OBR Daily Commentary

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Payers Weigh the Implications of Multigene Testing Coverage in New UCSF Study

(NCCN) Feb 15, 2017 - Innovation in precision medicine has introduced an amalgam of testing options, of which hereditary cancer panels—multigene tests—are a major component. Additionally, the importance of inherited cancer genomics was further bolstered by Former President Barack Obama’s Precision Medicine Initiative in 2015.

Winston Wong, PharmD (Posted: February 22, 2017)

quotesWhile payers may not be in agreement for covering these multigene panels for assessing hereditary risk, payers do support assessing hereditary risk WITH genetic counseling. If one were to look at these genes panels, only a small fraction of the genes assayed have been shown to have any true utility to predict hereditary risk. All of the other genes in the panel have been shown to have a link, but have not been vetted enough to show utility. Thus, payers only will want to pay for the genes that have show clinical utility, and not the rest. From the payer perspective, why would they pay for the assessment of genes that have not been shown to provide value.quotes

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Non-Profit Drug Development Could Cut Cost of Cancer Medicines

(ICR [UK]) Feb 9, 2017 - Universities should work with new forms of commercial partner to take their own cancer drugs to market and drive down the ‘spiralling’ cost of new medicines, leading experts propose.

Thomas Marsland, MD (Posted: February 16, 2017)

quotesThere is no free lunch (unfortunately). I would like to comment on actually two reports in today's OBR that reference Dr Workman's paper on "how much longer will we put up with $100,000 cancer drugs?" Clearly current drug pricing is unsustainable and if allowed to continue will ultimately result in limitation of access in some form. I am not sure that the idea of using academic centers would really lower the costs of development. There is little data to suggest they can do it more cheaply. The authors talk about partnering with private companies in the development process but clearly these companies are going to be looking for a return.... profit. Perhaps the expected returns may be less than traditional pharma but that remains to be seen. So some concepts that also perhaps need to be explored. I agree that the research process needs to be streamlined. With targeted treatments, as the authors suggested, one may not need the huge, expensive trials that have traditionally been done. It would be useful to look at drug costs in the approval process. If a new drug is not significantly more effective or less toxic then perhaps it should show a cost advantage to get approval. We need more transparency in how drugs are priced. Certainly what the "market will bare" is one large determinant now. How much of the cost is determined by marketing (direct to consumer ???, see prior comments) and not actual development. Allowing negotiations for the cost of drugs by the government would also be big step in controlling pricing. So clearly we need to do a better job of pricing cancer drugs. quotes

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Memorial Sloan Kettering to Offer DigniCap® Scalp Cooling Device in New York Metro Area Locations

(Yahoo! Finance) Feb 13, 2017 - Dignitana AB, the world leader in medical scalp-cooling technology, announced today that the DigniCap® scalp cooling system, which was cleared in December 2015 by the U.S. FDA to effectively reduce the likelihood of chemotherapy-induced hair loss in women with breast cancer, will be available at all Memorial Sloan Kettering Cancer Center (MSK) facilities that treat breast cancer.

William Harwin MD (Posted: February 15, 2017)

quotesAt Florida Cancer Specialists we have been using DigniCap for several months at 3 of our site and it does appear to be a real advance in preventing alopecia from chemotherapy. I just completed treatment with 6 cycles of TCH + Pertuzumab in a woman with breast cancer with a full head of hair at completion of treatment. The problems with DigniCap are the cost and lack of insurance reimbursement. It may not be fully effective in all patients especially with an Adriamycin regimen.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

Associate Cancer Center Director, Yale Cancer Center P...

Radiation Oncology
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Howard Sandler, MD, MS, FASTRO

Professor and Chair, Department of Radiation Oncology...

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...

Health Policy
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Joseph Bailes, MD

National Health Policy Expert...

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

Professor and Physician-in-Chief of the Ohios State Uni...

Editor-In-Chief
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Robert A. Figlin, MD., FACP

Professor and Director, Division of Hematology Oncology...

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...