Trends in Oncology Dr Michael Kolodziej Expects to See in Coming Years

Michael Kolodziej, MD, vice president and chief innovation officer at ADVI Health, Inc., outlines the trends he expects to see in the coming years that will impact oncology.

Transcript

What are some trends you foresee happening in the coming years in regard to the cancer care landscape?

The cancer landscape has been really interesting the past several years. There’s little doubt it’s changed, although for me, not fast enough. I think we will see continued interest in at least 2 areas. The first is I think that [Center for Medicare and Medicaid Innovation] is going to declare the [Oncology Care Model] a success; we can debate whether that’s a true statement or not, but they surely are going to double down on it.

We’re going to see 2 more years of the same and we will see them propose a follow-up model. And what that follow-up model is going to be, I can’t tell you for sure, but it will be based on the same sort of care model. Although if I were a betting man, I’d bed the reimbursement model is going to go more toward a bundled reimbursement model, much like they’ve proposed in radiation oncology just recently.

The second thing we’ll see and I think we’ll see this mostly from the commercial payers is a really intense focus on the cost of drugs. I think we have learned from the OCM that whatever la la land we were living in about how much drugs were contributing to cost of care, no one, absolutely no one, would have predicted that 60% of the cost of care for patients with advanced disease receiving systemic therapy was related to the drugs. The commercials payers all over that and they’re going to do something about it. Interestingly enough, I think one thing they will surely do is evolve pathways programs that will promote value-based decision making and prescribing behavior where it’s appropriate.

The other thing we will surely see is some variation of step therapy. Oncologists will hate to hear this. The easiest step therapy for the commercial payers to implement is something like requirement of use of their preferred biosimilar in circumstances where a biosimilar is available, and I mean that in both the supportive care space, as well as the therapeutic space, because it’s the worst kept secret in the world that commercial payers are negotiating contracts with the biosimilars manufacturers, not unlike what oncology practices have been doing forever with manufacturers. So, we will see implementation of some sort of step therapy in certain treatment areas.

Those I think are almost certain to occur within the next 5 years.