OBR Daily Commentary

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COA Supports 340B Drug Discount Accountability Act

(COA) July 2, 2018 - HR 6240 will provide HRSA with proper funding for program oversight and fulfill longstanding bipartisan proposal.

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Thomas Marsland, MD (Posted: July 11, 2018)

quotesI absolutely agree with the COA comments. The intent of the 340B program is laudable. We clearly need to make every attempt to improve access to high quality care for those who need economic assistance. Unfortunately there have been multiple abuses of the system that have effected those goals. These abuses have resulted in many providers enriching themselves but using the program to provide drugs for patients with adequate resources. These activities have resulted in the migration of physicians out of private practices to hospital centered programs. This migrations has definitely altered patterns of care which clearly needs to be studied. As you know your ASCO delegation recently was successful in getting a resolution passed at the annual AMA meeting getting AMA support for greater oversight of the 340B program.quotes

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At AMA Leadership Meeting, ASCO Advocates Will Urge Action on Cancer Policy Priorities

(ASCO in Action) June 9, 2018 - From June 9 – 13, ASCO’s delegates will participate in the American Medical Association’s (AMA) Annual Meeting of the House of Delegates (HOD).

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Thomas Marsland, MD (Posted: June 22, 2018)

quotesGee, I recognize a few of those names.....As you probably can guess from my responses, I tend to binge read my OBR reports....(binge my House of Card series too....). Anyway, some comments on the AMA meeting. AMA as always is a lot of fun. The house of delegates is so diverse with old white dudes like myself mixed with energetic ladies (go Barb...rock star), individuals of all political sides, young docs starting their journey, folks of all racial backgrounds, and people of all sexual identities. We get together and argue the profound and esoteric. The debates are always respectful and we all leave as friends. This year, gun control, opioid issues, physician assistance in dying were hotly debated on the floor. In addition there was the usual alphabet soup of resolutions on MOC, MACRA, and payment resolutions. Our ASCO delegation (EB, RP, SL, KN, MF, ES and yours truly) proposed 5 resolutions. Two were reaffirmed (cancer survivorship care plan, alcohol and cancer). The three in the article were accepted with some amendments. All in all, we were happy with the results. As you know 340B needs a lot of work, and PBMs need some over site too. The electronic transfer of prescribed opioids will make life better for patients and docs. With all this busy agenda we even had time to hit Buddy Guy's House of Blues....(thanks Ray...). So if anyone ever asks what AMA does, the answer is everything. They are a strong voice advocating for our patients and us..... quotes

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Opinions: There’s A Miraculous Chance To Cure Cancer. But We’ll Have To Pay For It.

(Washington Post) June 5, 2018 - New treatments are expensive and experimental, but they sure seem worth it.

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Thomas Marsland, MD (Posted: June 06, 2018)

quotesSo back to the grind stone... in clinic today after and exciting ASCO AM. But as this article suggest there is no free lunch. All of these great exciting life prolonging therapies come at a great cost. The theme of the meeting was personalized care and certainly this offers opportunities to help control the costs but even there with the new (FDA approved) next generation testing we still are often left with many expensive choices for a given patient with really no knowledge of success rates. But there is I think hope on the horizon. I had the chance to meet with a group that is developing highly sophisticated computer programs that can actually predict which of the many mutations noted by the ngs testing will really result in a therapy with a high success rate. (and the flip side avoid those that don't.) The data bases are quite sophisticated and developed from true clinical trial materials. When these types of programs become universally available we really will have the idea of "personalized" therapy come to fruition. Then hopefully these costly treatments will be given to those who truly will benefit. quotes

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