August 2014 Vol 7, Special Issue ASCO 2014 Payers' Perspectives in Oncology

As usual, ample information pertaining to payers was available at this year’s American Society of Clinical Oncology (ASCO) meeting.
The addition of lapatinib (Tykerb) to trastuzumab (Herceptin) to create dual HER2 blockade was no better than trastuzumab alone in the adjuvant treatment of patients with HER2 breast cancer in the global phase 3 ALTTO (Adjuvant Lapatinib and/or Trastuzumab Treatment Optimisation) trial, reported Martine J. Piccart-Gebhart, MD, PhD, Chair, Breast International Group, Brussels, Belgium, at a plenary session at ASCO 2014.
In patients with breast cancer and bone metastasis, less frequent in­fusion of zoledronic acid was as effective as the standard monthly dose in the randomized OPTIMIZE-2 study.
Adjuvant exemestane is more effective at preventing breast cancer recurrences than ta­moxifen when given with ovarian function suppression (OFS) in young women with hormone receptor–­positive early breast cancer, reported Olivia Pagani, MD, Clinical Director, Breast Unit, Oncology Institute of Southern Switzerland, Bellinzona, during ASCO 2014.
The results of studies presented at ASCO 2014 highlight 2 novel drug classes that showed strong activity in multiple myeloma (MM), representing potential advances in relapsed or refractory disease.
The impact of federal budget cuts on cancer research is threatening progress in cancer therapy and access to increasing demand for cancer services, said ASCO president Clifford Hudis, MD, Chief of the Breast Medicine Service at Memorial Sloan Kettering Cancer Center, New York City, in his presidential address at ASCO 2014.
Oncologists should become value-­based providers by eliminating unnecessary tests, prescribing cheaper alternatives when therapeutic equivalents exist, and keep calling for payment reform, said Ezekiel J. Emanuel, MD, PhD, Chair of the Department of Medical Ethics and Health Policy, University of Pennsylvania, Philadelphia, at ASCO 2014. These measures will add value as a bridge to payment reform, which is the ultimate change that will bring value to cancer care, Dr Emanuel emphasized.
For the second-line treatment of patients with relapsed or refractory chronic lymphocytic leukemia (CLL) or with small lymphocytic leukemia (SLL), ibrutinib improved progression-free survival (PFS), overall survival (OS), and overall response rate ORR compared with ofatumumab, results of the phase 3 RESONATE study demonstrated. The results were presented at ASCO 2014 and were also published in the New England Journal of Medicine.
The cancer drug pipeline continues to boast many new therapies, reinforcing the recent trends of new and improved monoclonal antibodies and other classes of targeted therapies for different types of tumors. At ASCO 2014, researchers presented findings for many of these drugs, with immunotherapies leading the way in current drug development in oncology.
Contrary to belief, there appears to be little demand on the part of patients with cancer for unsuitable, high-cost, low-value tests or therapies. Furthermore, oncologists and nurse practitioners (NPs) are not frequently ordering such services, found Keerthi Gogineni, MD, MSHP, an oncologist at the Abramson Cancer Center, University of Pennsylvania, Philadelphia.
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  •  Association for Value-Based Cancer Care
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  • Value-Based Care in Rheumatology
  • Rheumatology Practice Management
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