New Cancer Medicines Driving Value for Patients

New Cancer Medicines Driving Value for Patients

07.22.14 | By Randy Burkholder

If conventional wisdom says that spending on new cancer medicines is at “unsustainable” levels, and a demonstration project designed to address this leads to increased spending on new cancer medicines and reduced total medical costs, then what happens to conventional wisdom? That’s one question you might be left with after reading the surprising results of the much-anticipated study by Lee Newcomer, MD from United Healthcare and two cancer centers. The study was designed to cut cancer treatment costs, and to do so by reducing use of new cancer medicines. It succeeded in reducing overall treatment costs (which were $64.7 million instead of a predicted $98.1 million), but it increased spending on cancer medicines ($21 million instead of a predicted $7.5 million).

The results of United Healthcare’s episode payment model for oncology demonstrate the importance of holistic approaches to payment and delivery reform that support patient access to treatment options and take a system-wide view of health care costs and value.  While it is not possible to identify the specific factors that led to a 34 percent reduction in predicted total medical costs, this evaluation also points to the potential of new medicines in helping to control overall medical costs.

Cancer medicines represent less than one percent of U.S. health care spending. And they are a major factor driving gains in patient survival and quality of life improvements in many cancers. Since the mid-1970s, for example, survival rates for childhood cancers have increased 58 percent. We can expect these gains to continue as newer, more effective treatments are introduced. At a recent Institute of Medicine forum, for example, former CMS Administrator Mark McClellan stated “We are heading towards an era of truly personalized medicine where the best treatment…isn’t going to be widely used, where the goal isn’t to get the volume up and the cost down, but rather the right combination of treatments for an individual patient. Those treatments will be extremely valuable.”

The UnitedHealth project also underscores the importance of sustaining continued progress against cancer. As stated by leaders from across oncology in a recent article in Clinical Cancer Research, “with continued support for science and innovation, we foresee accomplishing in oncology what has been achieved against other major public health problems, such as HIV/AIDS, in which scientific advances yielded major gains for patients and averted a predicted health spending crisis.”

New cancer medicines are driving value for patients. And that's why we should take more seriously the opportunity to advance policies that can enhance overall efficiency in care while at the same time improving, rather than restricting, patient access to newer, better treatment options.


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