This Week in Managed Care: January 10, 2020

Cancer deaths fall for the 25th straight year, a study finds no link between talc powder and ovarian cancer, and a poll finds 1 in 4 patients with Parkinson disease may be misdiagnosed.

Welcome to This Week in Managed Care, I’m Christina Mattina.

Cancer Deaths Drop for 25th Straight Year

Lower smoking rates and better therapies are behind a new milestone reported by the American Cancer Society: The cancer death rate has been falling for at least 25 years.

The findings are reported in CA: A Cancer Journal for Clinicians. Among the findings:

• The decline has meant 2.9 million fewer deaths since 1991, especially in the 4 major cancers: breast, lung, prostate, and colorectal.
• Declining smoking rates and early detection account for much of the progress. Overall, lung cancer deaths have dropped 50% since 1991.
• Death rates in breast cancer have stalled recently, while the decline in lung cancer deaths has accelerated since 2014, after checkpoint inhibitors were approved.
• With the good news comes word that cancers related to obesity are on the rise, including liver cancer.
• Cancer continues to hit hardest among minorities and the poor. Cervical cancer deaths are twice as high for women in poor counties compared with women in affluent counties.

Despite the progress, the ACS predicts there will be more than 1.7 million new cancer cases and 600,000 cancer deaths in the United States this year.

For more, visit ajmc.com.

No Significant Link Found Between Talc Powder, Ovarian Cancer

A new study finds no significant link between talc powder and ovarian cancer, despite a public uproar that has led to scrutiny of one of the country’s leading talc producers, Johnson & Johnson.

The JAMA study of more than 250,000 women published this week reviewed data from 4 separate studies that took place between 1976 and 2017.

Researchers found the following:

• The median age of the women in the study was 57 years, which is significant because older women were more likely to use talc powder in the genital area.
• After a median of 11.2 years of follow-up, there were 61 cases of ovarian cancer per 100,000 person-years among talc users, compared with 55 cases per 100,000 person-years among women who never used talc powder.
• The estimated difference in risk at age 70 was less than 1%.

Because talc and asbestos are mined in the same locations, Johnson & Johnson has faced a series of lawsuits from consumers claiming the powder caused ovarian cancer. The company settled a California case with a woman midtrial for $2 million last week, the day before the study appeared. However, the company has prevailed in several rulings.

For more, visit ajmc.com.

More Than 1 in 4 Patients With Parkinson Have Been Misdiagnosed

A poll of people with Parkinson disease found that more than 1 in 4 reported being misdiagnosed, and 21% had to see their primary care doctor 3 times before being referred to a specialist.

The poll was reported in The Guardian, based on data collected by Parkinson UK, a British charity.

Findings included:

• 48% of patients received treatment for a nonexistent condition
• 36% received medication they did not need
• 34% reported a decline in health after being misdiagnosed
• Women were more likely to be misdiagnosed than men

Katie Goates, of Parkinson’s UK, told The Guardian: “One of the biggest challenges for Parkinson’s research is that there is no definitive test for Parkinson’s, and as a result we’ve heard of people being misdiagnosed with anything from a frozen shoulder or anxiety to a stroke.”

Heart Failure, Kidney Failure Strongly Linked

A new study finds that patients hospitalized for heart failure have 11 times the risk of kidney failure.

Authors in the Journal of the American Society of Nephrology reported on the relationship between heart disease and kidney function, and found that among a group of cardiovascular diseases, heart failure had the strongest link to end-stage renal disease.

The results “highlight the importance of protecting the kidney health of individuals diagnosed with cardiovascular disease.”

The findings come amid a wave of trials examining how SGLT2 inhibitors can work to prevent hospitalization for heart failure and renal decline, two of the most expensive conditions in healthcare.

For more, visit ajmc.com.

Pfizer Launches Bevacizumab Biosimilar, Zirabev

Finally, the Center for Biosimilars, the sister site of AJMC^®, reported this week that Pfizer has launched its biosimilar for bevacizumab.

Zirabev will be priced at a 23% discount of the wholesale acquisition cost of Avastin, its reference product.

A Pfizer spokeswoman said the drug will be available Monday, January 13.

For the full story, visit the Center for Biosimilars.

For all of us at AJMC^®, I’m Christina Mattina. Thanks for joining us.