The Lynx Group

Economics & Value

Articles about real-world healthcare utilization and costs on Value-Based Cancer Care.
Hollywood, FL—Value-based decision-making at the bedside can be fraught with obstacles, with no clear agreement on what constitutes value, and for whom. In addition, the myriad insurance plans preclude uniform treatment strategies, despite clinical pathways and guidelines intended to reduce variation in care. Finally, value is becoming more difficult to achieve in oncology as each benefit becomes more expensive, with the cost of new therapies outpacing inflation.
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San Francisco, CA—According to a recent cost-effectiveness analysis, third-line therapy with regorafenib (Stivarga) in patients with previously treated metastatic colorectal cancer (CRC) far ­exceeded accepted willingness-to-pay thresholds based on incremental cost-effectiveness ratio (ICER) and quality-adjusted life-years (QALYs). Presented at the 2015 Gastrointestinal Cancers Symposium, the results showed that regorafenib provided an additional 0.04 QALYs, at a cost of $39,391.
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San Francisco, CA—In what is believed to be the first economic analysis of disease progression of patients with myeloma, researchers found that in patients with newly diagnosed myeloma, the monthly costs are reduced by 68% between the first 4 months through 18 months, but they then rise steeply when the disease relapses. The data were presented at the 2014 American Society of Hematology meeting.
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Although often criticized as being overly expensive, innovations in drug development for hematologic malignancies meet standard benchmarks for cost-effectiveness, delivering value for their cost, suggest a team of health economics researchers led by Peter J. Neumann, ScD, Director, the Center for the Evaluation of Value and Risk in Health, Tufts Medical Center, Boston (Saret CJ, et al. Blood. 2015 Feb 5. Epub ahead of print).
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Although increasing the reimbursement rate for cancer screening tests does not consistently improve the likelihood of Medicaid beneficiaries being screened for cancer, raising the rate of reimbursement for office visits does consistently increase the likelihood that they will be screened for cancer, including breast or prostate cancer, according to results of a new analysis of Medicaid claims and enrollment data (Halpern MT, et al. Cancer. 2014 Aug 25. Epub ahead of print).
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New York, NY—Four head and neck surgeons, 3 of whom use robots in their practice, squared off in a friendly debate on the pros and cons of advanced technology use, focusing on the examples of thyroidectomy and advanced oropharyngeal cancer, at the 2014 American Head and Neck Society annual meeting.
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The current fee-for-service reimbursement model used in oncology has jeopardized value-based cancer care, according to Jeffery Ward, MD, a member of the American Society of Clinical Oncology (ASCO) Workgroup on Payment Reform.
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The high cost of cancer care follows patients well into survivorship, as annual medical costs and losses in productivity exceed those of people without cancer by 50% to 100%, a study for the Centers for Disease Control and Prevention (CDC) showed (Ekwueme DU, et al. MMWR Morb Mortal Wkly Rep. 2014;63:505-510).
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Tampa, FL—Patients with HER2-positive metastatic breast cancer consume 2.5 times more financial resources in their last 6 months of life, according to study results presented at the 2014 Academy of Managed Care Pharmacy meeting.
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