THE PEER-REVIEWED FORUM FOR EVIDENCE IN BENEFIT DESIGN ™ FOR PAYERS, PURCHASERS, POLICYMAKERS, AND OTHER HEALTHCARE STAKEHOLDERS
ASH 2010: PAYERS’ PERSPECTIVES AMERICAN SOCIETY OF HEMATOLOGY HIGHLIGHTS
Photo by Curtis Compton, courtesy of the American Society of Hematology.
February 2011 I Vol 4, No 1 I SPECIAL ISSUE
Pharmacoeconomics: Hematologists Should Prepare for the Coming Debate on Costs versus Benefits By Neil Canavan
A Hal E. Broxmeyer, PhD, Distinguished Professor of Microbiology and Immunology, Indiana University School of Medicine, addressing attendees at the ASH 2010 Annual Meeting in Orlando.
European or Canadian approach to making formulary decisions is the inevitable future. In other words, costs must be weighed against benefits, according to Joseph Mikhael, MD, of the Mayo Clinic, AZ, a self-described “healthcare economics wonk,” who spoke at a session at the 2010 American Society of Hematology’s annual meeting on the new pharmacoeconomics in cancer care.
Dr Mikhael suggested that the audience consider that “US medical insurance costs are rising faster than earnings and general inflation.” Bevacizumab, approved for lung and colon cancers, costs $4000 to $9000 per month. Cetuximab, which is approved for colon and head and neck cancers, costs $17,000 per month. Many physicians are uncomfortable with discussing drug price; they are supposed to be their patients’ ultimate Continued on page 6
Hematology Drug Pipeline Is Robust
Healthcare Reform Addresses Quality of Care for Americans
Novel Therapies with Promising Options
Oncologist and Policy Expert Dispels Many Myths
By Caroline Helwick
By Caroline Helwick
S
tudies presented at the 2010 annual meeting of the American Society of Hematology suggest that patients with multiple myeloma (MM), lymphoma, and chronic myelogenous leukemia (CML) may have new treatment options in the future that offer outcomes superior to current therapies when used individually or in combination with current therapies. Some of the products described in this article are supported by pivotal or phase 2b data, whereas others are only in early-phase testing and are included because experts consider them so
promising, as was emphasized at the meeting. Multiple Myeloma Current treatment for MM is very effective but not curative. Two drugs in preliminary testing that have shown impressive survival rates and attracted much attention at the meeting are elotuzumab and pomalidomide. Elotuzumab, a humanized monoclonal antibody directed against the CS1 antigen, combined with lenalidomide and dexamethasone, achieved a very high response rate (81%) in the Continued on page 26
Ezekiel J. Emanuel, MD, PhD
T
he richer the nation, the more it spends on healthcare, “but the US is phenomenally off the chart,” spending a total of $2.4 trillion annually, or $7300 per person in 2007. By contrast, the next biggest spenders are Switzerland and Norway, and
Continued on page 7
IN TH IS ISSUE HEALTH ECONOMICS . . . . . . . . . . .6 Healthcare survival depends on innovation Thrombotic microangiopathies total $227.4 million annually New outpatient treatment criteria for PE can cut costs NON-HODGKIN LYMPHOMA . .13 Rituximab effective in several combinations and in asymptomatic patients HODGKIN LYMPHOMA . . . . . . .15 Brentuximab promising Rx for refractory disease
©2011 Engage Healthcare Communications, LLC
they spend 40% less, said Ezekiel J. Emanuel, MD, PhD, then-Special Advisor for Health Policy in the Office of Management and Budget, and Chair of the Department of Bioethics at the National Institutes of Health.
LEUKEMIA . . . . . . . . . . . . . . . . .16 Imatinib enhances overall survival in ALL Excellent outcomes with nilotinib Ponatinib makes a splash MULTIPLE MYELOMA . . . . . . . . Bortezomib-based induction emerging as new standard Promising drugs in the pipeline
19
MYELODYSPLASTIC SYNDROMES . . . . . . . . . . . . . . . 25 First population-based MDS drug comparison OTHER HIGHLIGHTS . . . . . . . . 26 Incorporating genomic research into personalized medicine