OBR Daily Commentary

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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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Essay: We Can’t Afford the Drugs That Could Cure Cancer

(Wall Street Journal) Sept 20, 2018 - Customized immunotherapies are ready—if drug companies stop charging so much for them.

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Thomas Marsland, MD (Posted: September 25, 2018)

quotesHow drugs are priced remains a huge black box. There is no question that costs are rising and making it more and more difficult for patients to obtain needed treatments. Although not a big fan of Dr E I do agree that "what the market will bear" plays a large part in that. Clearly research costs are a major component. It is unbelievable how expensive it is to bring a new drug to market. Certainly we need to develop less expensive research designs in the drug approval process. One point not made is the the US pricing is responsible for a large part of drug development costs, with pricing in other markets outside the US covering significantly less of those costs. How much of the cost of a drug comes from marketing is also a complete unknown? How much does direct to consumer marketing really cost and what does it really add for our patients? There are solutions out there. ASCO and others have developed position papers worth reading with some good suggestions on how to help control costs. Hopefully someone is listening. quotes

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Medicare Advantage Plan Proposed Use Of Step Therapy For Part B Drugs

(Forbes) Sept 17, 2018 - Payers must balance patient access to biopharmaceuticals and cost containment. A public payer such as Medicare and its contractors is no different in this regard.

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

quotesDelays in accessing the appropriate therapy for patients is a growing problem. Step therapy is just one of another barrier that the payer community is implementing to reduce access to needed drugs. This is especially true when one looks at the entire PBM companies that are rapidly expanding. These programs limit access and delay care. PBMs are a huge black box where transparency is nowhere to be found. Payers use these companies which more and more are part of the payer community itself. How these entities determine which drugs are preferred as part of fail first and step therapies is completely unclear. These organizations are compensated by payers and negotiate discounts and rebates with industry reaping large profits that can drive drug preferences and determine how step therapies are determined. There often is no savings for patients and care is delayed. Adding Part B drugs to this failed system will lead to further care access problems for patients.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...