April 2019

AJMCtv® interviews let you catch up with experts on what’s new and important about changes in healthcare. The interviews provide insights from key decision makers-from the clinician to the health plan leader to the regulator. When every minute in your day matters, AJMCtv® interviews keep you informed. You can access the video clips at www.ajmc.com/interviews.

Managed care updates.

Regulatory and clinical updates.

Conference coverage updates from the Community Oncology Alliance's annual meeting.

Updates from the Association of Community Cancer Centers annual meeting.

Policy updates from the National Comprehensive Cancer Network's annual meeting.

Clinical updates from the National Comprehensive Cancer Network's annual meeting.

We learned that a true patient-centered approach would be a combination of objective, numerical, centripetal measures defined in the Oncology Care Model (OCM) and subjective centrifugal emotions, aspirations, and expectations. We created smart teams, enabling an efficient transition from volume to value. These exercises were similar to building a higher pyramid on top of what we already achieved during our journey toward Patient-Centered Speciality Practice (PCSP) accreditation by the the National Committee for Quality Assurance in 2015. Although the transition to being a PCSP was speciality agnostic and truly patient centric, the OCM gave us a blueprint that was specific to the needs of PCCC.

In an article published in Electronics Magazine on April 9, 1965, Intel cofounder Gordon Earle Moore noted that the number of transistors in an integrated circuit doubled every year. He extrapolated that this rate of growth in computing power would continue to double every 2 years throughout the late 1960s and in to the 1970s and 1980s. The prediction, which became known as Moore’s Law, proved prescient. Intel and other industry leaders took this as both a prediction for the pace of innovation and a push for the industry to create “computing [that] would dramatically increase in power, and decrease in relative cost, at an exponential pace.” From 1965 to today, the technologies, depth of innovation, and corresponding impact from discoveries made in the pursuit of achieving and sustaining Moore’s vision have affected our lives in profound and unexpected days. Conversations rarely take place today without someone glancing at a smartphone to close a business deal, to let family know they will be late, or to post pictures of the conversation on a social media site.

Academic medical centers and a group representing community oncology practices have both raised concerns about CMS’ proposed reimbursement plan for chimeric antigen receptor (CAR) T-cell therapy, the individually manufactured gene treatments that are revolutionizing cancer care. The plan will be finalized next month, a year after the federal government launched a national coverage analysis to determine how to pay for these lifesaving yet expensive cancer treatments.

Patients with hematologic malignancy who are undergoing chemotherapy or a conditioning regimen for hematopoietic stem cell transplant (HSCT) are at high risk of infection because of the severity and duration of neutropenia. Fever with neutropenia is a common presentation that suggests an infection leading to empiric antibacterial therapy. To prevent infection and thus the neutropenic fever, antibacterial prophylaxis, especially with fluoroquinolones, emerged as a common practice based on results of 2 randomized controlled trials published in 2005 that showed reduced incidence of fever and bacteremia despite lack of a mortality benefit.

Research documentation is a critical aspect of running a clinical trial. Key patient information such as informed consent, adverse events (AEs), concomitant medications, and medical and surgical histories are collected and used to determine patient safety and efficacy as the trial proceeds. Ultimately, the sponsor may make decisions—ranging from modifying the dose of the investigational drug to closing the study due to AEs—based on the data collected.