ASCO 2015 Highlights

Blue Cross Blue Shield (BCBS) is implementing value-based care and payment models across the country to reward quality and improve outcomes, and these are amounting to billions of dollars in cost-savings and reduced hospitalizations.

Economists predict that, in less than 3 years, the average household in the United States will use 50% of its income on health insurance and out-of-pocket medical bills. According to Lee N. Newcomer, MD, MHA, Senior Vice President, Oncology, Genetics and Women’s Health, UnitedHealthcare, Minnetonka, MN, creating payment models that can reimburse physicians for cost-effective care is difficult in itself, but demonstrating that the new models are indeed cost-effective involves another set of hurdles.

New payment models that reward cost-effective, high-quality cancer care are needed. An experimental physician payment model that rewards physicians for focusing on best treatment practices and health outcomes rather than the widely used fee-for-service (FFS) model resulted in cost-savings, without affecting the quality of care among patients with 3 types of cancer.

Clinical pathways have been suggested as a good method to implement guidelines into clinical practice and to reduce treatment variability. Although oncology clinical pathways have been studied previously, a new study looked at supportive care services and their effect on reducing emergency department visits and hospitalizations associated with chemotherapy toxicitie.

Little is known about why patient care varies greatly for patients with similar illnesses, such as in patients with different types of cancer. Variation in the care of patients with cancer signals a lack of consensus about what constitutes optimal care; this suggests important gaps in the evidence base in which research may have an effect. In a new study, researchers sought to systemically assess interinstitutional variation in the management decisions for 4 common cancers using the National Comprehensive Cancer Network (NCCN) Outcomes Database.

In a head-to-head study comparing ibrutinib (Imbruvica) and ofatumu­mab (Arzerra) for the second-line treatment of patients with relapsed or refractory chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma (SLL), ibrutinib significantly improved progression-free survival (PFS) time, overall survival (OS), as well as response rate.

Milan, Italy—More than 60% of patients with chronic myeloid leukemia (CML) were free of relapse 6 months after stopping tyrosine kinase inhibitor (TKI) therapy that led to deep molecular remission, according to the interim results from an ongoing trial reported by Susanne Saussele, MD, of Universitätsmedizin Mannheim, Germany, at the 2014 European Hematology Association meeting.

Milan, Italy—Older patients with acute myeloid leukemia (AML) gained a “clinically significant,” if not statistically significant improvement in survival when treated with azacitidine (Vidaza) rather than with conventional therapy, reported Hervé Dombret, MD, hematologist, Hôpital Saint Louis in Paris, France, at the European Hematology Association meeting.

In April, the American Society of Clinical Oncology (ASCO) released a policy statement recommending how to fix the 340B Drug Pricing Program.

Sandra Wade first e-mailed me on July 15, 2011. As you can see in the excerpts from her correspondence with me below, she asked me to contact her oncologist and let her know that as a breast cancer survivor, Sandra had suffered more than she should have, because she was not referred for rehabilitation services.