancer Center (MSKCC)’s DrugAbacus are 2 recent examples of an increasing trend of value-­based modeling to assess pharmaceuticals. Of particular interest, these methodologies represent some of the first efforts to incorporate a systematic approach to value specific to oncology. Xcenda, an AmerisourceBergen company, has previously reported on the increasing shift to value-based care with the Department of Health & Human Services and select large US payers.1 Outside of the United States, single-payer systems in Europe have taken an even more aggressive approach to value-based models, going as far as to quantify the value of human life, and then to measure the use of a drug versus its ability to prolong life in a demonstrable way. [ Read More ]

Who Exactly Would Benefit from Lower Cost of Cancer Drugs?

Daniel J. Klein

VBCC Perspectives

The high costs of specialty medications and the burden they place on individual patients and on the healthcare system overall are the media topics du jour. Cancer drugs are often cited as examples of unrestrained medication costs, so it is not surprising that the oncology community has responded by proposing alternative pricing models for cancer treatments based on the incremental value they provide. [ Read More ]

The Search for Value-Based Healthcare Delivery: The Agenda for Oncology

Chase Doyle

Value in Oncology

Chicago, IL—The presidential keynote address at the 2015 American Society of Clinical Oncology meeting was presented by Michael E. Porter, PhD, MBA, Bishop William Lawrence University Professor, Harvard Business School, Boston, who started the value discussions a decade ago. A strong proponent of changing the healthcare system to focus on value, Dr Porter suggests that the fundamental purpose of healthcare is to deliver great outcomes with increasing efficiency, but achieving this goal requires more holistic thinking about delivery care as science. [ Read More ]

Value Propositions in Oncology: The Physician Perspective

Chase Doyle

Value in Oncology

Chicago, IL—The rising costs of cancer drugs and medical services, along with increased copays and high deductibles for patients, are adding a serious financial hardship to patients diagnosed with cancer, according to Neal J. Meropol, MD, Associate Director, Clinical Programs, University Hospitals Seidman Cancer Center, Case Western Reserve University, Cleveland, OH. [ Read More ]