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Roger B. Fillingim, PhD, president of the American Pain Society is one advocate speaking out about the problem faced by patients who suffer from chronic pain, defined as being present for 3-months or more. But he's not the only expert who is talking about finding better ways to help people in pain.

Shelley Toreson had health insurance for years, but not anymore. Instead, she is part of an unusual Nevada nonprofit that helps connect 12,000 uninsured residents to doctors and hospitals who are willing to accept a lower-cost, negotiated fee for their services.

Mr. Shopenn, 67, an architectural photographer and avid snowboarder, had been in such pain from arthritis that he could not stand long enough to make coffee, let alone work. He had health insurance, but it would not cover a joint replacement because his degenerative disease was related to an old sports injury, thus considered a pre-existing condition.

Delaying the employer insurance mandate until 2015 has cost the government an estimated $12 billion in fees. This coming after an assessment conducted by The Congressional Budget Office (CBO) and the Joint Committee on Taxation (JCT) on the impact the delay will have on the Affordable Care Act (ACA) implementation.

It was the late C. Everett Koop, a former U.S. surgeon general, who once famously said: Drugs don't work in patients who don't take them. That's a simple way to look at a costly and complex problem - medication non-adherence - where the failure to take drugs on time in the dosages prescribed is both dangerous for patients and costly to the health care system.

Panelists agreed that the cost of the new agents discussed to treat melanoma will be a challenge, just as the cost of healthcare as a whole in the United States is a major challenge.

It's very, very complex to try to envision how you would come up with a single payment for an episode and not have a thousand different types of episodes in order to capture the heterogeneity of these diseases and the cost, said Dr Malin when asked to discuss the bundled payment method in oncology.

Panel moderator and AJMC co-editor-in-chief Dr Mark Fendrick introduced panelists Jennifer Malin, MD, PhD, manager and medical director of oncology, WellPoint; Jeffrey Weber, MD, PhD, senior member, H. Lee Moffitt Cancer Center Director, Donald A. Adam Comprehensive Melanoma Research Center; and Antoni Ribas, MD, PhD, Jonsson Comprehensive Cancer Center, UCLA.

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