VBCC_August 081110_ASCO Highlights Tabloid 8/13/10 4:49 PM Page 1
JULY/AUgUst 2010 VOL 1 NO 3
www.ValueBasedCancer.com
Consumer Genetics: Paradigm Shift or Flash in the Pan?
Do End-of-Life Products Deserve Special Treatment?
Conference touts promise, but real-world regulation intrudes
More issues than answers at lively session
By Cherie Dewar Boston, MA—“An insurance provider with 1 million members spends $11,000,000 annually on 15 drugs that patients either do not respond to, or are likely to have an adverse reaction with,” declared Rick Schatzberg, president and CEO of Generation Health, at the 2nd Annual Consumer Genetics Conference held June 2-4. To mitigate these costs and improve healthcare, conference participants discussed how the power of an unlocked genome can forecast a patient’s reaction to drug treatment,
optimize a medicinal cocktail, provide pinpoint diagnostics of a disease, and even foretell a patient’s propensity to develop a disease before symptoms occur. The burgeoning consumer genetics industry presents the possibility that genetic testing will streamline the decision process for disease treatments. Mara Aspinall, president and CEO of On-Q-ity, forecasted that Continued on page 27
Individualizing Colorectal Cancer Care through Genetics
By Daniel Vollaro Atlanta, GA—Echoes of the recent contentious American debate over healthcare could be clearly heard in a session at the meeting of the International Society for Pharmacoeconomics and Outcomes Research that addressed issues surrounding the funding of new treatments, technologies, and drugs for patients nearing the end of the life, covering everything from standards for economic evaluations of new drugs to the philosophical questions surrounding treatments near the end of life. In a wide-ranging discussion, a 3speaker panel comprised of Nicole Mittmann, PhD, Marc Berger, MD, and Mark Sculpher, PhD, generally agreed that significant tradeoffs occur when healthcare systems fund new
treatments, but in a spirited Q&A session that followed, some audience members challenged these basic assumptions. One audience member took pointed aim at the British healthcare system’s denial of coverage for some new cancer drugs, asking Dr Sculpher, a University of York professor of Health Economics and director of the Program on Economic Evaluation and Health Technology Assessment for the school’s Center for Health Economics, “Would you feel any different about the societal perspective if you yourself were diagnosed with metastatic colon cancer knowing that there are drugs Continued on page 17
By Jennifer Erickstad San Diego, CA—Three nurse researchers from the Oncology Nursing Society (ONS) Cancer Genetics Special Interest Group shared how the results of genetic testing conducted within the care setting are individualizing— and improving—care for colorectal cancer (CRC) at a session at the Annual ONS Congress. Beginning with an overview of the carcinogenesis of CRC, Carol Viele, RN, MS, a clinical nurse specialist at the University of California San Francisco (UCSF) Medical Center, detailed both its modifiable and nonmodifiable risk factors. She stated that
even though keeping good health habits, such as exercising regularly, avoiding tobacco, and minimizing alcohol use, can greatly reduce one’s CRC risk, other risk factors, such as advancing age, family history, and genetics, cannot be controlled. By accepting this latter fact, however, and learning more about patients’ genetic make-up, Ms Viele and the other presenters illustrated that healthcare professionals are improving patients’ prognosis, reducing treatment toxicity, and saving cost. Karen Roesser, RN, MSN, oncology clinical nurse specialist at CIW Medical Center in Richmond, VA, detailed that by determining whether Continued on page 15
Cost Considerations Change Dialogue Physicians, patients must navigate shifting conversational landscape By Wayne Kuznar
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lthough financial concerns are increasingly influencing choices in cancer therapy, barriers to cost discussions between physicians and patients often limit the scope of such discussions. Incentives for oncologists to use high-cost interventions and patients’ perceptions that cost consideration equates to second-class care are but 2 barriers to meaningful cost discussion. The issue of addressing the cost of cancer care with patients was examined in an educational session at the
2010 American Society of Clinical Oncology (ASCO) annual meeting. Traditionally, physicians were warned to avoid limiting treatment based on cost considerations, with the belief that all patients should be treated the same regardless of their ability to pay, said Lidia Schapira, MD, assistant professor, department of medicine, Harvard Medical School, Boston, MA. But an ethical detour has emerged in the past few years— physicians are now expected to provide advice to patients regarding the treatments that best meet the patients’ interests and values. Continued on page 5
IN THIS ISSUE Reasons for breast cancer care disparities.............................................
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How will costs be contained in the new environment? ..........................
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Oncology-related updates from the FDA................................................. 23 Focus on hematopoietic growth factors.................................................. 24 Meetings calendar..................................................................................... 25 ©2010 Engage Healthcare Communications, LLC