OBR Daily Commentary

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NICE Draft 'No' for Roche's Tecentriq

(PharmaTimes [UK]) Oct 3, 2019 - The National Institute for Health and Care Excellence says it is looking to Roche to ensure a new treatment for advanced breast cancer with significant unmet need is cost-effective. The cost watchdog published draft guidelines rejecting the PD-L1 inhibitor Tecentriq (atezolizumab) for breast cancer that has spread to other parts of the body, ruling that based on current evidence it is too expensive for NHS use.

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Thomas Marsland, MD (Posted: October 09, 2019)

quotesHmmmm....just read very interesting "Perspective" in NEJM (my light bathroom reading...) on Medicare drug negotiations. I must admit that that report and the associated one on redesigning Medicare D to control price burden did have some very interesting and provocative ideas. One that really turned me off however was the suggestion for an "independent" body to negotiate drug costs and pricing with Pharma with the use of "value" (QALY) as a determinant for the decisions on pricing and coverage. Gee...sounds like a US (not) NICER...if something like this were to become reality clearly access would be limited. We all need to pay close attention. quotes

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Congress Must Improve Prior Authorization to Ensure People With Cancer Have Timely Access to Care

(ASCO) Sept 10, 2019 - The American Society of Clinical Oncology (ASCO) joined approximately 350 health care groups in urging members of the U.S. House of Representatives to support the Improving Seniors’ Timely Access to Care Act (H.R. 3107). The bipartisan bill would help protect patients from unnecessary care delays by streamlining and standardizing prior authorization under Medicare Advantage (MA) and providing program oversight and transparency for MA beneficiaries.

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Thomas Marsland, MD (Posted: September 11, 2019)

quotesI have been doing this a long time, and one of the biggest frustrations I face today is the delay it takes to get patients the appropriate care they need. It didn't use to be that way. Prior auths are a big part of these delaying tactics foisted on us by the payer community. Hopefully this dysfunctional Congress can literally get this act together..... (comment from a long standing R). I would hope that in this bill that they also assure that those nasty PBM's also have to play by the new rules. quotes

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Updated Real-World Data Shows Giotrif®/Gilotrif® (Afatinib) Followed By Osimertinib Provided A Median Overall Survival Of Up To Almost Four Years In Patients with EGFR Del19 and T790M Mutation-positive NSCLC

(Boehringer Ingelheim) Aug 2, 2019 - Boehringer Ingelheim today announced updated, interim analysis results from the GioTag study, showing that initiating treatment with afatinib followed by osimertinib provided an overall survival (OS) of almost four years (45.7 months) in patients with Del19-positive tumours.[i] The GioTag study is a real-world retrospective, observational and unblinded study which examined the impact of treatment with Giotrif®/Gilotrif® (afatinib) followed by osimertinib in epidermal growth factor receptor mutation-positive (EGFR M+) non-small cell lung cancer (NSCLC) patients with acquired T790M mutations*, the most common mechanism of resistance to first- and second-generation EGFR tyrosine kinase inhibitors (TKIs).

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Thomas Marsland, MD (Posted: August 20, 2019)

quotesIt is rare that I comment on a "clinical" report as opposed to one more tied into regulatory or business aspects of practice. But partially to prove that I really do read the clinical report I thought I would comment on this one. What intrigued me about this is the fact that it is real world data. While clearly on "practice changing" this report does show how real world data has the potential to impact clinical practice. One might like to know how the data has been screened since it is collected from multiple sites on a given emr (?? which one). For these types of reports to be valid it is important to understand how the data is collected and scrubbed. Obviously the randomized trial is the gold standard but as this report demonstrates not every clinical situation can be reproduced in a randomized study.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

Associate Clinical Professor, Medical Oncology Executi...

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...