OBR Daily Commentary

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Loxo and Bayer's Amazing Drug Has An Expensive Price

(Forbes) Nov 26, 2018 - A little more than a year ago, I wrote the story of a cancer drug developed by a tiny company called Loxo Oncology.

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

quotesSorry to all my Pharma buddies but it is rare when I get excited when a detail rep come to visit. Today was the exception. The Bayer rep visited today (terrible lunch...) and presented the information on their (and Loxo) new NTRK inhibitor. I had seen the preliminary data at several of the national meetings and indeed they are impressive. It is exciting to see a new targeted drug approved on biology rather than tumor type. Hopefully this is something we will be seeing more of. The other exciting information was the drug support. As the article alludes to, it IS expensive but the program put together by Bayer and Loxo is very innovative and perhaps a model for others. They generously support programs but the best "value" proposition is the approach that the company will pay back if the patient doesn't respond. Wonder if DT is watching? quotes

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Medicare Costs Drop As Humana Shifts Doctors To Value-Based Models

(Forbes) Nov 13, 2018 - Humana’s shift from fee-for-service medicine to value-based payments for physicians continues to reduce costs and improve quality of care for seniors enrolled in Medicare Advantage plans, the insurer says, citing a new internal study.

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Thomas Marsland, MD (Posted: November 13, 2018)

quotesOK so I went into this with an negative attitude but actually to give the devil his due they actually did a good job with this report and program. (I might just point out that their CMO is Roy Beveridge a Med onc... and had I known that before I might have not been quite as much surprised Roy is one sharp fellow...) The program really emphasizes all the components we expect in a good medical home. There multiple studies that show that patient focus medical home programs (including in oncology) can produce savings and good care. Two comments: One of the individuals quoted in the Forbes article mentioned that it isn't about right place, right treatment, right time. But a lot of the saving resulted from reduced hospital admissions and ER visits so clearly place makes a difference. In oncology care clearly right drug and right time have to be a key component to any program. The other point I wanted to emphasize is that under the full value program the practice was responsible for 100% of part B services. Clearly again something like that would not work in the medical oncology setting. All in all though I was impressed with the organization and outcome from the Humana program quotes

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Dr. Lucio Gordan Co-Authors Study Validating Financial Impact of Medicare Sequester Cut on Community Oncology

(FCS) Sept 12, 2018 - Florida Cancer Specialists physician Dr. Lucio Gordan, who also serves as Director, Medical Informatics and Co-Director, Quality CTE, was lead author of the study “The Financial Impact of the Sequester Cut to Medicare Part B Drug Reimbursement in Community Oncology,” which was recently published in the American Journal of Managed Care (AJMC).

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Thomas Marsland, MD (Posted: September 26, 2018)

quotesThanks Lucio - good job. It is hard to believe that there is not a concerted effort to destroy community practice. The sequester cuts represents just another nail in the coffin. If the new proposals in the PFS go forward as presented, community oncology will again face significant revenue reductions, forcing more closings and transitions to hospital based programs ( which is probably the intent). This will ultimately result in less access to care and a higher cost.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...