Clinical Pathways

San Diego, CA—Patient-centered clinical pathways may hold the promise of truly personalized medicine, improving value-based care and clinical outcomes. However, according to Cary P. Gross, MD, Director, Cancer Outcomes, Public Policy and Effectiveness Research Center, Yale School of Medicine, New Haven, CT, substantial challenges still stand in the way of including the patient’s voice in these pathways.

Chicago, IL—Clinical pathways have an important role in the integration of new cancer drugs into clinical practice. Between January 2015 and mid-2017, the FDA granted more than 60 new approvals in oncology, with new drugs accounting for the vast majority (as opposed to new indications). Staying abreast of new drugs and new indications for specific types of cancer requires much time, which presents an extra burden on community oncologists.

San Fransisco, CA—An economic model designed to determine the cost of instituting a clinical pathway inmetastatic colorectal cancer (mCRC) showed that the costs associated with implementing such a pathway may outweigh any potential cost-savings it may provide, at least for the near-term, according to Tanya G.K. Bentley, PhD, PHAR LLC, Beverly Hills, CA, and colleagues.

It does not take a crystal ball, or even an economist, to foretell that disaster is imminent in the healthcare system if premiums and out-of-pocket costs continue to rise, along with the cost of cancer drugs. Although the government attempts to rectify the situation with Medicare payment reform, new payment and care delivery models, such as the Oncology Care Model (OCM) pilot, and laws, such as the 2015 Medicare Access and CHIP Reauthorization Act (MACRA), present financial challenges for oncologists.

With $137 billion and growing spent on treatment in the US healthcare annually, cancer care delivery poses a significant challenge. At a special session at ASH 2015 on new payment models, Michael Kolodziej, MD, National Medical Director for Oncology Solutions at Aetna, discussed pathways and the medical home as transitional solutions to value in cancer care.

Chicago, IL—At the special session on value during the 2015 American Society of Clinical Oncology meeting, Jennifer Malin, MD, PhD, Staff Vice President for Clinical Strategy, Anthem, Thousand Oaks, CA, presented the payer perspective on value in cancer care. The role of the payer, Dr Malin said, is to balance different stakeholders’ values and needs at various time points.

Clinical pathways have been suggested as a good method to implement guidelines into clinical practice and to reduce treatment variability. Although oncology clinical pathways have been studied previously, a new study looked at supportive care services and their effect on reducing emergency department visits and hospitalizations associated with chemotherapy toxicitie.