August 2015, Vol 6, No 7

Chicago, IL—An analysis of chemotherapy infusion by Aetna shows that approximately 75% of their patients still receive chemotherapy in a community oncology setting, suggested Michael A. Kolodziej, MD, National Medical Director for Oncology Strategy, Aetna at the 2015 American Society of Clinical Oncology meeting.

Chicago, IL—It is not a surprise that targeted therapies are the main drivers of spending on anticancer drugs in the United States. At the 2015 American Society of Clinical Oncology meeting, researchers presented data from several major cancer centers about the cost of targeted therapies.

Although we all admire and support the efforts put forth by many experts to help quantify the “real” value of cancer medications, they still miss the mark in 2 dramatic ways.

How can cancer care decisions be based on value? Two champions are starting to add science to this controversial discussion, which will eventually help all stakeholders make more informed decisions.

Medicare’s Oncology Care Model (OCM) proposes a partial shift in financial risk from Medicare to oncologists. This incentivizes oncologists to use higher-­value, lower-cost services. Information such as the recently released American Society of Clinical Oncology (ASCO) framework to assess new cancer treatment options will likely garner keen interest among providers participating in the OCM or similar programs, to the benefit of providers, payers, and patients.

The American Society of Clinical Oncology (ASCO) value framework essentially calls for accountability and transparency, which are qualities that are beneficial to providing complete care for patients and to improving positive patient outcomes.

The emergence of various tools for assessing value or, more to the point, drug costs—both direct and indirect—by leaders within the oncology and hematology community is highly commendable. Those of us on the managed care side of healthcare look forward to practical and meaningful tools in helping patients, pro­viders, employers, and health plans navigate through the complexity of oncology drug therapy and drive better informed decision-making.

My personal journey to understanding and experiencing up close and personal the complexities in cancer care started some 20 years ago, when, like many of us, someone extremely close to you gets the dreaded news, “you have cancer.” For me, this was my mom. Regretfully, as we grow older, we all continue to hear this dreadful tale more frequently. These events have transformed my career over time to turn it into a mission—improving cancer care and seeking the cure.