February 2016, Vol 7, No 1

With the recent FDA approval of the first oral proteasome inhibitor ixazomib (Ninlaro), patients with relapsed or refractory multiple myeloma who have received previous treatment now have access to an all-oral regimen. The FDA-indicated triplet regimen of ixazomib, lenalidomide (Revlimid), and dexamethasone (Decadron) significantly improved progression-free survival (PFS) compared with the doublet of lenalidomide and dexamethasone, reported Philippe Moreau, MD, University of Nantes, France, at ASH 2015.

Medicare is poised to incorporate new quality metrics as a guide for payments. At ASH 2015, Helen Burstin, MD, MPH, Chief Scientific Officer, National Quality Forum, Washington, DC, discussed the need for measures and reporting systems that reflect patient care and care coordination.

Given the high cost of care for acute leukemia, innovative payment strategies that reward longitudinal care and create economic incentives for data-driven care delivery are needed, according to Joseph Alvarnas, MD, Director of Value-Based Analytics, and Associate Clinical Professor of Hematology and Hematopoietic Cell Transplantation, City of Hope, Duarte, CA.

Medicare has initiated several programs in the past decade to encourage value, but questions remain regarding their effectiveness. At ASH 2015, Andrew Ryan, PhD, MA, Associate Professor of Health Management and Policy, University of Michigan School of Public Health, Ann Arbor, addressed the implications of using financial incentives to drive care quality and reduce cost.

Many presentations at ASH 2015 focused on novel therapies currently in development for the treatment of patients with hematologic malignancies, including a second generation of new agents recently approved by the FDA for a variety of hematologic cancers.

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.

The multikinase inhibitor midostaurin is the first targeted therapy to improve overall survival (OS) in patients with acute myeloid leukemia (AML) and the FLT3 mutation.

The year 2015 saw an explosion of new drugs approved by the FDA and new indications for drugs already on the market for multiple myeloma. Overall, 4 new drugs from 2 new classes were approved in 2015, changing the standard of care for patients with this disease.