Segment 7 - The Payer's Role and Future Trends

Panelists all agree that there needs to be evidence and guidelines for both payers and providers. There are not enough resources to try every drug on every patient. Although it will be costly, there needs to be evidence on putting these drugs together as combinations.

Panelists all agree that there needs to be evidence and guidelines for both payers and providers. There are not enough resources to try every drug on every patient. Although it will be costly, there needs to be evidence on putting these drugs together as combinations. “We have the American ingenuity and the wherewithal that we’ll find better ways to do it, or other drugs that come along that are less expensive in the same category,” said Dr Crawford. “I think we really owe that to men with advance state prostate cancer to make that step and start doing it.” “I think there is a blend here of continuing to do the envelope-pushing combination strategies,” said Dr George. “With cost to the wind, let’s try to cure the disease because that’s going to be the most cost-effective manner of managing these patients in the long-run anyway.”

Dr Shore offers his rebuttal by saying he thinks that a real issue is having patients reimbursed for all of the expensive newly approved agents. He says, by law, if there is a level 2 recommendation by the National Comprehensive Cancer Network the Centers for Medicare & Medicaid Services has to reimburse which is important to the payer population