Articles

Value-Based Payment Reform: Focus on the Oncology Care Model
The Oncology Care Model was designed to provide higher quality, more highly coordinated oncology care at the same or lower cost to Medicare. As the program matures, new data is expected to provide insight on the achievement of that ambitious goal.
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Development and optimization of patient support programs requires organizational alignment and a comprehensive understanding of the payment and care delivery ecosystem in cancer.
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As the number of people living with cancer continues to increase, so does the need for advocacy, education, and safety net programs to help patients afford the cost of care.
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On November 2, 2018, the FDA approved pegfilgrastim-cbqv (Udenyca; Coherus BioSciences), as the second biosimilar to pegfilgrastim (Neulasta), to reduce the risk for infection in patients with nonmyeloid malignancies who receive myelosuppressive chemotherapy, which may result in febrile neutropenia.
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On October 16, 2018, the FDA approved talazoparib (Talzenna; Pfizer), a poly (ADP-ribose) polymerase (PARP) inhibitor, for the treatment of patients with HER2-­negative, locally advanced or metastatic breast cancer and deleterious or suspected deleterious germline BRCA mutation, as identified by an FDA-approved test.
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Chicago, IL—So far, 2 chimeric antigen receptor (CAR) T-cell therapies have been approved by the FDA for some types of relapsed or refractory lymphoma and leukemia. Although CAR T-cell therapy has shown promise in many ­patients who have run out of standard treatment options, it is incredibly ­resource-intense: the complexities of its administration ­require an interdisciplinary approach for success, the side effects can be severe, and its high cost can reach upward of $1 million per course of treatment.
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Although the cost of care can have severe effects on patients with cancer and their families, oncologists rarely address financial toxicity, according to Hanna K. Sanoff, MD, MPH, Medical Director, University of North Carolina (UNC) NC Cancer Hospital Clinics.
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In a prospective trial, the VEGFR-2 small-molecule inhibitor apatinib has shown promising efficacy and safety signals.
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Although the combination of 2 antivascular agents showed preliminary efficacy, increased cardiac toxicity has resulted in premature discontinuation of the trial.
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