Special Issue: Payer/Provider Relationships in Oncology

The editors introduce this special issue, which contributes to an ongoing dialogue in cancer care that explores the tension between new therapeutics and the ever-increasing need to limit resources.

This study characterized patterns and costs of medical care by disease phase in patients with newly diagnosed mCRC using a large US national commercially insured claims database.

The American Society of Clinical Oncology Quality Oncology Practice Initiative has grown to include 973 practices as of 2010. Practices demonstrated rates of end-of-life care and other measures of quality.

Ten percent of patients abandon newly initiated oral oncolytics at the pharmacy. Patients facing higher cost sharing or increased concurrent prescription activity have a higher abandonment rate.

Retrospective evaluations of electronic health records and claims databases to assess clinical outcomes and costs associated with evidence-based pathways in colon cancer.

A study of major US private payers showed an important role and considerable shortcomings of external health technology assessment in coverage decisions on personalized medicine.

Economic evaluations of adjuvant trastuzumab were reviewed. Three primary shortcomings were identified including incorporation of local data and estimation and representation (visual) of decision uncertainty.

Healthcare coverage is simply unaffordable for too many people. It will only become affordable with radical changes in payment incentives and elimination of care that doesn%u2019t really matter.

With an increasing demand for cancer care driven by the demographics of the aging population far outpacing the supply of oncologists, and the ongoing transformation of the reimbursement system, the challenges facing oncology are formidable.