Value-Based Cancer Care Issues


March 2015, Vol 6, No 2

High-Quality Cancer Care Focus of ASCO’s Medicaid Reform Recommendations

Rosemary Frei, MSc

Health Policy

Late last year, the American ­Society of Clinical Oncology (ASCO) issued a policy statement on Medicaid reform, with recommendations on ensuring quality of care for all patients with cancer, including the underserved population, while also improving provider reimbursement to ensure value-based care. ASCO’s poicy statement advocates for the expansion of Medicaid coverage to all Americans with cancer, an increase in Medicaid pay­­ment rates to reach those of Medicare, and a greater emphasis on rewarding providers for the delivery of quality care. [ Read More ]

ASSURE Trial: No Role for Adjuvant Sorafenib or Sunitinib in Locally Advanced Kidney Cancer

Phoebe Starr

Genitourinary Cancers Symposium

Orlando, FL—Surprisingly, the use of adjuvant sorafenib (Nexavar) and sunitinib (Sutent) failed to extend disease­-free survival (DFS) in patients with locally advanced kidney cancer who are at high risk for recurrence, according to initial results of the ASSURE study. The ASSURE trial is the first and largest study investigating the use of adjuvant tyrosine kinase inhibitors/vascular endothelial growth factor (VEGF) inhibitors in kidney cancer. [ Read More ]

Value of New Drugs for Hematologic Cancers—Improving Quality, Extending Survival

Wayne Kuznar

Economics of Cancer Care

Although often criticized as being overly expensive, innovations in drug development for hematologic malignancies meet standard benchmarks for cost-effectiveness, delivering value for their cost, suggest a team of health economics researchers led by Peter J. Neumann, ScD, Director, the Center for the Evaluation of Value and Risk in Health, Tufts Medical Center, Boston (Saret CJ, et al. Blood. 2015 Feb 5. Epub ahead of print). [ Read More ]

AR-V7 Predicts Chemotherapy Sensitivity in Metastatic Prostate Cancer

Phoebe Starr

Personalized Medicine

Orlando, FL—Experts are hopeful that the field of prostate cancer will soon be catching up to breast cancer and some other tumor types with regard to genomic markers. A study featured at the 2015 Genitourinary Cancers Symposium sug­­gests that the an­drogen receptor (AR) abnormality known as “AR-V7” will turn out to be a predictive marker to help in treatment selection for patients with metastatic castration-resistant prostate can­­cer (CRPC). [ Read More ]

FDA News – March 2015

FDA Approvals, News & Updates

  • First HDAC Inhibitor, Panobinostat, Approved by the FDA for the Treatment of Patients with Multiple Myeloma
  • Palbociclib Approved for Metastatic Breast Cancer in Postmenopausal Women
  • FDA Expedites Approval of Lenvatinib for Refractory Differentiated Thyroid Cancer
  • Lenalidomide Combined with Dexamethasone Receives Expanded Indication for Patients with Newly Diagnosed Myeloma
  • Nivolumab First Immuno­therapy to Get FDA Approval for Metastatic Lung Cancer
[ Read More ]

Value Propositions – March 2015

Value Propositions

  • CLL Therapy Named “Cancer Advance of the Year” by ASCO
  • Novel Test Can Identify Apoptosis from Cancer Drugs in 16 Hours
  • Filgrastim-Sndz First Biosimilar Approved by the FDA
  • Type of Health Insurance Affects Clinical Outcomes in Patients with Brain Tumor
[ Read More ]

Preventing Relapse in Myeloma Carries Economic Benefits, Reduces Overall Costs

Dana Taylor

Economics of Cancer Care

San Francisco, CA—In what is believed to be the first economic analysis of disease progression of patients with myeloma, researchers found that in patients with newly diagnosed myeloma, the monthly costs are reduced by 68% between the first 4 months through 18 months, but they then rise steeply when the disease relapses. The data were presented at the 2014 American Society of Hematology meeting. [ Read More ]

Regorafenib in Metastatic Colorectal Cancer: High Cost with Little Benefit

Chase Doyle

Economics of Cancer Care

San Francisco, CA—According to a recent cost-effectiveness analysis, third-line therapy with regorafenib (Stivarga) in patients with previously treated metastatic colorectal cancer (CRC) far ­exceeded accepted willingness-to-pay thresholds based on incremental cost-effectiveness ratio (ICER) and quality-adjusted life-years (QALYs). Presented at the 2015 Gastrointestinal Cancers Symposium, the results showed that regorafenib provided an additional 0.04 QALYs, at a cost of $39,391. [ Read More ]

Caution: Active Surveillance Ill Advised in Men with Intermediate-Risk Prostate Cancer

Phoebe Starr

Genitourinary Cancers Symposium

Orlando, FL—Active surveillance is sometimes used as management strategy in patients with intermediate-risk prostate cancer, especially in older, sicker men with short life expectancy. A new study validates the use of active surveillance for men with low-risk prostate cancer but provides sobering data regarding this type of management for those with intermediate-risk prostate cancer. The study results were presented at the 2015 Genitourinary Cancers Symposium. [ Read More ]

History of Testicular Cancer Increases Risk for Aggressive Prostate Cancer Later on

Phoebe Starr

Genitourinary Cancers Symposium

Orlando, FL—Previous studies have shown that a history of testicular cancer increases the risk for developing prostate cancer. A new study presented at the 2015 Genitourinary Cancers Symposium shows, for the first time ever, a link between a history of testicular cancer and an increased likelihood of intermediate- and high-risk prostate cancer sometime in the future. [ Read More ]

Debate on PSA Prostate Cancer Screening Redux

Phoebe Starr

Genitourinary Cancers Symposium

Orlando, FL—A new retrospective study of 87,562 men diagnosed with prostate cancer between January 2005 and June 2013 show that the incidence of prostate cancer and men with prostate-specific antigen (PSA) >10 decreased gradually between 2005 and 2011. However, the incidence of high-risk prostate cancer at diagnosis increased annually by 3% between 2011 and 2013, totaling 6%. This increase could lead to an additional 1400 prostate cancer deaths 10 years later. [ Read More ]

Foreign-Trained Physicians Less Likely to Screen for Cancer, Especially Among Immigrant Populations

Rosemary Frei, MSc

Quality Care

Screening for cancer is suboptimal among some immigrant populations, especially those whose primary care physicians are trained in foreign countries, according to results of a new study of primary care practices in Canada; specifically, women from South Asia whose family physicians were trained in South Asia were less likely to be screened for cervical cancer than nonimmigrant women whose physicians were not immigrants. [ Read More ]

Lowering Dietary Fat Increases Long-Term Survival in Women with Hormone-Negative Breast Cancer

Alice Goodman

Breast Cancer

San Antonio, TX—Results of a new nutrition study show that women who reduced their intake of dietary fat for 5 years after being diagnosed with early breast cancer had significantly lower rates of death from all causes compared with controls, at 15 years of follow-up; this reduction was seen specifically in women with hormone receptor (HR)-­negative breast cancer. No long-term effect of dietary fat reduction on mortality was observed in women with HR-positive breast cancer. The results of the study, called Women’s Intervention Nutrition Study (WINS), were presented at the 2014 San Antonio Breast Cancer Symposium. [ Read More ]

A Conversation with Alberta Hickman, a Lung Cancer Survivor Who Benefited from Cancer Prehabilitation

Julie K. Silver, MD

Cancer Rehabilitation

Timothy Sherwood, MD, the thoracic surgeon who was featured in Part 2 of this series, referred Alberta Hickman for prehabilitation before operating on her after she was diagnosed with lung cancer. Alberta received her care at Mary Washington Hospital in Fredericksburg, VA, which recently adopted the STAR Program, a best practices cancer rehabilitation model of care. The medical team published Alberta’s story as a case report, because she did so well and her physical function improved after surgery compared with her baseline status before the operation. Moreover, she had a shorter-than-usual hospital length of stay for this type of surgery. This is Alberta’s perspective about cancer prehabilitation in her own words. [ Read More ]