Oncology

When a drug becomes first-line, I would like to think that as a clinician I would have access to that, but most importantly that my patients would not have to have a bake sale or take out a second mortgage on their homes to get therapies that are designed specifically for them, said A. Mark Fendrick, MD, director of the Center for Value-Based Insurance Design at the University of Michigan.

The American Society of Clinical Oncology (ASCO) recommends that CMS guard cancer patients from high out-of-pocket costs that will impede patient access to life-extending cancer drugs, according to the society’s comments regarding proposed financial revisions to the Medicare Prescription Drug Benefit Program (Part D).

Every year, central lines are associated with causing blood infections in an estimated 400,000 patients with cancer. However, new research has found that changes in the microbiome may be responsible for some or many of the infections usually attributed to central lines.

Bo Gamble, director of Strategic Practice Initiatives at the Community Oncology Alliance (COA), explains how COA plays a role in supporting practices in preparing for Oncology Care Model.

Via Pathways covers more than 2000 different patient representations in cancer care.

Non-Hispanic black women diagnosed with HER2-negative, lymph node-negative breast cancer who had recurrence score testing had higher estimated risks of distant recurrence than their non-Hispanic white counterparts.

High cost sharing is associated with reduced and/or delayed access to targeted therapies under Medicare Part D for patients with metastatic renal cell carcinoma, suggesting that financial barriers play a significant role in treatment decisions, according to a study published in Cancer Medicine.

Patients diagnosed with cancer want their doctors to ask them their desire location for end-of-life (EOL) care, according to a recent study published in the Journal of the National Comprehensive Cancer Network.

Over the next years, these spheres (ACOs, primary care, and oncology) that are going on in CMMI need to be coalesced together so that when we have learning collaboratives, not only do we have learning collaboratives within each of these spheres, but we learn from each other in these similar projects, said Peter Aran, MD, medical director of Population Health Management at Blue Cross Blue Shield of Oklahoma.

The FDA has approved a supplemental New Drug Application to add new overall survival (OS) data for carfilzomib (Kyprolis). The label will now show that carfilzomib and dexamethasone reduced the risk of death by 21% and increased OS by 7.6 months compared with bortezomib and dexamethasone in patients with relapsed or refractory multiple myeloma (MM).

Estimating episodic target prices for each patient in the Oncology Care Model (OCM) can be challenging and time consuming. Applying that time to quality-focused care management tactics, based on observed utilization and patient outcomes, may wind up being more valuable, and help to reduce unnecessary spending.

Researchers at The University of Texas MD Anderson Cancer Center recently reported in Lancet Oncology that a pair of targeted therapies given before and after surgery for melanoma produced a 6-fold increase in time to progression of the disease, compared with standard-of-care surgery for patients with stage 3 melanoma.

Every week, The American Journal of Managed Care® recaps the top managed care news of the week, and you can now listen to it on our podcast, Managed Care Cast.

Aetna is focusing on the healthcare triangle (patients, providers, and payers) and connecting those lines, said Roger Brito, DO, national director for oncology, Aetna.

This week in managed care, the top stories included the announcement that Kentucky is the first state approved to require patients work to receive Medicaid benefits; FDA Commissioner Scott Gottlieb, MD, reveals a new program to improve clinical trial transparency; research finds the worst cases of attention-deficit/hyperactivity disorder could lower life expectancy.

Although risk targeting may improve screening efficiency in terms of early lung cancer mortality per person screened, the gains in efficiency are modest in terms of life-years, quality-adjusted life-years, and cost-effectiveness, according to a study recently published in Annals of Internal Medicine.

In order to adapt to the Oncology Care Model (OCM), Regional Cancer Care Associates had to undergo the process of adjusting and customizing its electronic medical records, explained CEO Terrill Jordan.

New Jersey's largest payer will track a host of measures, including some that will evaluate the quality of end-of-life care.

We should try to remove barriers that are not only in place, but getting higher for clinicians and patients to get evidence-based care, said A. Mark Fendrick, MD, director of the Center for Value-Based Insurance Design at the University of Michigan.

Electronic health record (EHR)-based comorbidity assessment had low sensitivity for identifying major comorbidities and poorly predicted survival. EHR-based comorbidity data require validation prior to application to risk adjustment.

A study finds that protein markers may be a better predictor of drug response than genetic mutation are in patients with acute myeloid leukemia (AML). As a result, some patients who could benefit from treatment may not be eligible under current approval specifications.

Poor baseline Lung Immune Prognistic Index (combining derived neutrophils ratio greater than 3 and lactate dehydrogenase greater than upper limit of normal), or LIPI, was associated with worse outcomes for immune checkpoint inhibitor (ICI) treatment in patients with non-small cell lung cancer (NSCLC), but not with results of chemotherapy, according to a study in JAMA Oncology.

The language used by doctors contributes to why patients don't understand what they are told; the number of American adults without health insurance grew 1.3 percentage points from the end of 2016 to the end of 2017; women are increasingly faced with the decision between 2D and 3D mammograms.

The challenges that adolescents and young adults face before and after treatment are all unique to an individual patient, according to Julie Wolfson, MD, of the University of Alabama at Birmingham School of Medicine.

The approval expands the use of olaparib to include the treatment of patients with BRCA-mutated HER2-negative metastatic breast cancer. The FDA also expanded the approval of Myriad’s BRCAnalysis CDx, a companion diagnostic to olaparib, to include the detection of BRCA mutations.

It’s very unusual to see significant cost savings in the first year of a program; that was true of all the pioneer ACO programs, said Jeff Patton, MD, CEO of Tennessee Oncology.

More than half of octogenarians and nonagenarians with stage III non–small-cell lung cancer did not receive treatment, according to a study in CANCER. Older age, black race, and living in a lower educated census tract were found to be risk factors for not receiving treatment.

Involving providers in the development process of new reimbursement models increases the chance that the initiative will be successful and works against caregiver burnout, said Peter Aran, MD, medical director of Population Health Management at Blue Cross Blue Shield of Oklahoma.

AstraZeneca’s epidermal growth factor receptor (EGFR) inhibitor, osimertinib (Tagrisso), is on the fast track in 2018 to become a first-line treatment for adult patients with locally-advanced or metastatic non-small cell lung cancer (NSCLC) whose tumors have EGFR mutations.

Eisai’s multiple receptor tyrosine kinase inhibitor lenvatinib and Merck’s anti–PD-1 therapy pembrolizumab as a combination therapy for patients with renal cell carcinoma received the designation based on results from the renal cell carcinoma cohort in Study 111.