Value-Based Care

Specialty pharmacies are facing specific challenges in the ways they interact with payers, providers, and even with the pharmaceutical industry in relation to access and delivery of cancer drugs.

At the 2012 Gastrointestinal Cancers Symposium, Value-Based Cancer Care (VBCC) asked Al B. Benson, III, MD, FACP, Professor of Medicine, Associate Director for Clinical Investigations, Robert H. Lurie Comprehensive Cancer Center, Northwestern University Feinberg School of Medicine, Chicago, Immediate Past President, ACCC, and editorial board member of VBCC, to discuss the growing importance of molecular profiling in cancer care.

The clinical and economic impact of multiple myeloma is tremendous. With the onset of novel therapies used in multiple myeloma, as well as the release of new data demonstrating progression-free survival and overall survival, therapy used in multiple myeloma is now on the radar for payers, despite the relatively low incidence of the disease.

It is next to impossible for a day to go by without thinking about the contributions of personalized medicine to the care of patients living with cancer. Whether we are treating a newly diagnosed patient with HER2/neupositive breast cancer using trastuzumab, or using erlotinib in the management of a patient with non–small-cell lung cancer (NSCLC) whose tumor harbors specific mutations in the epidermal growth factor receptor genes, individualizing therapy based on molecular biology and genetic testing has become commonplace in contemporary oncology practice.

Philadelphia, PA—The “one-size-fitsall” approach to current benefit designs does not recognize that health services have different levels of value; such an approach, therefore, lacks incentives for patients to adhere to diagnostic tests and treatments with proven effectiveness that may help to contain costs to various healthcare stakeholders.

The focus on value in patient care has taken a prominent place in any discussion related to improving care delivery, but no agreement exists on what that “value” is.

Each year, oncologists return to their respective practices after attending the annual American Society of Clinical Oncology or American Society of Hematology meetings armed with knowledge of new drug/biologic combinations, modified regimen dosing, and other novel approaches that may provide incrementally better outcomes for cancer patients.

Prostate cancer patients have 2 new therapeutic options this summer with the approvals of sipuleucel-T and cabazitaxel. The former drug is an important scientific advance as one of the pioneering cancer vaccines to show a prolongation of survival.