The Lynx Group

Value-Based Care

We understand that the financial sustainability of cancer care is a serious issue as cancer diagnoses around the world continue to rise. We commend those organizations seeking to address the issue of value in cancer care, which is an incredibly difficult, multifaceted challenge.
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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.
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There has been talk regarding pricing in healthcare for a number of years, so the recent move by the American Society of Clinical Oncology (ASCO) and by Memorial Sloan Kettering Cancer Center (MSKCC), discussed in this issue of Value­-Based Cancer Care, is certainly a big deal, but is hardly surprising.
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In the face of escalating costs of cancer drugs, the American Society of Clinical Oncology (ASCO) rightly asks, what is the value of these new medicines?
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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.
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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."
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Significant gains in cancer research and prevention have led to longer survival, improved quality of life, and decreased disease burden. The 2015 annual report on “Clinical Cancer Advances” from the American Society of Clinical Oncology (ASCO) outlines the biggest advances made in oncology, and for the first time designates one cancer as the Advance of the Year, as well as emphasizing the ongoing challenge of value-based care.
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Hollywood, FL—Value-based decision-making at the bedside can be fraught with obstacles, with no clear agreement on what constitutes value, and for whom. In addition, the myriad insurance plans preclude uniform treatment strategies, despite clinical pathways and guidelines intended to reduce variation in care. Finally, value is becoming more difficult to achieve in oncology as each benefit becomes more expensive, with the cost of new therapies outpacing inflation.
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The Merriam-Webster dictionary defines “logistics” as the things that must be done to plan and organize a complicated activity that involves many people. The modern delivery of cancer care precisely parallels this definition.
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