December 2016, Vol 7, No 11

Washington, DC—Employers recognize that oncology care is expensive, and they are shifting their focus on cost management. As such, employers are seeking approaches to determine which drugs and health plan designs will help them manage pharmacy and medical costs to improve patient outcomes, said F. Randy Vogenberg, PhD, RPh, Partner, Access Market Intelligence, and National Institute of Collaborative Healthcare, Greenville, SC, at the Sixth Annual Conference of the Association for Value-Based Cancer Care.

Washington, DC—In the past 6 years, more than $4 billion in charitable assistance has been dedicated to patients in need. In 2015 alone, the Patient Access Network (PAN) Foundation provided $950 million in cancer care support. The only people with deep enough pockets to support this type of assistance are drug manufacturers, adding to an already complicated regulatory environment for charitable assistance programs, said Daniel J. Klein, President and Chief Executive Officer, PAN Foundation, at the Sixth Annual Conference of the Association for Value-Based ­Cancer Care.

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.

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.

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.

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.

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.

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.

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.