The advance of CAR-T technology and the rise of immuno-oncology alongside emerging new payment models highlight the annual review in Evidence-Based Oncologyâ„¢, which looks at how researchers are harnessing the immune system to bring unprecedented results in cancer care.
FOR IMMEDIATE RELEASEFebruary 23, 2017
CRANBURY, N.J.—Early results suggest that chimeric antigen receptor (CAR)-T cells could be the next game-changer in treating leukemia, but making this treatment method widely available will depend on more than clinical trial results, according to the third annual issue of Evidence-Based Oncology™ dedicated to the state of immuno-oncology (I-O).
In this issue, EBO™, a publication of The American Journal of Managed Care®, examines recent clinical achievements in I-O within the context of payment reform, which causes payers to evaluate the value of treatments that come with price tags above $100,000 a year. Authors from McKesson Specialty Health outline the near-term challenge of making I-O work with alternative payment models that are sought under the Medicare Access and CHIP Reauthorization Act, known as MACRA.
EBO™ Managing Editor Surabhi Dangi-Garimella, PhD, interviews Jae Park, MD, a hematologist-oncologist, at the Memorial Sloan Kettering Cancer Center, to explore the clinical processes associated with CAR T-cell treatment. Park gets to the heart of the value discussion: “Compared with a transplant or where you need repetitive treatments with a drug such as an oral targeted drug, the advantage with CAR T-cell treatment is that one infusion of the drug can induce a great degree of remission,” he said.
Authors Bruce Feinberg, DO; Jennifer Fillman, MBA; Justin Simoncini, MBA, MPH; and Chadi Nabhan, MD, MBA, FACP, see a separate set of challenges, those tied to the process of using CAR-T technology. “First and foremost in the discussion is recognizing that CAR T does not represent a drug, but, rather, a complex therapeutic process. Whereas most of the previously commercialized I-O interventions—from interferons to interleukins to checkpoint inhibitors—are essentially drug therapies, CAR T is operationally more similar to hematopoietic stem cell transplantation,” they write.
Ultimately, however, Feinberg and his co-authors see stakeholders embracing CAR-T treatment because of its therapeutic value. Doing so requires managing patient expectations and offering plenty of support, especially through a patient navigator, as authors from the Cancer Support Community discuss.
Challenges aside, there’s no denying the leap forward that CAR T-cell treatment and other I-O advances represent, said EBO™ Editor-in-Chief Joseph Alvarnas, MD, of the City of Hope, in Duarte, California. “Over the past decade we have seen extraordinary advances in cancer therapeutics that have moved us far beyond what was imaginable early in my career,” Alvarnas writes. “The idea of harnessing the power of the immune system as a means of bringing more effective, better tolerated treatment solutions to patients in need is deeply inspiring.”
About the Journals and AJMC.com
The American Journal of Managed Care® is the leading peer-reviewed journal dedicated to issues in managed care. AJMC.com distributes healthcare news to leading stakeholders across a variety of platforms. Other titles in the franchise include The American Journal of Accountable Care®, which publishes research and commentary on innovative healthcare delivery models facilitated by the 2010 Affordable Care Act; and The American Journal of Pharmacy Benefits. AJMC®’s Evidence-Based series brings together stakeholder views from payers, providers, policymakers and pharmaceutical leaders in oncology and diabetes management. AJMC® also leads the ACO & Emerging Healthcare Delivery Coalition™, which brings together healthcare stakeholders seeking to advance payment reform and share best practices for assuming risk in healthcare. For information about publications or the ACO Coalition, please call (609) 716-7777, x. 144.
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