Oncology

A statewide collaboration between payers and providers to create a cancer clinical care pathways program is successful.

It is not just 1 physician who cares for a patient enrolled onto a clinical trial but rather a complex system of several physician teams, sometimes with very different opinions, who must work together for therapy to be successful and for the patient to have faith in his treating team.

The oncology patient“centered medical home is a physician-driven, patient-focused value proposition that can make a difference for patients, oncologists, and the cost of healthcare.

Dr. Singh discusses CVS Caremark's strategies for managing oncology spending.

Higher use of performance-based payment mechanisms and capitated arrangements is associated with a decrease in the amount of time physicians spend with patients with cancer.

Out-of-pocket payments differ widely among oral oncolytic options. As cost for therapy becomes a greater part of treatment decisions, an understanding of patient out-of-pocket cost will be critical in informing choices.

In a safety-net hospital, patients with Medicaid have rates of advanced-stage cancer similar to those patients with other types of insurance; however, patients with no insurance have significantly higher rates of advanced disease.

To improve formulary design processes and support payers in providing more effective healthcare, policy makers should consider involving commercial payers in the development of comparative effectiveness research and creation of research and treatment guidelines.

Comparative effectiveness research and pragmatic clinical trials are valued methods to address the limitations of traditional randomized trials, answer questions of cost-effectiveness or noninferiority, and inform data-driven dialogue and decision making by stakeholders.

As physicians enter a new world of therapies for molecularly defined lung cancer, it will be critical for hospitals, drug companies, and insurance companies to work out the interplay of molecular testing and coverage for expensive therapies that are effective but only in smaller, defined groups of patients.

Journal of Oncology Practice (JOP) and The American Journal of Managed Care (AJMC) join efforts to highlight work focusing on issues affecting payers and providers.

As calls for improving the quality and cost efficiency of oncology increase, future empirical work is needed to examine the responsiveness of oncologists' treatment decision making to incentives among patients of all ages and insurance types.

Stereotactic body radiation therapy for low- to intermediate-risk prostate cancer has potential cost savings and may improve access to radiation, increase convenience, and boost quality of life.

Payment reform may be used to better align appropriate financial incentives with better quality of care.

The development of subspecialty tumor groups for uncommon malignancies represents an effective approach to building experience, increasing patient volumes and referrals, and fostering development of increased therapeutic options and clinical trials for patients afflicted with otherwise historically neglected cancers.

There have been many research advancements in oncology over the past several weeks, including a new blood test designed to predict the onset of breast cancer; new control techniques for oncology payer management; and the creation of a new electronic tool for oncology nurses to improve patient outcomes.

The American Journal of Managed Care team had the opportunity to attend the Academy of Managed Care Pharmacy's 24th Annual Meeting in San Francisco this past week. Here are some of the key takeaways from the very informative sessions.

In this video, Mark Zitter, MBA, CEO of the Zitter Group, speaks about how oncology pathways are affecting drug use.

Wednesday morning at the Academy of Managed Care Pharmacy 24th Annual Meeting featured a satellite symposium that focused on the evolving role of managed care and oncology pharmacy management. The presentations by distinguished faculty reviewed current evidence-based data to enable decision making based on indicators of treatment outcomes for multiple myeloma; demonstrated the use of comparative effectiveness research (CER) as a decision support tool; and evaluated innovative pharmacy benefit models and specialty management services.

Metabolomics, Proteomics, and Epigenetics

Why Oncologists Must Tailor Clinical Features to Their Needs

Promise and Pitfalls Along the Path to Personalized Care

The Duke Cancer Institute