
Staying Focused on the Cancer Patient, Amid Rising Drug Costs and New Payment Models
Giving cancer patients what they want and need is the goal, but getting there isn't easy, according to healthcare experts who took part in Patient-Centered Oncology Care 2015, presented November 19-20, 2015, by The American Journal of Managed Care. Drug costs demand difficult conversations about value, and changes in the law require oncologists to learn whole new ways to be paid.
FOR IMMEDIATE RELEASENOVEMBER 22, 2015
BALTIMORE, Md.—Stakeholders from across healthcare met here November 19-20 to discuss the challenges of rising drug costs, new payment models, and staying on top of innovation—all while keeping the focus on cancer patients, who are under more financial stress than ever.
Understanding both the big picture—what high drug costs mean to society—and the small—how costs affect the individual patient—was a theme throughout Patient-Centered Oncology Care 2015, the fourth installment of the multi-stakeholder meeting presented each year by The American Journal of Managed Care. The meeting took place at the Baltimore Marriott Waterfront.
Designed to bring together payers, providers, policymakers, leading researchers from academia, the pharmaceutical industry, and patient advocates, the meeting gives healthcare experts from different realms an opportunity to hear perspectives from others they might not encounter at professional meetings. “Each year we strive to not only address the most current topics in cancer care delivery, but we also bring together those leaders who understand where we are headed,” said Brian Haug, president of The American Journal of Managed Care.
Keynote speaker
The drive to measure quality is a good thing, she said, but there is a downside. “Unfortunately, there is an administrative burden that physicians have to bear, and so there’s not much time to spend with the patient,” she said, adding, “We have to take this back to the patient, and physicians need to ensure that they don’t just turn into data-entry operators.”
Vose and others discussed the financial pressures on community oncology practices, many of which have folded or consolidated in recent years. During a panel discussion, Ted Okon, MBA, executive director of the Community Oncology Alliance, called for reform of the 340B program, which was designed for safety net hospitals but has exploded beyond that purpose.
Pressure on patients. Despite administrative pressures, rising cancer drug costs make conservations with patients about their goals and values more important than ever, experts said. A
Joseph Alvarnas, MD, a hematologist-oncologist at City of Hope, and the editor-in-chief of Evidence-Based Oncology, said innovation has given physicians the ability to treat some cancers where few options existed. Multiple myeloma, for example, has seen an explosion of new therapies after a 40-year dearth of discovery. But as Stacey McCullough, PharmD, of Tennessee Oncology pointed out, innovation only helps if patients take the medication.
Oral chemotherapy may seem better for the patient because it’s more convenient, “but they are also tasked with the responsibility of managing their own care. There’s a correlation with how much medication the patient takes and their outcome.” Adherence rates with oral chemotherapy are only 63 percent, she said.
Shifting Risk. For all the advances in cancer drug therapy, several experts said the bigger change may be in payment reform: CMS’ goals for value-based care will require physicians to start assuming risk, and this may alter decision-making in cancer care. For starters, “Physicians rarely talked about costs, but as risk is shifting to us, we’re having those conversations,” Alvarnas said.
Payers on hand asked whether the shift in risk would bring more focus on palliative care, and whether there should be standards for disclosure. “Would you want to know that your oncologist is at risk for your cancer care?” asked Burton VanderLaan, MD, FACP, of Priority Health.
So far, some changes aren’t as dramatic as advertised, said Kavita Patel, MD, MSHS, of the Brookings Institution. Accountable care organizations (ACOs) she said, “are just dressed up fee for service.”
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