Economics & Value

Tampa, FL—Combining dabrafenib (Tafinlar) with trametinib (Mekinist) as upfront treatment for patients diagnosed with BRAF V600 mutation–positive metastatic melanoma should lead to improved survival, but it increases the direct costs of treatment compared with other first-line therapies.

Tampa, FL—Genetic testing and targeted medicines, the key players in personalized medicine, are seen as the waves of the future for managing patients with cancer, but getting there remains a challenge when it comes to insurance coverage for these expensive tests and therapies.

Charles Kennedy, MD, Chief Executive Officer of Aetna’s Accountable Care Solutions, is responsible for leading Aetna’s accountable care partnerships with healthcare providers. Dr Kennedy also serves as the health insurance industry representative on the Health IT Policy Committee, a federal advisory committee that makes recommendations to the National Coordinator for Health IT on a policy framework for the development and adoption of a nationwide health information infrastructure.

The total annual cost of mammography screening for women aged 40 to 85 years in the United States is estimated to be $7.8 billion, according to a new analysis (O’Donoghue C, et al. Ann Intern Med. 2014;160:145-153). That is $4.3 billion more than the cost would be if mammography intervals were lowered to fall in line with the recommendations of the US Preventive Services Task Force (USPSTF), the study researchers calculated.

Value Propositions for May 2014.

Advances in cancer treatment, from detection and diagnosis to drugs, surgical techniques, and new imaging capabilities, have collectively enabled many patients to live longer, healthier lives with or after cancer. However, a new landmark report, “The State of Cancer Care in America, 2014: A Report by the American Society of Clinical Oncology” (ASCO), identifies the many challenges that will impact the future delivery of cancer care (ASCO. J Oncol Pract. 2014;10:119-143). These challenges include an increasing demand for care, predicted workforce shortages, rapidly rising costs, imbalances in access to care, and an unstable practice environment.

The promise of big data–driven personalized healthcare mandates reform of the oncology reimbursement system, suggested Jeffery C. Ward, MD, Medical Oncologist, Swedish Cancer Institute, Edmonds, WA, in a recent commentary.

Hollywood, FL—The Affordable Care Act (ACA) is in its infancy, but it is already changing oncology practice, said panelists at the 2014 National Comprehensive Cancer Network (NCCN) Conference roundtable discussion. The consequences of the ACA include the changing composition of oncology patients, the risk pool of the exchanges, new payment and reimbursement models, acquisition fever, and oncology workforce demands, the panelists said.

San Francisco, CA—Concerns that healthcare utilization will increase dramatically once more patients are insured under the Affordable Care Act (ACA) may be overblown, based on results of a large study of Medicaid and underinsured patients with seminoma, the most common type of tes­ticular cancer.

New Orleans, LA—The efficiency of rituximab (Rituxan) and the associated cost can be improved by switching from intravenous (IV) to subcutaneous (SC) administration. Such a switch led to a substantial reduction in patient chair time and in active healthcare professional time, said Christof Wiesner, PhD, MPH, of the Market Access Department, Genentech, San Francisco, CA, at the ASH 2013 meeting.