Articles

Even before enactment of national healthcare reform initiatives, development and implementation of a variety of comparative effectiveness research (CER) was well under way, even if it was not specifically called comparative effectiveness.

Recent articles in the New England Journal of Medicine¹ and the Journal of the American Medical Association² note the tremendous increase in the cost of cancer care, which has at least doubled since 1990. The reasons for this steep increase have been attributed to the release and utilization of new medications, in tandem with more sophisticated surgery and radiation techniques.

Washington, DC—Health information technology (IT) and informatics are fundamental to all comparative effectiveness research (CER), Amy Abernethy, MD, associate director of the Duke Comprehensive Medical Center and founder and director of the Duke Cancer Care Research Program, told attendees at a session of the American Association of Cancer Research (AACR) 101st Annual Meeting.

With the inclusion of $1.1 billion in the American Recovery and Reinvest ment Act of 2009 for comparative effectiveness research (CER), this topic has suddenly become a matter of great importance in the clinical and research communities.

There’s no question that when, on March 29, a federal district court judge ruled the patents held by Myriad Genetics to the BRCA1 and 2 gene mutation sequences are invalid, a shock went through the healthcare and genetics communities.

As health plans grapple with the rapidly rising cost of oncology medications and a “buy and bill” system that does not work for physicians or for the plans, they are seeking new strategies for providing these life-saving drugs to their members and for freeing up oncology and hematology practices to focus solely on caring for patients, not managing a pharmacy.

Due to changes in the US Food and Drug Administration (FDA) approval process for cancer drugs, many new cancer drugs have been approved over the past 10 to 15 years. Although the availability of these new drugs has improved survival for many cancer patients, there is increasing concern over the cost of these agents.

New chemotherapies for metastatic colon cancer have improved life expectancy, but at a significant cost, say the authors of a study that explores the value of medications including bevacizumab (Avastin, Genentech), capecitabine (Xeloda, Roche Laboratories), cetuximab (Erbitux, Bristol-Myers Squibb), irinotecan hydrochloride (Camptosar, Pfizer, Inc), and oxaliplatin (Eloxatin, Sanofi-Aventis LLC).

A Canadian study examining the reasons why a patient with cancer will visit the emergency department near the end of life points out shortcomings in current care delivery systems and suggests a greater role for more effective palliative care, say the authors.