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Community Oncology Alliance (COA) Payer Exchange Summit 2018

Dr Lalan Wilfong on the Struggle for Reimbursement of Novel Cancer Therapies

"The cost of cancer care is rising dramatically," said Lalan Wilfong, MD, executive vice president of quality programs at Texas Oncology.


"The cost of cancer care is rising dramatically," said Lalan Wilfong, MD, executive vice president of quality programs at Texas Oncology.

What is the struggle for reimbursement for new innovative cancer therapies?

Transcript:


So, cost of cancer care is rising dramatically, and the cost of new innovative cancer therapies is quite high– there are many reasons behind that– but the cost of care is quite high. It’s difficult to address that in a practice because we don’t control the cost of care. You want to provide the appropriate care for the appropriate patient at the appropriate time– that’s the mantra for taking good care of patients. 

It’s a difficult question to figure out how do we address that in the care that we provide. I think pathways is one way to do that where we can look at what an appropriate, new, innovative therapy is and which patient population they should be given to. Doing innovative payment adjustments is also important so the practices aren’t discouraged from using novel therapies where they are appropriate. I think the challenge is figuring out which novel therapies are appropriate for which patients and making sure you’re utilizing them appropriately for the patients that you have. 

 
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