February 2020

Special approval programs have increased FDA administrative costs (paid for mostly by user fees), and postponements of generic competition have been costly to the US healthcare system, according to a recent article in JAMA.

The decline can be attributed to long-term drops in death rates for the 4 major cancers—lung, colorectal, breast, and prostate.

With patients living longer thanks to new therapies, we need more accurate, sensitive, and standardized tools to guide their therapy.

Opportunities for precision medicine can be lost if clinicians do not perform biomarker testing, and payers may be part of the reason, according to Stuart Goldberg, MD, a hematologist/oncologist and chief of the Division of Outcomes and Value Research at the John Theurer Cancer Center at Hackensack University Medical Center in New Jersey.

As today’s employers try to balance the need to provide healthcare for their workers while keeping an eye on cost, they are banding together to learn more about cancer care and how to gain value for the millions they are spending. Last fall during the Community Oncology Alliance Payer Exchange Summit, leaders from employer and purchasing groups shared experiences from their members in a roundtable discussion.

Dr Alvarnas is editor-in-chief of Evidence-Based Oncology.™ He is vice president of Government Affairs, senior medical director for Employer Strategy, and associate clinical professor, Hematology & Hematologic Cell Transplantation, City of Hope, Duarte, Califonia.

As the cost of oncology drugs only continues to rise, incorporating clinical pathways into cancer care helps streamline the integration of evidence-based best practices while improving quality and reducing costs for patients and payers.

As cancer care becomes more complex and more expensive, decision-support algorithms offer a mechanism to define best practice, reduce unwarranted variation, and control costs across growing networks.