Economics of Cancer Care

The promise of big data–driven personalized healthcare mandates reform of the oncology reimbursement system, suggested Jeffery C. Ward, MD, Medical Oncologist, Swedish Cancer Institute, Edmonds, WA, in a recent commentary.

Hollywood, FL—The Affordable Care Act (ACA) is in its infancy, but it is already changing oncology practice, said panelists at the 2014 National Comprehensive Cancer Network (NCCN) Conference roundtable discussion. The consequences of the ACA include the changing composition of oncology patients, the risk pool of the exchanges, new payment and reimbursement models, acquisition fever, and oncology workforce demands, the panelists said.

San Francisco, CA—Concerns that healthcare utilization will increase dramatically once more patients are insured under the Affordable Care Act (ACA) may be overblown, based on results of a large study of Medicaid and underinsured patients with seminoma, the most common type of tes­ticular cancer.

New Orleans, LA—The efficiency of rituximab (Rituxan) and the associated cost can be improved by switching from intravenous (IV) to subcutaneous (SC) administration. Such a switch led to a substantial reduction in patient chair time and in active healthcare professional time, said Christof Wiesner, PhD, MPH, of the Market Access Department, Genentech, San Francisco, CA, at the ASH 2013 meeting.

The American Cancer Society has recommended annual magnetic resonance imaging (MRI) as an adjunct to mammography for breast cancer screening in women who have a lifetime risk of breast cancer of approximately 25% to ?50%, as determined by models such as the Gail risk test. A new simulated clinical trial evaluated the cost-effectiveness of using 7 single-nucleotide polymorphisms (7SNPs) in combination with the Gail test to assess the cost-benefit of annual MRI screening in women at risk for breast cancer (Folse HJ, et al. Cancer Prev Res [Phila]. 2013;6:1328-1336).

>New Orleans, LA—New research has confirmed that 30-day readmission for reduced-toxicity conditioning allogeneic hematopoietic-cell transplantation (allo-HCT) is linked to greater 100-day posttransplant hospital charges.

>New Orleans, LA—More patients with diffuse large B-cell lymphoma (DLBCL) are receiving rituximab infusions in the hospital setting, incurring greater costs than those receiving infusions in the office or clinic, an examination of medical and pharmacy claims has shown.

New Orleans, LA—Recipients of allogeneic hematopoietic cell transplant are at high risk for financial burden, according to survey-based data collected by Nandita Khera, MD, MPH, a medical oncologist from the Blood and Marrow Transplant Program, Mayo Clinic Arizona, Phoenix, and colleagues.

New Orleans, LA—The use of decitabine (Dacogen) is more cost-effective than conventional induction therapy for patients aged >60 years with acute myeloid leukemia (AML), according to data from a recent economic analysis.

>Patients with chronic myeloid leukemia (CML) and high out-of-pocket (OOP) costs for treating their disease have a 70% chance of discontinuing treatment and a 42% chance of nonadherence to treatment compared with patients with lesser copays. These conclusions, which were recently published online (Dusetzina SB, et al. J Clin Oncol.