Oncology

Mohs surgery is generally the gold standard for rare and more aggressive tumors because the surgeon can ensure the roots of the tumor are gone, but the technique keeps the hole small, said Ally-Khan B. Somani, MD, PhD, at the 25th European Academy of Dermatology and Venereology Congress.

Reimbursement issues surrounding Mohs surgery are getting worse, which provides a challenge for surgeons who would perform the procedure, explained Aleksandar L. Krunic, MD, PhD, during the 25th European Academy of Dermatology and Venereology Congress.

A new study presented at the annual meeting of the American Society for Radiation Oncology has found a significant survival advantage of combining chemotherapy and radiotherapy following surgery in patients with medulloblastoma.

Use of stereotactic body radiation therapy improved survival in elderly patients diagnosed with early-stage non-small cell lung cancer by about 20% over a decade.

Advancement in basic science and medical technology has made cancer a curable disease for many patients. Approximately 40% of Americans will be diagnosed with cancer in their lifetime, but as of 2014, 1 in 22 Americans is a cancer survivor, which equals 14.5 million cancer survivors in the US, explained Joseph C. Alvarnas, MD, director of value-based analytics for the City of Hope.

Jack Whelan, an e-patient advocate and patient with a rare blood disease, spoke at The American Journal of Managed Care’s 4th Annual Patient-Centered Oncology Care Meeting. In his presentation, Whelan explained that patient centricity and education is important for all parties in the healthcare industry to better take hold of.

In the United States healthcare system, discussions of value are almost always associated with the equation of quality over cost. However, patients don’t necessarily think that way, explained Yousuf Zafar, MD, MHS, associate professor of medicine and public policy at the Duke Cancer Institute.

While President Barack Obama outlined a series of budget plans for oncology care in the fall of 2015, which was designed to allocate an estimated $130 million to sequence 1 million volunteers, $70 million to identify “genome drivers” and $10 million to the FDA to build databases, Michael A. Kolodziej, MD, FACP, national medical director of Oncology Solutions at Aetna, believes there to be different areas of oncology care that need more attention and resources. Kolodziej presented at The American Journal of Managed Care’s 4th Annual Patient-Centered Oncology Meeting.

There are a number of issues concerning big data in the oncology world, the most prominent of which concerns the number of patients participating in clinical trials, Robert J. Green, MD, MSCE, vice president of clinical strategy at Flatiron Health, explained during his presentation at The American Journal of Managed Care’s 4th Annual Patient-Centered Oncology Meeting. He added that only 4% of adult cancer patients participate in a clinical trial.

Family history is at the core of precision medicine, Joy Larsen Haidle, MS, CGC, 2015 president of the National Society of Genetic Counselors, said during her presentation at The American Journal of Managed Care’s 4th Annual Patient-Centered Oncology Care Meeting. During her presentation, Haidle explained that while hereditary cancer was traditionally viewed as occurring between 5% and 10% of the cancer population, recent data suggest that number may be a lot closer to 25% today.

Scott Gottlieb, MD, resident fellow at the American Enterprise Institute; Michael A. Kolodziej, MD, national medical director of oncology strategy at Aetna; Bruce Quinn, MD, PhD, MBA, senior director at FaegreBD Consulting; and Joy Larsen Haidle, MS, CGC, 2015 president of the National Society of Genetic Counselors, discussed the impacts of FDA regulation on diagnostics in oncology during The American Journal of Managed Care’s 4th Annual Patient-Centered Oncology Care Meeting. The panel discussion was moderated by Dennis P. Scanlon, professor of health policy and administrator and director of the Center for Health Care and Policy Research at The Pennsylvania State University.

Competition as a means of tackling the escalating issue of drug prices is not working, said Peter B. Bach, MD, MAPP, physician at Memorial Sloan Kettering Cancer Center, in a panel discussion at The American Journal of Managed Care’s 4th Annual Patient-Centered Oncology Care Meeting. He explained that implementing a system in which the attributes of the drug determine its price is a more reasonable, value-based approach.

One of the reasons Julie M. Vose, MD, MBA, FASCO, 2015-2016 president of the American Society of Clinical Oncology, became involved with medicine in the first place was the ability to help patients. However, she said that the administrative burden physicians take on in today’s health system can often take away from that experience.

Population health is a method that looks at the total costs of care, focuses on the prevalent chronic diseases, and, additionally, examines the various social determinants of health of an entire community. However, Burton F. VanderLaan, MD, FACP, medical director of Priority Health, explained that precision medicine, specifically in precision oncology, seeks to do just the opposite by employing variation and individualizing treatment rather than standardizing it.

Stacey W. McCullough, DO, senior vice president of Pharmacy at Tennessee Oncology, PLLC; Bruce W. Sherman, MD, FCCP, FACOEM, medical director for Population Health Management for the RightOpt private exchange offering for Buck Consultants, A Xerox Company; and Glen D. Stettin, MD, senior vice president of clinical research and new solutions at Express Scripts, came together to discuss the role of pharmacy benefit managers (PBMs) as a means of helping to manage high-cost treatment options. The discussion, moderated by Bruce A. Feinberg, DO, vice president and chief medical officer of Cardinal Health Specialty Solutions, was held during The American Journal of Managed Care’s 4th Annual Patient-Centered Oncology Care Meeting.

Julian Malinak, MPH, finance lead for the pioneer accountable care organization (ACO) and next generation ACO models and technical advisor for financial policy at CMS Innovation Center, explained that CMS, as well as other organizations, are pushing away from the traditional fee-for-service methods by creating delivery models like ACOs and employing various tools and services, such as bundled payments, and are beginning to examine these methods in the oncology setting.

In the past 5 years, the FDA has approved 52 new agents for oncology use, and 24 of those agents have novel mechanisms, explained Stacey W. McCullough, PharmD, senior vice president of Pharmacy at Tennessee Oncology, PLLC, during her presentation at The American Journal of Managed Care’s 4th Annual Patient-Centered Oncology Care Meeting. With these emerging options in oncology care, there are 3 things to consider when choosing the appropriate option for the patient, she said.

A new study by researchers at the Perelman School of Medicine has identified a predictive biomarker in stage IV patients with melanoma being treated with the pembrolizumab.

UnitedHealth has posted a presentation on its website that provides an update to its pharmacy benefits and prescription drug lists for 2017.

Research published in the journal JAMA Oncology argues that major lifestyle changes can significantly delay the onset of cancer.

Research conducted at the University of North Carolina Lineberger Comprehensive Cancer Center has found that white women performed better than black women on physical and functional health-related quality-of-life (HRQOL) scores, but not spiritual HRQOL.

Colombia has decided to slash the price of imatinib mesylate (Gleevec), manufactured by Novartis, by nearly half.

The National Cancer Institute's Cancer Moonshot initiative received yet another boost following Vice President Joe Biden’s announcement of several activities to accelerate the pace of oncology clinical research.

Using prophylaxis with biosimilar granulocyte colony-stimulating factor can reduce the severity of neutropenia in patients with soft tissue sarcoma.

This week, the top managed care stories included news that Risa Lavizzo-Mourey, MD, MBA, will be leaving the Robert Wood Johnson Foundation, a report that obesity rate in the military are also on the rise, and CMS denied Ohio's proposal to charge fees for Medicaid.

The American Journal of Managed Care reached out to Daniel F. Hayes, MD, FASCO, 2016-2017 president of the American Society of Clinical Oncology (ASCO), to understand his perception of how the recommendations of the Cancer Moonshot initiative's Blue Ribbon Panel would impact cancer care in the United States.

Patients with a history of cancer were more likely to suffer from obesity than the general population. This incidence was even greater in patients who were survivors of colorectal and breast cancers.

There has been a steady decline in death rates among children and adolescent patients diagnosed with cancer (ages 1 to 19 years), minus gender or racial disparity, between 1999 and 2014, according to a new report from the National Center for Health Statistics.

Following an FDA advisory on ovarian cancer screening tests, London-based Abcodia has announced that it will temporarily stop sales of its Risk of Ovarian Cancer Algorithm test in the United States.

A cost-effectiveness analysis has found that Oncotype DX may not be economical to make clinical decisions on adjuvant radiation treatment in patients with DCIS.