July 2015, Vol 6, No 6

There has been talk regarding pricing in healthcare for a number of years, so the recent move by the American Society of Clinical Oncology (ASCO) and by Memorial Sloan Kettering Cancer Center (MSKCC), discussed in this issue of Value­-Based Cancer Care, is certainly a big deal, but is hardly surprising.

In the face of escalating costs of cancer drugs, the American Society of Clinical Oncology (ASCO) rightly asks, what is the value of these new medicines?

Rising to a level of equal status with cancer providers is a tall order for patients with cancer, yet it is precisely the intent of the Meaningful Use Stage 3 proposed standards that are set to take effect in 2018 (ie, patient-reported outcomes), as well as the value-based care initiatives. Providers need to drop their resistance and contemplate the following benefits of patient centricity.

The FDA’s Oncologic Drug Advisory Committee (ODAC) reviewed necitumumab (Eli Lilly & Co) for use in patients with metastatic squamous non–small-cell lung cancer (NSCLC). Necitumumab is an immunoglobulin G1 monoclonal antibody that inhibits the interaction between the human epidermal growth factor receptor (EGFR) and its ligands. EGFR expression is elevated in NSCLC and affects >95% of squamous NSCLC tumors.

The American Society of Clinical Oncology (ASCO) new value framework abandons the Hippocratic Oath. No longer is the doctor’s first obligation to “apply, for the benefit of the sick, all measures which are required.” Instead, ASCO’s value framework has the potential to help insurers “evaluate the relative value of new treatments” as they develop “benefit structures, adjustment of insurance premiums, and implementation of clinical pathways and administrative controls."

Cancer care is one of the fastest growing components of US healthcare costs and is estimated to reach $158 billion by 2020. The American Society of Clinical Oncology (ASCO) Value in Cancer Care Task Force attributes the rising cost of cancer care to several factors, including the overall aging of the population, the introduction of costly new drugs and innovative surgery and radiation techniques, and the adoption of more expensive diagnostic tests.