OBR Daily Commentary

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The Winners and Losers of 340B Changes

(COA) Jan 12, 2018 - On January 1, a ruling from the Centers for Medicare and Medicaid Services went into effect that reduces reimbursement rates on 340B qualified drugs from 6% above the sales price to 22.5% less than the sales price.

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Thomas Marsland, MD (Posted: January 18, 2018)

quotesIt will be a while to see how this reduction in the 340B compensation for drugs really plays out. I the article they talk about how the "margin" is used to provide additional services for patients that otherwise would not be available. While this is certainly true that many of the 340 B institutions do provide some additional services they also have rapidly expanded their oncology service line absorbing private practices at an exponential rate. How will the cuts effect that?? Will current programs be cut ??? Will we the physician be forced out or be made to work more for less ??? As private practices have contracted will there even be alternatives for those who may wish to return to a private practice setting. Will hospitals learn to be more efficient as those in private practice were force to do when the ASP pricing went into effect ??? Guess time will tell but it certainly will be interesting to watch quotes

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A Cancer-Drug Pricing Experiment Just Got More Interesting

(BloombergGadfly) Dec 8, 2017 - The results from late-stage trial data released on Friday for Pfizer’s breast cancer drug talazoparib could push an experiment in cancer-drug price competition into overdrive.

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Thomas Marsland, MD (Posted: December 12, 2017)

quotesSo how many part inhibitors do we need, how many check point inhibitors are necessary? Does every company need a "me too" drug. Clearly the cost of pharmaceuticals is a major problem for all of us. One "experiment" that should be considered is including the price of a new drug as part of the approval process. If a new drug in a given class is truly interchangeable, then as part of the value proposition there should be some cost benefits to the payers and patients. quotes

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In Cancer, Talking About Bad News Can Be Good

(UC Davis Health) Nov 17, 2017 - A Journal of Clinical Oncology study may provide reassurance to oncologists worried that talking about a patient’s chances of survival may do more harm than good.

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Thomas Marsland, MD (Posted: December 06, 2017)

quotesSo the glass is half full or half empty. Clearly conveying bad news is never easy but honestly is the best policy. Most patient do appreciate the truth but sometime the messenger is killed. It is difficult to offer hope and realistic expectations. In all of the changes to the idea of patient centered care seems that what patients value most is an open and honest discussion of realistic expectations. These types of discussions often require more time and indeed need to be repeated over a number of visits. Going forward the hope is the system will allow for these types of interactions.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
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Jeff Patton, M.D.

CEO Tennessee Oncology...

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Jennifer Levin Carter, MD, MPH

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

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Michael G. King Jr.

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Gastrointestinal Cancers
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Richard Goldberg, MD

Director WVU Cancer Institute Director of Cancer Signa...

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Robert A. Figlin, MD., FACP

Professor and Director, Division of Hematology Oncology...

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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...