Value in Oncology

The rising cost of healthcare, including cancer care, is an established trend in the United States. In 2015, Americans spent $3.2 trillion (nearly $10,000 per person) on healthcare, including hospital inpatient and outpatient care, physicians’ services, and prescription drugs. The National Cancer Institute estimates that by 2020, the annual cost of healthcare for Americans with cancer will reach $156 billion; based on current trends, this means that cancer care will represent approximately 20% of the country’s annual healthcare expenditures.
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Washington, DC—Although significant advancements in oncology research, development, and treatment have improved cancer care, they have been accompanied by rising drug costs, and differences in drug availability and delivery worldwide. These trends will continue into 2020, according to Douglas Long, Vice President, Industry Relations, IMS Health.
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Washington, DC—An innovative, value-based approach to managing the cost of oncology care moves away from drug-spending volume toward the appropriate use and quality of drug therapy, said Alan Lotvin, MD, Executive Vice President, Specialty Pharmacy, CVS Health, Woonsocket, RI, at the Sixth Annual Conference of the Association for Value-Based Cancer Care.
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Washington, DC—Risk arrangements with physicians and transferring the costs of care onto patients are expected to increase in 2017, as payers attempt to manage high-cost disease states, such as cancer care, said Marie A. Hollowell, Senior Manager, Syndicated Research, Zitter Health Insights, at the Sixth Annual Conference of the Association for Value-Based Cancer Care.
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Washington, DC—Treatments and technologies for cancer care are becoming increasingly expensive, fueling a need to define and improve value. As a result, the American Society of Clinical Oncology (ASCO) is refining its value framework that supports informed shared decision-making between doctors and patients and considers the clinical benefit, cost, and toxicity of cancer treatments. The goal is to have a tool that can customize information for each patient.
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Washington, DC—An opportunity for value enhancement from the drug manufacturer’s perspective includes the improved use of data to meet the needs of stakeholders, especially the patient. Data that are generated should support the value of the manufacturer’s therapies in light of newly established value-based models, which often rely on quality metrics, for example, that are not obvious from clinical trials. Finally, wraparound services can add to a drug’s value and help to distinguish it from a competitor’s drug.
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Washington, DC—Oncology care is facing rising costs that will demand a transformation from a fee-for-service reimbursement model to a value-based, shared-risk incentive plan for Medicare and commercial insurance plans. Bruce Pyenson, FSA, MAAA, Principal and Consulting Actuary, Milliman, New York, NY, provided an overview of the cost trends of cancer treatment costs at the Sixth Annual Conference of the Association for Value-Based Cancer Care.
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Washington, DC—Payers are increasingly evaluating methods to manage oncology care costs in the new value-driven healthcare system. These methods include improved quality measurement and value-assessment tools, the appropriate use of drugs, and value-based contracts with health plans.
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Boston, MA—Are we winning the war on cancer? According to Joshua J. Ofman, MD, MSHS, Senior Vice President, Global Value, Access and Policy, Amgen, the answer is yes. Dr Ofman discussed the economics of cancer, including challenges facing insurance providers and ways to impact the rising cost of cancer care, at the War on Cancer forum hosted by The Economist.
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San Francisco, CA—For patients with hematologic malignancies, end-of-life care varies but often involves high-intensity interventions as death approaches. According to a recent analysis by Cara L. McDermott, PharmD, PhD, MSc, Senior Fellow, Fred Hutchinson Cancer Research Center, Seattle, WA, and colleagues, these interventions can come with a hefty price tag, too.
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