Comments for Oncology Business Review http://www.oncbiz.com/blog Wed, 25 Jan 2012 20:53:27 +0000 hourly 1 http://wordpress.org/?v=3.0.4 Comment on 2011: A Year of Firsts in Oncology by Ellen Shnidman http://www.oncbiz.com/blog/2012/01/2011-a-year-of-firsts-in-oncology/#comment-426 Ellen Shnidman Wed, 25 Jan 2012 20:53:27 +0000 http://www.oncbiz.com/blog/?p=750#comment-426 So the critical question is, whether the diagnostic tests that are helping to usher in the new era of personalized medicine accompanying targeted therapies will doom chemotherapy to a more rapid obsolescence, or will it force the chemo manufacturers to develop their own diagnostic tests? So the critical question is, whether the diagnostic tests that are helping to usher in the new era of personalized medicine accompanying targeted therapies will doom chemotherapy to a more rapid obsolescence, or will it force the chemo manufacturers to develop their own diagnostic tests?

]]> Comment on The Positioning and Payment for Oncology Within Accountable Care Initiatives. A 2011 Research Survey Conducted by the Cancer Center Business Summit by thomas marsland http://www.oncbiz.com/blog/2011/12/the-positioning-and-payment-for-oncology-within-accountable-care-initiatives-a-2011-research-survey-conducted-by-the-cancer-center-business-summit/#comment-406 thomas marsland Mon, 12 Dec 2011 16:42:38 +0000 http://www.oncbiz.com/blog/?p=741#comment-406 Indeed the times they are achanging.... Current reimbursement models have worked well in the past but for lots of reasons are unsustainable going forward ( rising costs, misalligned incentives others). All of the proposed newer models ( ACO's, bundling, episodes of care, medical homes) assume some component of risk and limited payments. The survey makes a number of key points. Oncology care is very complex. A recent article in Health Affairs reported on the Promethius Bundled Payment Experiment. In three pilot programs no bundled payments had been made yet. The reason was that "the pilots have taken longer to set up because of the complexity of the payment model and the healthcare system..... it may take more time and considerable effort to materialize." It was also pointed out that considerable expense is found not just in drugs but in ER visits and hospital admissions (in personal discussions with a national medical director he suggested these expenses far outweighed drug cost as part of the rising expense of oncology care). In many instances the oncologist really has little control over these costs. The survey alluded to the concept of medical homes and indeed demos are being put in place as potential new payment methodologies to look at oncology medical homes. But even there I have concerns on the role of the physician. OBR just recent reported on a medical oncology home being develped in Michigan where the prime movers were ION, Priority, and PRM ( a pharmaceutical company, an insurance company and a physican management company..... where are the docs?....) So new payment models are definitely in play. Watchful waiting is indeed a reasonable option but as with prostate ca not all of these changes are indolent.... Indeed the times they are achanging…. Current reimbursement models have worked well in the past but for lots of reasons are unsustainable going forward ( rising costs, misalligned incentives others). All of the proposed newer models ( ACO’s, bundling, episodes of care, medical homes) assume some component of risk and limited payments. The survey makes a number of key points. Oncology care is very complex. A recent article in Health Affairs reported on the Promethius Bundled Payment Experiment. In three pilot programs no bundled payments had been made yet. The reason was that “the pilots have taken longer to set up because of the complexity of the payment model and the healthcare system….. it may take more time and considerable effort to materialize.” It was also pointed out that considerable expense is found not just in drugs but in ER visits and hospital admissions (in personal discussions with a national medical director he suggested these expenses far outweighed drug cost as part of the rising expense of oncology care). In many instances the oncologist really has little control over these costs. The survey alluded to the concept of medical homes and indeed demos are being put in place as potential new payment methodologies to look at oncology medical homes. But even there I have concerns on the role of the physician. OBR just recent reported on a medical oncology home being develped in Michigan where the prime movers were ION, Priority, and PRM ( a pharmaceutical company, an insurance company and a physican management company….. where are the docs?….) So new payment models are definitely in play. Watchful waiting is indeed a reasonable option but as with prostate ca not all of these changes are indolent….

]]> Comment on Immediate Market Feedback and Global Clinical Impact of the FDA’s Revocation of Avastin in Metastatic Breast Cancer by Vishal http://www.oncbiz.com/blog/2011/11/immediate-market-feedback-and-global-clinical-impact-of-the-fda%e2%80%99s-revocation-of-avastin/#comment-397 Vishal Wed, 30 Nov 2011 13:02:30 +0000 http://www.oncbiz.com/blog/?p=679#comment-397 Great.. Very useful Great.. Very useful

]]> Comment on Putting Patients in the Driver’s Seat for Molecular Diagnostics and Treatments by Jack West, MD http://www.oncbiz.com/blog/2011/10/putting-patients-in-the-driver%e2%80%99s-seat-for-molecular-diagnostics-and-treatments/#comment-353 Jack West, MD Wed, 05 Oct 2011 23:32:16 +0000 http://www.oncbiz.com/blog/?p=642#comment-353 I'm afraid this sounds like a constructed PR piece. Though I'm all for testing for appropriate molecular markers under the right circumstances, it's not surprising that a company that sells and profits by molecular testing wants to create a website promoting molecular testing, especially if "putting patients behind the wheel" means instigating inappropriate but profitable testing. If Clarient/GE Healthcare want to promote their wares, that's OK, but it's misleading to shroud this as an ennobling venture. It's too close to basic crass marketing. -Jack West, MD Medical Director, Thoracic Oncology Program Swedish Cancer Institute Seattle, WA I’m afraid this sounds like a constructed PR piece. Though I’m all for testing for appropriate molecular markers under the right circumstances, it’s not surprising that a company that sells and profits by molecular testing wants to create a website promoting molecular testing, especially if “putting patients behind the wheel” means instigating inappropriate but profitable testing.

If Clarient/GE Healthcare want to promote their wares, that’s OK, but it’s misleading to shroud this as an ennobling venture. It’s too close to basic crass marketing.

-Jack West, MD
Medical Director, Thoracic Oncology Program
Swedish Cancer Institute
Seattle, WA

]]> Comment on OBR’s Top Ten Stories of 2010 by 2012 United HealthCare Medicare Plans http://www.oncbiz.com/blog/2011/01/obrs-top-ten-stories-of-2010/#comment-348 2012 United HealthCare Medicare Plans Sun, 18 Sep 2011 09:23:06 +0000 http://www.oncbiz.com/blog/?p=233#comment-348 End-of-life care, which consumes a large chunk of healthcare dollars, became a hot-button issue during the healthcare reform debate when some conservatives accused the Obama administration of trying to create government-run "death panels" that would have ultimate power to ration costly care to the elderly and disabled. End-of-life care, which consumes a large chunk of healthcare dollars, became a hot-button issue during the healthcare reform debate when some conservatives accused the Obama administration of trying to create government-run “death panels” that would have ultimate power to ration costly care to the elderly and disabled.

]]> Comment on Three Approvals in 2 Weeks, But… by Raj http://www.oncbiz.com/blog/2011/09/619/#comment-345 Raj Fri, 16 Sep 2011 18:09:36 +0000 http://www.oncbiz.com/blog/?p=619#comment-345 If the FDA waits on OS data prior to approval, it would delay the availability of good drugs to patients. It is right that the Seattle Genetics and Pfizer drugs, for example, are available to the general public. What FDA should do improve upon is holding companies accountable to conditional approvals. If RR or PFS does not translate to improved OS or improved quality of life outcomes, FDA should withdraw a previously granted marketing indication. However huge machines like Roche (ie, Avastin in breast cancer) attempt to block such actions, which will inevitably push the FDA to delay the approval of marketing indications for good drugs until more mature data are available, which in the end hurts both pharma and patients. If the FDA waits on OS data prior to approval, it would delay the availability of good drugs to patients. It is right that the Seattle Genetics and Pfizer drugs, for example, are available to the general public. What FDA should do improve upon is holding companies accountable to conditional approvals. If RR or PFS does not translate to improved OS or improved quality of life outcomes, FDA should withdraw a previously granted marketing indication. However huge machines like Roche (ie, Avastin in breast cancer) attempt to block such actions, which will inevitably push the FDA to delay the approval of marketing indications for good drugs until more mature data are available, which in the end hurts both pharma and patients.

]]> Comment on Three Approvals in 2 Weeks, But… by thomas marsland http://www.oncbiz.com/blog/2011/09/619/#comment-341 thomas marsland Wed, 14 Sep 2011 17:23:25 +0000 http://www.oncbiz.com/blog/?p=619#comment-341 The above comments are right on the money ( no pun intended). These drugs for the correct populations have the potential to make dramatic impacts on the clinical coarse of our patient. Going forward it is all the more important that the medical community work closely with the payer community to clearly define when one of these drugs will indeed be covered. In addition with these prices untoward delays in payment cannot be tolerated. Practice cannot in today's environment afford to carry large AR waiting inordinate time for these new drugs to be paid. Fears about these major concerns are keeping practices from utitializing these drugs. this obviously is limiting patient access. The cost of these and additional new agents scream for the need to have Pharma, payers and providers to have a very clear understanding of the appropriate clinical senarios that provide coverage and quick reimbursement. A transparent picture of how new drugs are prices ( as alluded to) would go a long way in helping this process... The above comments are right on the money ( no pun intended). These drugs for the correct populations have the potential to make dramatic impacts on the clinical coarse of our patient. Going forward it is all the more important that the medical community work closely with the payer community to clearly define when one of these drugs will indeed be covered. In addition with these prices untoward delays in payment cannot be tolerated. Practice cannot in today’s environment afford to carry large AR waiting inordinate time for these new drugs to be paid. Fears about these major concerns are keeping practices from utitializing these drugs. this obviously is limiting patient access. The cost of these and additional new agents scream for the need to have Pharma, payers and providers to have a very clear understanding of the appropriate clinical senarios that provide coverage and quick reimbursement. A transparent picture of how new drugs are prices ( as alluded to) would go a long way in helping this process…

]]> Comment on Three Approvals in 2 Weeks, But… by carlos trapani http://www.oncbiz.com/blog/2011/09/619/#comment-340 carlos trapani Wed, 14 Sep 2011 10:50:55 +0000 http://www.oncbiz.com/blog/?p=619#comment-340 From my perspective, during the last five years many drugs have been approved without a real benefit on OVERAL SURVIVAL. Only little differences in PFS and RR were demonstrated in small groups of patients. FDA should improve requirements for drug approvals, taking these into account. From my perspective, during the last five years many drugs have been approved without a real benefit on OVERAL SURVIVAL. Only little differences in PFS and RR were demonstrated in small groups of patients. FDA should improve requirements for drug approvals, taking these into account.

]]> Comment on PI3K Inhibitors: A Promising New Class of Cancer Therapeutics? by Tatiana Spicakova http://www.oncbiz.com/blog/2011/07/pi3k-inhibitors-a-promising-new-class-of-cancer-therapeutics/#comment-330 Tatiana Spicakova Mon, 01 Aug 2011 16:21:09 +0000 http://www.oncbiz.com/blog/?p=583#comment-330 PX-866 has been reviewed by Kantar Health and is included in the article we created for the July issue of OBR Green. To view the full article, please click here: http://www.oncbiz.com/journal-obrgreen-201107.php and go to page 16. Pathway Therapeutics received funding at the end of May 2011 to conduct a Phase I on PWT33597 (PI3Kalpha/mTOR inhibitor); we will continue to monitor its progress as well as the other isoform-specific inhibitors in preclinical development by Pathway Therapeutics. PX-866 has been reviewed by Kantar Health and is included in the article we created for the July issue of OBR Green. To view the full article, please click here: http://www.oncbiz.com/journal-obrgreen-201107.php and go to page 16.

Pathway Therapeutics received funding at the end of May 2011 to conduct a Phase I on PWT33597 (PI3Kalpha/mTOR inhibitor); we will continue to monitor its progress as well as the other isoform-specific inhibitors in preclinical development by Pathway Therapeutics.

]]> Comment on PI3K Inhibitors: A Promising New Class of Cancer Therapeutics? by Mike http://www.oncbiz.com/blog/2011/07/pi3k-inhibitors-a-promising-new-class-of-cancer-therapeutics/#comment-326 Mike Fri, 29 Jul 2011 16:47:25 +0000 http://www.oncbiz.com/blog/?p=583#comment-326 There is also a compound in development called PX-866 that appears to be an irreversible PI3K inhibitor that is in what looks like 4 Phase II trials. There is also a compound in development called PX-866 that appears to be an irreversible PI3K inhibitor that is in what looks like 4 Phase II trials.

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