Unbiased Analysis of Today's Healthcare Issues

Access to cancer care in the UK

Being sick in the United Kingdom has advantages and disadvantages.  Supporters will cite that out-of-pocket costs are generally low, coverage is universal, and the price of health care to the government is lower. One question is, what is the quality of care received?  Critics cite that access to cutting edge, innovative treatments is often restricted or […]

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Innovative Cancer Care models

What does CMS consider to be innovative oncology care?  The following three programs won a CMS Health Care Innovation Award for their initiative. Community Oncology Medical Home (COME HOME).  This model relied on three key principles: (i) triage pathways to help first responders and nurses identify and manage patient symptoms; (ii) enhanced access to care through […]

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Will OCM dis-incentivize innovation?

The answer seems to be yes according to a paper by Seiden, Neubauer and Verrilli (2017).  Although the Oncology Care Model (OCM) rewards practices both for improving quality and reducing cost, practices are not rewarded for dramatic increases in quality at marginal cost increases because financial returns are dependent on the creation of some cost savings. The […]

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Measuring the quality of cancer care

How do you measure the quality of care patients with cancer receive?  How long they live?  Avoiding side effects?  Patient satisfaction? Process measures? Further, there are multiple types of cancer and different cancer have different recommended treatments and methods of providing care.  To further complicate the issue, new cancer treatments are being introduced in rapid succession; […]

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Innovations in Cancer Care: Capturing What Patients Value in the Calculus of Drug Costs

My current employer, Precision Health Economics, has posted an interesting research brief describing how traditional notions of value may not be capturing the full value patients receive from oncology treatments. A brief description is below but do check out the full report. As health care spending continues to rise, payers and providers struggle to accurately measure […]

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Which cancer treatment is best?

This seems like a straightforward question, but clearly depends on what you mean by “best”.  Some drugs will be more efficacious and have more adverse events; other drugs may be less efficacious but have fewer adverse events.  What if a one drug shows an 80% improvement in progression free survival (PFS), but a 50% improvement in overall […]

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Some good news on cancer

In the long-run, death rates from cancer are falling.  The L.A. Times reports: In the year to come, an estimated 1,688,780 people in the United States are expected to get a cancer diagnosis, and cancer will claim the lives of a projected 600,920. That death toll, however grim, represents a death rate from cancer that […]

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Are new anti-cancer drugs worth the cost?

The high price of cancer treatment often grabs headlines. But how much have patients benefited from these new treatments.  A paper by Howard et al. (2016) look at new cancer treatments for chronic myeloid leukemia (CML), metastatic kidney, breast, or lung tumors and they generally find that the answer is ‘yes’, recent anti-cancer treatments have delivered […]

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Cancer deaths are rising…is that a good thing?

A JAMA Oncology paper estimating the global burden of cancer is getting a lot of attention in the press.  The study’s key findings are: In 2015, there were 17.5 million cancer cases worldwide and 8.7 million deaths. Between 2005 and 2015, cancer cases increased by 33% A 33% increase in cancer cases!!! There must be an […]

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Cancer drug pricing in Europe

How do Euroepan countries reimburse for pharmaceuticals? A paper by Pauwels et al. (2014) provides an nice summary. I review that article today. With the exception of Germany, most countries had a national and/or regional drug budget.  Germany is also unique in that only Germany and the UK allow for free pricing, whereas other countries […]

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