Currently Viewing:
American Society of Clinical Oncology (ASCO) 2017
Dr Barbara McAneny on How the COME HOME Model Helps Cut Hospitalization Rates
June 14, 2017
Real-World Treatment Patterns Highlight Need for Clinical Education on PD-L1 Testing in NSCLC
June 13, 2017
Currently Reading
Can the 4 Ps Devise Interventions to Reduce the Financial Toxicity of Cancer?
June 06, 2017
Daratumumab With Standard Regimen Improves PFS in Multiple Myeloma, Independent of Cytogenetic Risk
June 05, 2017
MACRA 2.0 and Beyond: Preparing Your Practice to Meet the Quality and Reporting Challenges
June 05, 2017
Dr Craig Portell Highlights New and Exciting Treatments for Non-Hodgkin's Lymphoma
June 05, 2017
Dr Edward Li Discusses the Benefit Biosimilars Can Have in Oncology
June 04, 2017
Switching Study Reports Equivalence Between Filgrastim, Biosimilar in Breast Cancer
June 04, 2017
Do We Have Adequate Surveillance in Cancer Survivor Care?
June 04, 2017
Dr Basit Chaudhry on Experiences in the Oncology Care Model and Early Indications of Success
June 04, 2017
Dr Scott Ramsey: Value Frameworks Are Moving Toward Harmonization
June 03, 2017
Physician, Regulatory, and Payer Perspectives on the Value of Real-World Data
June 03, 2017
Patient Selection Vital in Ensuring Improved Response to PD-1, PD-L1 Inhibitors in NSCLC
June 03, 2017
Dr Daniel George Highlights Successes of Checkpoint Inhibitors in Prostate, Bladder Cancers
June 03, 2017
ASCO Study Finds Shift in Diagnosis Stage for Several Cancers Following ACA Implementation
June 01, 2017
HPV Vaccination May Lower Prevalence of Oropharyngeal Cancers in Young Adults
May 31, 2017

Can the 4 Ps Devise Interventions to Reduce the Financial Toxicity of Cancer?

Surabhi Dangi-Garimella, PhD
A discussion at the 2017 American Society of Clinical Oncology Annual Meeting addressed the practical solutions to address the financial toxicity of cancer care and identified leads for future intervention studies aiming to prevent or reduce this burden.
There is no arguing that cancer care can drain an individual’s or their family’s coffers. Now that this has been reaffirmed by various sources, a discussion at the 2017 American Society of Clinical Oncology Annual Meeting addressed the practical solutions to address the financial toxicity of cancer care and identified leads for future intervention studies aiming to prevent or reduce this burden.
 
The session, chaired by Yousuf Zafar, MD, MHS, associate professor of medicine, Duke University Medical Center, included the 4 Ps:
  • Pharma: Matthew Shaulis, president, North America Oncology, Pfizer
  • Payer: Lee N. Newcomer, MD, senior vice president, Oncology and Genetics, UnitedHealth Group
  • Physician: Leonard Saltz, MD, chief, gastrointestinal oncology service and head of colorectal oncology section, Memorial Sloan Kettering Cancer Center
  • Patient: Shelley Fuld Nasso, MPP, chief executive officer, National Coalition for Cancer Survivorship.
Zafar asked the panelists to provide their 1 clear solution to this problem of financial toxicity in oncology…without using slides.

Shaulis said that Pfizer shares the goal of improving quality of care for patients. “We need to focus and prioritize. We have to tailor market-based solutions to ensure continued innovation,” Shaulis said.

A longitudinal actuarial study conducted by Milliman and sponsored by Pfizer among cancer patients identified a 500% increase in care costs in the first month, mainly due to diagnosis and initial treatment, Shaulis told the audience. The costs were highest for colorectal cancer and lung cancer, followed by breast cancer. “However, consistent across the numerous studies was that cancer drugs accounted for only 20% of the total cost of care.” From a more holistic perspective, we also should include peripheral costs such as loss of work for the patient and caregivers, Shaulis added.

“Market-based solutions are important because innovation and choice are necessary to ensure support for new medications,” Shaulis said, and competition paves the path to affordable access, investment in data, and novel reimbursement mechanisms.

“As a federal or commercial insurance program, you are mandated to provide coverage to all FDA-approved drugs. So I propose ending the mandate for providing coverage for each and every drug that is out there even if it does not provide value,” said Newcomer, the payer voice in the discussion.

“When you make a value decision, you are using a set of principles that others may not agree with,” he said. “But with the mandate on cancer drugs, we cannot use the value quotient."

He referenced a retrospective study by UnitedHealth Group that was presented at the meeting using data from stage 4 patients with metastatic non-small cell lung cancer (mNSCLC). The study found that patients treated with the 5 most commonly prescribed first-line therapies for mNSCLC have much shorter duration of therapies (52-76 days) than reported in published clinical trials with a significant risk of hospitalization (18% to 30%) and at substantial cost ($34,971 to $108,100).

“This is an easy value decision to make, but the mandate creates a barrier,” Newcomer said. He concluded that when there’s competition among multiple regimens that give us the same results, we need to have the flexibility to make those value decisions.



 
Copyright AJMC 2006-2017 Clinical Care Targeted Communications Group, LLC. All Rights Reserved.
x
Welcome the the new and improved AJMC.com, the premier managed market network. Tell us about yourself so that we can serve you better.
Sign Up
×

Sign In

Not a member? Sign up now!