Unbiased Analysis of Today's Healthcare Issues

Are new cancer treatments improving survival or quality of life?

This is the question that a recent study in BMJ by Davis et al. (2017) attempts to answer.  They use data from 48 cancer drugs for 68 indications that were approved by the European Medicines Agency (EMA) between 2009 and 2013.  Among these 68 indications, they found that: only 35 (51%) were associated with significant improvement […]

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The cost of cancer care: Examining four common cancers

An interesting study by Chen et al. (2017) examines the cost of cancer care among Medicare patients.  Using SEER-Medicare data of people diagnosed with cancer between 2007 and 2011, they found: Over the year of diagnosis, mean per-patient annual Medicare spending varied substantially by cancer type: $35,849 for breast cancer, $26,295 for prostate cancer, $55,597 […]

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Off-label use of cancer drugs

When each drug is approved by the FDA, the drug is not approved to treat all patients.  Each drug receives an “indication” which basically represents the types of patients the drug can treat.  Giving the treatment to patients with said indication is known as “on label” prescribing. Drugs developed to treat one disease may sometimes […]

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Too many trials, not enough patients

As research in new cancer treatments has grown, scientists may have run into a serious roadblock: there many not be enough patients to fill the needed clinical trials.  As the New York Times reports: There are too many experimental cancer drugs in too many clinical trials, and not enough patients to test them on. The logjam […]

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It’s Okay to Be a Coward about Cancer

That is the title of an interesting Time article from cancer surviver Josh Friedman. Friedman is a well-known screenwriter whose work includes credits for such franchises as Terminator, Avatar and War of the Worlds. The article was prompted in part by John McCain’s recent brain cancer diagnosis (glioblastoma to be specific). One excerpt is especially […]

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A cancer tool to improve survival?

A recent paper by Basch et al. 2017, found that electronic patient-reported symptom monitoring improved patient overall survival by 5 months.  This finding came from a randomized clinical trial at Memorial Sloan Kettering. For patients in the arm with electronic patient-reported symptom monitoring, when “…participants reported a severe or worsening symptom, an email alert was triggered to a clinical […]

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Predicting Real-World Effectiveness of Cancer Therapies Using OS and PFS Clinical Trials Endpoints

Clinical trials for cancer treatments aim to demonstrate whether one treatment is better than another. What is of most interest to patients, providers and payers, however, is which treatment works best in the real-world, not in a randomized controlled trial. Further, clinical trials often use progression free survival to measure treatment outcomes rather than overall […]

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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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