Unbiased Analysis of Today's Healthcare Issues

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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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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