OBR Daily Commentary

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Foundation Medicine Announces Final National Coverage Determination (NCD) from the Centers for Medicare & Medicaid Services (CMS), Including Coverage for FoundationOne CDx™ Across All Solid Tumors

(MarketWatch) Mar 18, 2018 - Foundation Medicine, Inc. today announced that the Centers for Medicare & Medicaid Services (CMS) issued a final National Coverage Determination (NCD) for patients who receive next generation sequencing (NGS) testing with an assay that meets the coverage criteria.

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Thomas Marsland, MD (Posted: March 27, 2018)

quotesWho says you can't teach an old dog new tricks..... I am delighted to see this NCD. In my practice I have been using more and more NGS. These technologies have allowed me to use a much more personalized approach to many patients with difficult to treat tumors. New cancer with an aggressive clinical presentation now have the option of more targeted treatments. Also patients who have been on treatments for a time have additional choices to help control their cancers. This move keeps in step with the evolving trend of thinking of cancers biologically as opposed to anatomically. It is very encouraging to see the payer community more and more accepting of target therapies across tumor types. The wider usage of Foundation One testing will allow wider access to more effective treatments SO Woof, Woof from an old dog..... quotes

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For Cancer, Cannabis Has Many Virtues, Says Large Study

(Medscape Medical News) Mar 19, 2018 - Cannabis, or marijuana, may improve a variety of cancer-related symptoms, including nausea and vomiting, sleep disorders, pain, anxiety, and depression, conclude the authors of a 2960-patient observational study from Israel.

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Thomas Marsland, MD (Posted: March 21, 2018)

quotesAs a still somewhat new practitioner in California, I have seen a much broader use of "medical marijuana" than what I was used to before. The patients seem more open to its use and at least from my personal experience they do seem to benefit. As the article suggests, my patients use it for a wide variety of reasons including: pain control, anxiety, nausea, appetite, fatigue and malaise. Clearly it works for many. I had the opportunity to attend a pain conference recently and was greatly impressed with research being done on neuro receptors and how there are multiple different cannabinoid receptors. We are now at a point where clinical trials are called for to look at the effectiveness of cannabinoids in a truly clinical manner. Which cannabis products are most effective in individual clinical cases? How does route of administration play into their effectiveness? Just for the record (since recreational marijuana is also legal in CA), my person drug of choice is a good Napa cab..... quotes

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Oncologists Getting 6% of Drug Price Is 'Financial Conflict'

(Medscape Medical News) Mar 7, 2018 - "No one is immune from $ temptation.... We have a system that rewards oncologists and their chemotherapy offices with more $ for giving more expensive chemo. This has to change," said Vincent Rajkumar, MD, a professor of medicine and a hematologist/oncologist at the Mayo Clinic, Rochester, Minnesota.

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Thomas Marsland, MD (Posted: March 14, 2018)

quotesDrug pricing and the costs of medications is clearly an ongoing problem. But as always, this report puts the blame on the oncologist. First and foremost, we the physicians do not control drug prices. That falls on pharma. The margin that oncologist make is really just a very small piece of the overall drug costs. The author picks on two specific drugs in this article, but really fails to look at the total drug revenue to practices. There are many drugs that are actually money losers at the current pricing program. In the end, at least at Medicare reimbursement rates, drugs overall are at best a pass though. The private practice of medical oncology is not a non-profit business, although we compete with non profits who clearly have been shown to make much larger "profits" though the widespread mis-uses of the 340B program (addressed in many other forums). Practices maintain an expensive infrastructure on infusion suites, admixture facilities, and highly trained staff to provide high quality services at what I might point out is less costly than similar hospital-based programs. So yeah I'm not a charity, yes I look at drug prices, but that is needed to keep the doors open. I am anxiously awaiting the new, better system. quotes

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Meet the Editorial Board

Community Oncology
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Dean Gesme, MD

FACP FACPE FASCO President, Minnesota Oncology...

Breast Cancer
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Debu Tripathy, MD

Professor and Chair, Department of Breast Medical Oncol...

Lung Cancer
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H. Jack West, MD

Medical Director, Thoracic Oncology Program, Swedish Ca...

Gastrointestinal Cancers
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Howard S. Hochster, MD

Distinguished Professor of Medicine, Rutgers Robert Woo...

Radiation Oncology
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Howard Sandler, MD, MS, FASTRO

Ronald H. Bloom Chair in Cancer Therapeutics
Pr...

Community Oncology
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Jeff Patton, M.D.

CEO Tennessee Oncology...

Precision Medicine Section Editor
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Jennifer Levin Carter, MD, MPH

Chief Medical Officer and Founder, N-of-One...

Financial Sector
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Michael G. King Jr.

Managing Director and Senior Biotechnology Analyst...

Gastrointestinal Cancers
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Richard Goldberg, MD

Director WVU Cancer Institute Director of Cancer Signa...

Editor-In-Chief
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Robert A. Figlin, MD., FACP

Professor and Director, Division of Hematology Oncology...

Health Policy
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Ted Okon

Executive Director Community Oncology Alliance...

Community Oncology
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Thomas Marsland, MD

Vice President Integrated Community Oncology Network ...

Community Oncology
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William Harwin MD

Florida Cancer Specialists President and Managing Part...

Health Policy
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William McGivney, PhD

National Health Policy Expert...

Payer
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Winston Wong, PharmD

President, W-Squared Group...