OBR Daily Commentary - Leukemia (includes ALL, AML, APL, CLL, CML, MDS, Myeloproliferative Disorders, Myelofibrosis)

forumImage

Government Quit Test Of Pricey Cancer Treatment Amid Concerns Over Industry Role

(Politico) July 9, 2018 - Medicare and Medicaid administrators earlier this year quietly killed a plan to pay for a breakthrough, half-million-dollar cancer treatment based on how well it worked, scuttling one of the Trump’s administration’s first and most highly touted attempts to lower the cost of drugs.

Winston Wong, PharmD (Posted: July 09, 2018)

quotesThe math is simple. Under the proposed agreement, we pay for all doses of the CAR-T, and get refunded the cost when the patient does not fully respond. At worse case, you pay for everyone's dose. On the other side, we pay for everyone's dose. If it does not work, no refund, and we continue treatment with another agent. Who's the winner here? I'm not even sure.quotes

Read Article arrow
Add Comment 1 Comment
forumImage

CMS Starts to Cover Broad Cancer DNA Tests, Boosting Foundation, Thermo

(Xconomy Boston) Mar 19, 2018 - The Centers for Medicare & Medicaid Services, which administers the federal Medicare insurance program, will begin covering FDA-approved diagnostic tests that scan tumors for a range of genetic mutations.

Winston Wong, PharmD (Posted: April 05, 2018)

quotesFrom a payer perspective, the CMS approval for coverage means that reimbursement for medicare and medicaid plans are mandated. This does not mean that coverage for the commercial population is mandated. Coverage for commercial members will be based upon the clinical utility study results. If the tests are specific to a drug, and will predict if a drug will be effective or not, then commercial business will follow suit. This is because the clinical utility of the test is sound. Anything beyond this will be suspect, and will undergo much scrutiny. There still need to be clinical justification for coverage. As I have noted in the past, FDA approved indication based upon genomic profiling results will prove to be a challenge for payers, and so far, that has held true.quotes

Read Article arrow
Add Comment 1 Comment
forumImage

Novartis Wants Japan To Link Drug Price To Patient Outcomes

(Nikkei Asian Review) Oct 5, 2017 - Swiss drugmaker Novartis seeks to bring a cutting-edge cancer treatment to Japan under a pricing model linked to patient outcomes, asking for payments from only those who benefit from the therapy.

Thomas Marsland, MD (Posted: October 05, 2017)

quotesThis is an interesting concept. Although this sounds good it may not in the long run hold down drug costs. If a producer knows that 20% (40,50 whatever %) of the treatments are not effective then what is to prevent them from just adding 20% to the initial cost of the drug knowing that they will have to refund that 20%? This indeed is a proposal that should be studied and indeed was discussed in the ASCO white paper on drug costs but is really needed is transparency on how drug prices are developed in the first place. quotes

Read Article arrow
Add Comment 1 Comment

Meet the Editorial Board

Prostate Cancer
member photo
Tomasz M. Beer, MD, FACP

Professor of Medicine, Division of Hematology/Medical O...

Community Oncology
member photo
Dean Gesme, MD

FACP FACPE FASCO President, Minnesota Oncology...

Breast Cancer
member photo
Debu Tripathy, MD

Professor and Chair, Department of Breast Medical Oncol...

Lung Cancer
member photo
H. Jack West, MD

Medical Director, Thoracic Oncology Program, Swedish Ca...

Gastrointestinal Cancers
member photo
Howard S. Hochster, MD

Distinguished Professor of Medicine, Rutgers Robert Woo...

Radiation Oncology
member photo
Howard Sandler, MD, MS, FASTRO

Ronald H. Bloom Chair in Cancer Therapeutics
Pr...

Community Oncology
member photo
Jeff Patton, M.D.

CEO Tennessee Oncology...

Precision Medicine Section Editor
member photo
Jennifer Levin Carter, MD, MPH

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

Financial Sector
member photo
Michael G. King Jr.

Managing Director and Senior Biotechnology Analyst...

Gastrointestinal Cancers
member photo
Richard Goldberg, MD

Director WVU Cancer Institute Director of Cancer Signa...

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

Professor and Director, Division of Hematology Oncology...

Health Policy
member photo
Ted Okon

Executive Director Community Oncology Alliance...

Community Oncology
member photo
Thomas Marsland, MD

Vice President Integrated Community Oncology Network ...

Community Oncology
member photo
William Harwin MD

Florida Cancer Specialists President and Managing Part...

Health Policy
member photo
William McGivney, PhD

National Health Policy Expert...

Payer
member photo
Winston Wong, PharmD

President, W-Squared Group...