Cancer care is one of the fastest growing components of US healthcare costs and is estimated to reach $158 billion by 2020. The American Society of Clinical Oncology (ASCO) Value in Cancer Care Task Force attributes the rising cost of cancer care to several factors, including the overall aging of the population, the introduction of costly new drugs and innovative surgery and radiation techniques, and the adoption of more expensive diagnostic tests.
The American Society of Clinical Oncology (ASCO) new value framework abandons the Hippocratic Oath. No longer is the doctor’s first obligation to “apply, for the benefit of the sick, all measures which are required.” Instead, ASCO’s value framework has the potential to help insurers “evaluate the relative value of new treatments” as they develop “benefit structures, adjustment of insurance premiums, and implementation of clinical pathways and administrative controls."
Value-based oncology was one of the high-profile topics at the 2015 American Society of Clinical Oncology (ASCO) meeting. It is something that is discussed widely in print and on social media. It is certainly top of mind for payers, doctors, policymakers, business leaders, and, in particular, patients.
The FDA’s Oncologic Drug Advisory Committee (ODAC) reviewed necitumumab (Eli Lilly & Co) for use in patients with metastatic squamous non–small-cell lung cancer (NSCLC). Necitumumab is an immunoglobulin G1 monoclonal antibody that inhibits the interaction between the human epidermal growth factor receptor (EGFR) and its ligands. EGFR expression is elevated in NSCLC and affects >95% of squamous NSCLC tumors.
- Eli Lilly and Immunocore Launch New Collaboration to Develop Next-Generation Immuno-oncology Therapies
- Biosimilars Focus on Oncology, Could Reach $55 Billion by 2020
- ImmunoCellular Therapeutics and Novella Clinical to Collaborate on a Phase 3 Trial in Glioblastoma
- House Passes New Medicare Bill That Includes a Value-Based Insurance Design Pilot Project
In the modern era of increasing healthcare costs, and with prescription drug expenditures forecasted to increase by 7% to 9% in the next year, a focused discussion on the value proposition of cancer care is warranted. The American Society of Clinical Oncology (ASCO) Value in Cancer Care Task Force should be commended for igniting the conversation about the value of chemotherapy regimens. We live in a society with a limited amount of resources, and, therefore, resources such as treatment options must be allocated appropriately to maximize the benefits to society.
Rising to a level of equal status with cancer providers is a tall order for patients with cancer, yet it is precisely the intent of the Meaningful Use Stage 3 proposed standards that are set to take effect in 2018 (ie, patient-reported outcomes), as well as the value-based care initiatives. Providers need to drop their resistance and contemplate the following benefits of patient centricity.
There has been talk regarding pricing in healthcare for a number of years, so the recent move by the American Society of Clinical Oncology (ASCO) and by Memorial Sloan Kettering Cancer Center (MSKCC), discussed in this issue of Value-Based Cancer Care, is certainly a big deal, but is hardly surprising.
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