Interviews

Susan Sabo-Wagner, MSN, RN, OCN, executive director of clinical strategy for Oncology Consultants of Houston, Texas, discussed how housing conditions can impede positive outcomes for patients with cancer who are receiving cancer care support at home.

Kristen K Ciombor, MD, MSCI, associate professor at Vanderbilt University, explains that results of neoadjuvant immunotherapy in colorectal cancer are promising, but long-term data is still needed.

Biosimilars are a wonderful option for patients, but the growing number available can be challenging to manage when different payers prefer different agents, said Susan Sabo-Wagner, MSN, RN, OCN, executive director of clinical strategy for Oncology Consultants of Houston, Texas.

Paul Thurmes, MD, medical oncologist and hematologist, Minnesota Oncology, spoke on key responsibilities and approaches that are often lacking in cancer care.

Susan Sabo-Wagner, MSN, RN, OCN, executive director of clinical strategy for Oncology Consultants of Houston, Texas, talked about the importance of having adequate support not only from clinical staff, but also emotional and moral support at home.

Hilary Tindle, MD, MPH, associate professor of medicine, Vanderbilt University, spoke on increased rates of smoking and lung cancer within a particular region of the United States called "Tobacco Nation."

Kyle Lamb, MD, associate medical director of population health at Vancouver Clinic, discusses how super-utilization trends have changed since the start of COVID-19, the necessity of transitional care in implementing value-based medicine, and how technology can decrease super-utilization.

Martin Levine, MD, MBA, chief medical officer at the PolyClinic at Optum Washington, describes why caregivers need more resources to adequately manage patients with Alzheimer disease and what clinics can do to ensure access to those resources.

Kristen K. Ciombor, MD, MSCI, associate professor at Vanderbilt University discusses why neoadjuvant immunotherapy is superior to other immunotherapy treatments in colorectal cancer.

During an Institute for Value-Based Medicine® event held in New York City, Samyukta Mullangi, MD, MBA, fellow in medical oncology at Memorial Sloan Kettering Cancer Center, discussed how disruptions from the COVID-19 pandemic are ushering in health care delivery reform.

There is a major role for telehealth in oncology care, not only for its convenience but also for giving clinicians the ability to scale nononcologic visits, explained Emeline Aviki, MD, MBA, FACOG, assistant attending gynecologic cancer surgeon at Memorial Sloan Kettering Cancer Center (MSKCC) in New York City and lead of the MSKCC Affordability Working Group.

Stephen M. Schleicher, MD, MBA, chief medical officer at Tennessee Oncology, addresses the “huge problem” of financial toxicity among patients with cancer, which can be attributed in part to both the high price of targeted treatments and even from ordering only necessary testing.

With multiple biosimilars approved for a reference product and different payers preferring particular products, communication between the clinical pharmacy team and the managed care team is crucial, said Timothy Murphy, MD, FACP, medical oncologist/hematologist with Rocky Mountain Cancer Centers.

Having a plan in place to educate providers and the pharmacy team has contributed to the success that Rocky Mountain Cancer Centers (RMCC) has had with rapidly implementing biosimilars, said Timothy Murphy, MD, medical oncologist/hematologist with RMCC.

Biosimilars have had such an impact on driving down costs, that in some instances the reference product might be the lowest cost option, explained Paul Forsberg, PharmD, director of pharmacy, Minnesota Oncology.

Even though there is a 1-year gap between the Oncology Care Model and the Enhancing Oncology Model, there remain value-based oncology payment programs with private payers, said Glenn Balasky, executive director of Rocky Mountain Cancer Centers.

With more and more biosimilars reaching market, there are considerations around whether to keep patients on their current biosimilar or switch them to another biosimilar as the market dictates, said Paul Forsberg, PharmD, director of pharmacy, Minnesota Oncology.

Lung cancer screening rates remain low nationwide, and there is a need to better educate patients and clinicians about the importance of screening, said Ticiana Leal, MD, associate professor, director of the Thoracic Medical Oncology Program, Department of Hematology and Medical Oncology, Emory University School of Medicine.

With multiple pathways and stakeholders involved, there needs to be an arbiter who decides what is the highest quality and highest value care in oncology, said Lucy Langer, MD, MSHS, national medical director, oncology and genomics, UnitedHealthcare.

Co-hosted by Memorial Sloan Kettering Cancer Center, the most recent Institute for Value-Based Medicine® event took place on September 22, with a focus on improving cancer care delivery through innovation.

Targeted therapies have improved outcomes for patients with lung cancer, but the goal needs to be tailoring the right therapy to the right patient, said Ticiana Leal, MD, associate professor, director of the Thoracic Medical Oncology Program, Department of Hematology and Medical Oncology, Emory University School of Medicine.

When converting a patient to a biosimilar, having clear and consistent messaging will reduce confusion and prevent patients from having a lack of trust in the process, said Paul Forsberg, PharmD, director of pharmacy, Minnesota Oncology.

Being able to use minimal residual disease (MRD) negativity to make treatment decisions, such as stopping maintenance therapy, can have savings related to cost and quality of life (QOL) for patients, said Ajay Nooka, MD, MPH, FACP, associate professor, Winship Cancer Institute.

Biomarker testing should be done on all patients with an initial diagnosis of advanced nonsquamous non–small cell lung cancer, but the testing rates in the real world are lower than they should be, particularly for underserved or minority populations, said Ticiana Leal, MD, associate professor, director of the Thoracic Medical Oncology Program, Department of Hematology and Medical Oncology, Emory University School of Medicine.

While commercial payers have been engaged with the shift to biosimilars, they all have their own preferred biosimilar, which makes it challenging for practices, explained Lalan Wilfong, MD, vice president of payer relations & practice transformation at The US Oncology Network.

Everyone agrees that minimal residual disease (MRD) is the best prognostic tool for multiple myeloma, but there is disagreement on how to use the MRD results, said Ajay Nooka, MD, MPH, FACP, associate professor, Winship Cancer Institute.

While initially there was a need for education around biosimilars, now there is a need to keep an eye on the evolving biosimilar marketplace and update the formulary of biosimilar medicines, said Paul Forsberg, PharmD, director of pharmacy, Minnesota Oncology.

Minimal residual disease (MRD) testing is used to understand the depth of response, but currently the data at Emory are not used to make treatment decisions, said Ajay Nooka, MD, MPH, FACP, associate professor, Winship Cancer Institute.

The 1-year gap after the end of the Oncology Care Model (OCM) means some practices have to make hard decisions regarding cost of care or the financial health of the practice, explained Lalan Wilfong, MD, vice president of Payer Relations & Practice Transformation at The US Oncology Network.

While the Community Oncology Alliance (COA) was involved in humanitarian work in Puerto Rico after Hurricane Maria, the crisis in Ukraine caused COA to set up a special committee to jump into action, said Ted Okon, MBA, executive director, COA.