VBCC_Aug_11_2_Follow ASCO Tabloid 8/12/11 12:44 PM Page 1
AUGUST 2011 VOL 2 NO 5
www.ValueBasedCancerCare.com ONCOLOGY BEST PRACTICES
Northwestern University Comprehensive Cancer Center Advancing patient care through state-of-the-art clinical coordination and research Interview with Al B. Benson III, MD, FACP
Photo courtesy of Northwestern University
Professor of Medicine and Associate Director for Clinical Investigations, Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, IL
Q: How would you define the concept of best practices, and what makes an oncology center, such as the Northwestern University Robert H. Lurie Comprehensive Cancer Center, be among the best oncology practices in the country? Dr Benson: “Best practices” is a critical area for Northwestern and, in particular, is an important area of responsibility for our cancer center as a member of the National Comprehensive Cancer Network (NCCN). The NCCN has a very productive Best Practices Committee that has been active for many years. The committee members do surveys of NCCN practices and have very Continued on page 24
Upper GI Cancers: Are We Getting Value for the Money? By Audrey Andrews Chicago, IL—“Moving the Bar in Upper GI Malignancies” was a plenary session at ASCO 2011, with 2 experts discussing whether results of recent clinical trials of targeted agents are clinically meaningful or just statistically positive, and what is the value of the enormous amount of money
Patients with Cancer at Risk for Bankruptcy Filings increase drastically at 5 years after diagnosis By Caroline Helwick Chicago, IL—Nearly 2% of patients with cancer may file for personal bankruptcy 5 years after their diagnosis, according to researchers from Fred Hutchinson Cancer Research Center in Seattle who presented their data at the 2011 American Society of Clinical Oncology (ASCO) Annual Meeting. “We found that bankruptcy is a particular risk for patients with cancer,” said Scott D. Ramsey, MD, PhD, Professor of Medicine, Fred Hutchinson Cancer Research Center, University of Washington School of Medicine, and Director, Cancer Prevention Clinic, Seattle Cancer Care Alliance. Dr Ramsey and colleagues studied data for >230,000 patients with cancer showing that rates varied widely
Continued on page 22
By Robert “Bo” Gamble and Mary Kruczynski Mr Gamble is Director of Strategic Practice Initiatives, and Ms Kruczynski is Director of Policy Analysis, Community Oncology Alliance, Washington, DC
A
s we move forward in the scheme of healthcare reform, we are being directed toward an integrated care model, one with high quality and economic efficiency. Recently, a model known as an ac-
countable care organization (ACO) was introduced by the US Department of Health and Human Services in the form of a proposed rule open for public comment. Although the final rule Continued on page 8
INSIDE FDA UPDATES . . . . . . . . . . . . . . . . . . . . . . . .
3
HEALTH POLICY
VALUE PROPOSITIONS
7
ONCOLOGY PHARMACY
Novel nasal spray of fentanyl citrate for cancer pain
..............
NICE backs thalidomide and bortezomib for multiple myeloma ASCO ANNUAL MEETING
©2011 Engage Healthcare Communications, LLC
Continued on page 10
Benchmarks for Measuring the Success of a Medical Home in Oncology
spent in treating noncolorectal gastrointestinal (GI) cancer. Clinical versus Statistical Significance Eileen Mary O’Reilly, MD, of Memorial Sloan-Kettering Cancer
across cancer types, that younger patients aged <44 years were particularly at risk, and that bankruptcies increased over time. Bankruptcy rates averaged 0.5% at 1 year but rose to 1.9% at 5 years postdiagnosis. In comparison, the bankruptcy rate in the general population of western Washington State was only 0.28%. Using the Surveillance, Epidemiology and End Results registry, the researchers identified 231,799 adults with newly diagnosed first primary cancers between 1995 and 2009 living in western Washington State. They linked these to bankruptcy filings (Chapters 7 and 13) in federal bank-
.........
10
Genomic medicine in lung cancer Emerging regimen for metastatic pancreatic cancer Off-label drug use, advanced technologies driving up Medicare costs
...................
What does deficit reduction mean for oncology?
26
..........
28
ELECTRONIC HEALTH RECORDS .
32
ONCOLOGY REIMBURSEMENT . . .
33
Dose-monitoring, split fills reduce oral chemotherapy waste, save cost Impact of EHRs on oncology practice Post-ASCO: oncologists’ and payers’ treatment and coverage decisions