OBR Daily Commentary

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Payment Bundles That Include Drug Costs May Destabilize Cancer Care Delivery Environment

(ASCO in Action) Apr 12, 2018 - An analysis published today in the American Society of Clinical Oncology’s (ASCO) Journal of Oncology Practice (JOP), suggests that including cancer drug costs in bundled payments under Medicare risks destabilizing the cancer care delivery environment.

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Dean Gesme, MD (Posted: April 13, 2018)

quotesThere is no quicker way to "burn out" physicians than to put them "at risk" for expenses that they cannot reasonably and fairly control -- such as drug prices!quotes

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CMS Finalizes Coverage Of Next Generation Sequencing Tests, Ensuring Enhanced Access For Cancer Patients

(CMS.gov) Mar 16, 2018 - Today the Centers for Medicare & Medicaid Services (CMS) took action to advance innovative personalized medicine for Medicare patients with cancer. CMS finalized a National Coverage Determination that covers diagnostic laboratory tests using Next Generation Sequencing (NGS) for patients with advanced cancer (i.e., recurrent, metastatic, relapsed, refractory, or stages III or IV cancer).

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Dean Gesme, MD (Posted: March 19, 2018)

quotesThis NCD creates a bit of a conundrum for commercial insurers; do they follow CMS or try to analyze and promulgate their own rules in this dynamic and turbulent area of oncology? Watch this play out in many and varied ways over the months ahead.quotes

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Oncologists Getting 6% of Drug Price Is 'Financial Conflict'

(Medscape Medical News) Mar 7, 2018 - "No one is immune from $ temptation.... We have a system that rewards oncologists and their chemotherapy offices with more $ for giving more expensive chemo. This has to change," said Vincent Rajkumar, MD, a professor of medicine and a hematologist/oncologist at the Mayo Clinic, Rochester, Minnesota.

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Dean Gesme, MD (Posted: March 07, 2018)

quotesI respect Dr Rajkumar's clinical expertise but here in MN we have a 2% state drug tax as well as the federal government's 2% sequester; hence ASP plus 6% is totally illusory. The 1.8% net margin is insufficent to cover drug ordering, wastage, bad debt and pharmacy overhead unless they were being subsidized by 340b rebates! Thus 340b rebates may be the real perverse inducement and not "ASP plus 6%".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
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...