OBR Daily Commentary

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Dismissing Reduced Abiraterone Dose Is 'Absolutely Wrong'

(Medscape Medical News) Sept 17, 2018 - A debate has intensified about cutting the dose — and hence the cost — of the oral prostate cancer drug abiraterone acetate (Zytiga, Janssen) by taking it with food.

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Winston Wong, PharmD (Posted: October 15, 2018)

quotesI believe the difficulty here is not so much that a lower dose of drug when taken with a low-fat meal can produce a similar clinical effect, but rather, we are encouraging one to take their medications with food. The lower dose almost becomes a second issue. How many times are we telling patients to take their medication on an empty stomach e.g. antibiotics, biphosphonates? With that aside, in the patients who cannot afford their medication, this is an option. Education on a low-fat meal can serve 2 purposes: 1) offers an affordable option for abiraterone, and 2) promotes a more healthy diet. quotes

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The Secret Drug Pricing System Middlemen Use to Rake in Millions

(Bloomberg) Sept 11, 2018 - Not everybody reads the legal notices inside the Ottumwa Courier. But in January, Iowa pharmacist Mark Frahm noticed something unusual in the paper.

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Winston Wong, PharmD (Posted: September 18, 2018)

quotesSpread pricing has been a revenue generating tool for many years. Even I am surprised by the extent of the spread noted in the piece. I am not sure how spread pricing adds to the pricing stability for a payer, but it definitely contributed to the higher costs. quotes

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Some Pharmacy Benefit Manager Practices May Erode Patient Access to Cancer Care, ASCO Analysis Finds

(ASCO) Aug 30, 2018 - The American Society of Clinical Oncology (ASCO) warns that some of the practices used by pharmacy benefit manager (PBM) companies could hinder patient access to timely, high-quality cancer care. In a new position statement released today, ASCO describes a range of PBM practices that, while they may be intended to help control costs in cancer care, might compromise physicians’ ability to provide the right treatment at the right time for people with cancer; place cancer patients at risk of serious complications due to drug dispensing errors; or drive up out-of-pocket costs for patients. ASCO also recommends a series of actions to address PBM practices that interfere with the delivery of prescribed therapies. “Examples are emerging of PBM practices that may place patients at risk of life-threatening complications,” said ASCO President Monica M. Bertagnolli, MD, FACS, FASCO.

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Winston Wong, PharmD (Posted: September 08, 2018)

quotesWhile reality demonstrates that these practices do create issues with regards to access and financial toxicity, it is a bit one-sided in that if the PBM is doing their job, there are patient support benefits. The key issue here is that some pharmacies are more efficient and better at providing these services than others. Patient follow-up, compliance and adherence monitoring are among the benefits. No question that there are major disconnects, and fixes are needed. Unfortunately, they are a result of our disjointed health care system.quotes

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Meet the Editorial Board

Prostate Cancer
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Tomasz M. Beer, MD, FACP

Professor of Medicine, Division of Hematology/Medical O...

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...