Paying For Value In Cancer Care

Everyone wants to pay for value (and certainly not just for volume) and the value imperative is nowhere greater than in cancer care. Cancer care cost the US health care system $125 billion in 2010, accounting for 5 percent of total health care spending. Before Sovaldi hit the front pages for offering a breakthrough treatment for Hepatitis C at a cost of $84,000, and Turing Pharmaceuticals pushed Sovaldi out of the headlines for increasing the price of an HIV drug 50 fold, most of the attention to drug pricing was focused on cancer. With average yearly treatment costs exceeding $100,000, cancer drugs in the US cost nearly twice as much as anywhere else in the world. Drug pricing is driven by state and federal policies, as well as clinical advances that allow the development of specific treatments for targeted populations. It can be difficult to find any correlation between a drug’s price and the social value or efficacy of the drug. We recently published a case study comparing three cancer treatments, one for colorectal cancer and two for multiple myeloma, illustrating how the net health benefits versus costs for new treatments can vary widely. Medicare has a great deal at stake in the pursuit of value in cancer care because cancer incidence is highly correlated with age. The Center for Medicare and Medicaid Innovation (CMMI) has announced the Oncology Care Model (OCM) for physician practices that administer chemotherapy to Medicare patients. Its key features are a monthly c...
Source: Health Affairs Blog - Category: Health Management Authors: Tags: Costs and Spending Drugs and Medical Technology Long-term Services and Supports Medicare Once in a Weil Payment Policy Quality Bundled Payments Cancer ECRI performance payments Primary Care Source Type: blogs