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Aakash Desai, MPH, MD, on the Precision Oncology Promise: Can We Deliver?
Aakash Desai, MPH, MD, of the Mayo Clinic in Rochester, Minnesota, talks about the urgent need for drug pricing reform, given the average expenditure of Medicare part D, and the ultimate out-of-pocket costs for patients with cancer. The promise of precision oncology will fail, says Dr. Desai, if we ...
Tina Shih, PhD, on Trends in Total and Out-of-Pocket Costs of Cancer Care
Tina Shih, PhD, of The University of Texas MD Anderson Cancer Center, discusses the rising cost-sharing requirement from private insurance, which has worsened the financial burden for patients with cancer. She believes that cost-containment policies alone may not be enough to ease this hardship.
Veena Shankaran, MD, on Colorectal Cancer: Cumulative Financial Hardship of Treatment
Veena Shankaran, MD, of the Seattle Cancer Care Alliance, discusses study findings from a national sample of patients with metastatic colorectal cancer who are on systemic therapy. A year into their treatment, nearly three out of four patients had major financial hardships despite access to health...
Clifford A. Hudis, MD, and Allen S. Lichter, MD, on Oncology Drug Pricing in the United States: What You Need to Know
Allen S. Lichter, MD, of the Value in Cancer Care Consortium, interviews Clifford A. Hudis, MD, Chief Executive Officer of ASCO, on the question of whether cancer drug prices in the United States are the problem, or just the symptom, of a larger systemic issue.
Mark J. Ratain, MD, and Daniel Goldstein, MD, on Value in Cancer Care: How the Paradigm Is Shifting
Mark J. Ratain, MD, of the University of Chicago, and Daniel Goldstein, MD, of the Rabin Medical Center, discuss the challenges of achieving cancer care value, evolution of the “more-is-better” philosophy when it comes to oncology drugs, and highlights of the First International Summit on...
R. Donald Harvey, PharmD, BCOP, FCCP, FHOPA, on Cutting Cancer Care Costs With Alternative Pharmacologic Options
R. Donald Harvey, PharmD, BCOP, FCCP, FHOPA, of Emory University, discusses the ways in which clinical pharmacology can help yield cost savings without sacrificing efficacy by, for example, altering regimens to extend drug supplies, lowering doses, dosing less frequently, or shortening the duration ...
Blase N. Polite, MD, MPP, on Optimizing Cancer Policies in the United States
Blase N. Polite, MD, MPP, of the University of Chicago Medical Center, discusses his belief that, in the next few years, we can bend the cancer drug cost curve and tame health-care costs if physicians, pharmaceutical companies, payers, and government come together and agree on the value of...
Ryan Huey, MD, on the Financial Toxicity of Early-Phase Clinical Trials
Ryan Huey, MD, of The University of Texas MD Anderson Cancer Center, discusses his findings that showed the large financial burden on lower-income patients enrolled in phase I trials (Abstract 8).
Bernardo H.L. Goulart, MD, on Stage IV NSCLC: High Drug Costs May Affect Survival
Bernardo H. L. Goulart, MD, of Seattle Cancer Care Alliance, discusses his findings that high out-of-pocket costs for oral tyrosine kinase inhibitors may lower survival rates, shorten the duration of therapy, and reduce the number of prescriptions for patients with metastatic EGFR- or ALK-positive...
Linda D. Bosserman, MD, on Pathways for Personalized Precision Medicine and Value
Linda D. Bosserman, MD, of City of Hope, discusses guidelines vs pathways, how to personalize pathways, integrated diagnostics, supportive care regimens, and financial guidance for patients with cancer.
How Treatment Costs Affect Decisions for Breast Cancer Surgery
In a study reported in the Journal of Oncology Practice, Greenup et al found that cancer treatment costs influenced women’s decisions on breast cancer surgery. Researchers reported many women, even at the highest income levels, said that costs were higher than expected, and that most women...
Cost-Effectiveness of Single-Marker Genetic Testing vs Multigene Panel Sequencing in Advanced NSCLC
The results of an economic modeling study to estimate the cost-effectiveness of multigene panel sequencing as compared to standard-of-care single-gene tests for patients with advanced non–small cell lung cancer (NSCLC) showed that multigene panel sequencing tests are moderately...
Frequency, Complications, and Costs of Diagnostic and Postprogression Biopsies in NSCLC
In a retrospective study reported in the Journal of Oncology Practice, Kelly et al identified the frequency of diagnostic and postprogression biopsies, complication rates, and associated costs in patients with non–small cell lung cancer (NSCLC). The study involved patient data from the...
AMA Commends Final CMS Rule for Requiring Pricing Information in TV Drug Ads
Today, Health and Human Services Secretary Alex Azar announced a final rule from the Centers for Medicare & Medicaid Services (CMS) that will require direct-to-consumer television advertisements for prescription pharmaceuticals covered by Medicare or Medicaid to include the list price—the ...
Treat-and-Release Emergency Department Use by Patients With Gynecologic Cancers
In a study reported in the Journal of Oncology Practice, Albright et al found that treat-and-release emergency department use by patients with gynecologic cancers has increased in recent years, with an increase in total cost in this population but not in average visit cost. Visits and Costs...
Emergency Department Visits for Treatment-Related Complications of Systemic Therapy and Radiotherapy
In a study reported in JAMA Oncology, Jairam et al found that emergency department visits for complications of systemic therapy or radiotherapy in patients with cancer increased at a 5.5-fold higher rate over 10 years compared with overall emergency department visits. Study Details The study...
Does Oncotype DX–Guided Treatment Reduce Initial Costs of Breast Cancer Care?
A new study suggests that Oncotype DX–guided treatment could reduce the cost for the first year of breast cancer care in the United States by about $50 million (about 2% of the overall costs in the first year). These findings were published by Mariotto et al in the Journal of the...
Costs Associated With Continued Smoking in Patients With Cancer
In a study reported in JAMA Network Open, Warren et al quantified incremental costs of first-line cancer treatment failure attributable to continued smoking in patients with cancer. Study Details The study involved development of a model to identify attributable incremental costs of subsequent...
Effect of Increased VA Hospice Care on Use of Aggressive Care and Costs for Veterans With Advanced Lung Cancer
In a study reported in JAMA Oncology, Mor et al found that veterans with advanced lung cancer treated in Veterans Affairs (VA) Medical Centers with high hospice use were more likely to receive concurrent cancer care but less likely to receive aggressive care. Moreover, veterans treated at...
Preventive Medication Use in the Last Year of Life in Older Patients With Cancer
A new study reveals that preventive medications—such as those to lower blood pressure or cholesterol, or to protect bone health, among others—are commonly prescribed during the last year of life of older adults with cancer, even though they are unlikely to provide meaningful benefits....
Genomic Testing Associated With Lower Health-Care Costs in Patients With High-Risk Breast Cancer
New research published by Dinan et al in JNCCN—Journal of the National Comprehensive Cancer Network provides evidence that genomic recurrence score testing using the 21-gene assay is associated with decreased cancer care costs in real-world practice among certain patients with breast...
Karim Fizazi, MD, PhD: We Need to Find a Way to Make Cancer Drugs Affordable
Karim Fizazi, MD, PhD, of Gustave Roussy, urges governments, insurers, and pharmaceutical companies to work together in order to find a way to make anticancer drugs affordable and accessible for all patients.
Patients With Breast Cancer Provide Recommendations to Ease Financial Toxicity
A qualitative study yielded nine patient-driven recommendations across circumstances that include changes to insurance, supportive services, and financial assistance to reduce long-term, breast cancer–related economic burden. The study was published by Dean et al in Cancer. Unique...
Medical Expenses in Patients With Coronary Artery Disease and Cancer
New research published by Chopra et al in JNCCN—Journal of the National Comprehensive Cancer Network calls for much greater integration between cardiologists and oncologists for patients with coronary artery disease who are diagnosed with cancer. Coronary artery disease is the most...
Cost-Effectiveness Analysis of Gene-Expression Profiling Assay in Breast Cancer
A new report published by Wang et al in JNCCN—Journal of the National Comprehensive Cancer Network found that using Oncotype DX—the most commonly used test for predicting the benefit of adjuvant chemotherapy to reduce the risk of disease recurrence—is not...
Cancer Survivors and Medical Financial Hardship
New research indicates that cancer survivors carry greater financial burdens related to medical debt payments and bills compared with individuals without a cancer history, with the greatest hardships in younger survivors. Published by Zheng et al in Cancer, the study also found that among...
New Study Examines Orphan Drug Exclusivity and Pricing
A new report commissioned by the National Organization for Rare Disorders (NORD) and published by the IQVIA Institute demonstrates that the 7-year market exclusivity granted to drugs designated under the Orphan Drug Act of 1983 for rare diseases is working as intended. In nearly every case, orphan...
Mary K. Buss, MD, MPH, and Candice A. Johnstone, MD, MPH, on Financial Toxicity During Treatment and Beyond
Mary K. Buss, MD, MPH, of Beth Israel Deaconess Medical Center, and Candice A. Johnstone, MD, MPH, of the Medical College of Wisconsin, discuss a session they co-chaired on the perspective of stakeholders on the cost of cancer care, what drives patients’ preferences when faced with mounting medical ...
Financial Toxicity Experienced by Adults With Cancer
In a study reported in the Journal of Oncology Practice, Knight et al found that 26% of patients with cancer acknowledged ‘financial toxicity’—treatment-related financial harm—with respect to cancer care, and that this toxicity was associated with consequences such as...
New Report Demonstrates Cost of Blood Cancer Care
The costs to treat blood cancer are higher than costs for other cancers, and the costs incurred by a patient diagnosed with a blood cancer do not return to precancer levels, according to a Milliman study commissioned by The Leukemia & Lymphoma Society (LLS). The study—The...
Cost of Cancer Care in Community vs Hospital Settings
In a study reported in the Journal of Oncology Practice, Gordan et al found that costs of care for patients with breast, colorectal, and lung cancers were significantly higher at hospital-based vs community-based clinics, largely reflecting higher costs of chemotherapy and provider visits. Study...
Findings From the National Cancer Opinion Survey: Alternative Therapies, Cost of Care, and More
Nearly 4 in 10 Americans believe cancer can be cured solely through alternative therapies, according to ASCO's second annual National Cancer Opinion Survey. This is despite research showing that patients who use alternative therapies instead of standard cancer treatments have much higher...
Cost-Effectiveness of First-Line Brentuximab Vedotin Plus Chemotherapy in Hodgkin Lymphoma
In a cost-effectiveness analysis reported in the Journal of Clinical Oncology, Huntington et al found that the cost of brentuximab vedotin (Adcetris) would need to be reduced in order for the combination of the agent with chemotherapy in first-line treatment of stage III or IV Hodgkin lymphoma to...
ESMO 2018: Variations Between European Countries in Time to Reimbursement Decisions for New Cancer Treatments Approved by the EMA
Some European countries take more than twice as long as others to reach health technology assessment (HTA) decisions to reimburse new cancer treatments following their approval by the European Medicines Agency (EMA). The average decision time is longer than 1 year in some countries, according to a...
ICU Admissions During Terminal Hospitalizations in Patients With Stage IV Lung Cancer
In a study reported in the Journal of Oncology Practice, Mrad et al found an increase in the proportion of patients with stage IV lung cancer admitted to the intensive care unit (ICU) during terminal hospitalization between 1998 and 2014. A large increase in palliative care contacts also occurred,...
U.S. Spending on Antineoplastic Agents
In a study reported in the Journal of Oncology Practice, Hong et al found that the U.S. health-care system increased spending on antineoplastic agents from $26.8 billion in 2011 to $42.1 billion in 2016. The study was a retrospective, cross-sectional analysis of IQVIA (formerly QuintilesIMS)...
Aaron Lyss, MBA, on Getting the Highest-Value Quality Intervention
Aaron Lyss, MBA, of Tennessee Oncology, discusses ways that clinicians and patients can employ the most cost- and treatment-effective measures, clinical trials, and incident learning systems.
Douglas W. Blayney, MD, on Quality Care: Better, Safer, Cheaper
Douglas W. Blayney, MD, of Stanford University, and winner of the Joseph V. Simone Award for Excellence, summarizes his talk on the expense of cancer care and how we can reduce costs while maintaining safety and high value for people with cancer.
Cost-Effectiveness Models for Tisagenlecleucel in Relapsed or Refractory Pediatric B-Cell ALL
As reported by Lin et al in the Journal of Clinical Oncology, cost-effectiveness modeling of treatment with the anti-CD19 chimeric antigen receptor T-cell therapy tisagenlecleucel (Kymriah) in relapsed or refractory pediatric B-cell acute lymphoblastic leukemia (ALL) showed that price reduction...
2018 Quality Care: Few Women With Breast Cancer Discuss Costs With Physicians Before Beginning Treatment
Findings from a new study reveal that while many women with breast cancer experience significant financial burden and most prefer to discuss the cost of their cancer care before beginning treatment, few are having conversations about treatment costs with their cancer care teams. These findings will ...
2018 Quality Care: Nationwide Survey Reveals Patients With Metastatic Breast Cancer Face Major Financial Stress Due to Treatment Costs
A new nationwide analysis of more than 1,000 people living with metastatic breast cancer from 41 states reveals significant cancer-related financial burden known as financial toxicity, particularly for uninsured patients. The study will be presented by Wheeler et al at the upcoming 2018 ASCO...
2018 Quality Care: Older Patients With Advanced Cancer Experiencing Financial Difficulties Have Worse Quality of Life and Mental Health
Older patients with advanced cancer experiencing financial toxicity due to the cost of their treatment have higher rates of severe anxiety and depression and poorer quality of life than patients who do not experience financial hardship. In addition, for those patients having financial difficulty,...
Estimated Medicare Cost for Prostate Cancer Care in Older Men
Although national guidelines recommend against prostate cancer screening in men age 70 and older, researchers from the University of North Carolina (UNC) Lineberger Comprehensive Cancer Center estimate that screening for and treating prostate cancer in men in this age group costs Medicare more than ...
Patient-Reported Financial Sacrifice and Cancer Care
In a study reported in the Journal of Oncology Practice, Chino et al found that high proportions of insured patients with cancer—most with stage IV disease—reported being willing to make considerable personal and financial sacrifices to receive cancer care. The study included a...
ICER Report on Clinical Benefits and Value of Different Antiandrogen Therapies for Men With Nonmetastatic Castration-Resistant Prostate Cancer
The Institute for Clinical and Economic Review (ICER) has released an evidence report assessing the comparative clinical effectiveness and value of antiandrogen therapies for the treatment of nonmetastatic castration-resistant prostate cancer. The report focuses on three antiandrogen...
Cost Differences in Chemotherapy Administration by Site
Critics of health-care consolidation have cited higher costs of chemotherapy administration as an example of how mergers drive up costs. A new study by Kalidindi et al in The American Journal of Managed Care found that although drug administration costs in hospitals are higher,...
Geographic Differences in End-of-Life Cancer Care
When it comes to how much end-of-life care a patient with cancer receives, geography may, indeed, be destiny, according to new research led by Harvard Medical School that found differences in this type of cancer care across different parts of the country. The findings, published by Keating et al...
Allen S. Lichter, MD, and Mark J. Ratain, MD, on Better Dosing, Lower Cost: Improving Cancer Care and Value
Allen S. Lichter, MD, Board Chair of the Value in Cancer Care Consortium, and Mark J. Ratain, MD, of the University of Chicago, discuss the benefits—and challenges—of lowering dosages in the face of market forces. The content in this post has not been reviewed by the American Society of Clinical...
AMA Plans Advocacy Outreach to Expand Colorectal Screening
Building on the efficacy of colorectal cancer screening, the American Medical Association (AMA) endorsed a plan at its Annual Meeting to work with physicians and payers to make the screening more available and affordable. Challenges with insurance coverage remain a barrier to colorectal cancer...
Juliet Elizabeth Wolford, MD, on Ovarian Cancer: The Cost of Care
Juliet Elizabeth Wolford, MD, of the University of California, Irvine, discusses the cost-effectiveness of various types of maintenance therapy in advanced ovarian cancer: paclitaxel, bevacizumab, niraparib, rucaparib, olaparib, and pembrolizumab (Abstract 5508).
