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Value-based cancer care and the patient perspective
The business of cancer care is in transition. Driven by the Centers for Medicare & Medicaid Services’ (CMS) Oncology Care Model (OCM) program, practices around the country are working to re-engineer the way they provide services, and the way they charge for those services. The implicit goal of all this is to manage (as in reduce) the overall cost of cancer care. A more frequently stated goal is to improve value, typically defined as outcome (numerator) relative to cost (denominator). Alternative payment models are challenged to assess the value of transformational improvement in cancer care.
Click on the PDF icon at the top of this introduction to read the full article.
The business of cancer care is in transition. Driven by the Centers for Medicare & Medicaid Services’ (CMS) Oncology Care Model (OCM) program, practices around the country are working to re-engineer the way they provide services, and the way they charge for those services. The implicit goal of all this is to manage (as in reduce) the overall cost of cancer care. A more frequently stated goal is to improve value, typically defined as outcome (numerator) relative to cost (denominator). Alternative payment models are challenged to assess the value of transformational improvement in cancer care.
Click on the PDF icon at the top of this introduction to read the full article.
The business of cancer care is in transition. Driven by the Centers for Medicare & Medicaid Services’ (CMS) Oncology Care Model (OCM) program, practices around the country are working to re-engineer the way they provide services, and the way they charge for those services. The implicit goal of all this is to manage (as in reduce) the overall cost of cancer care. A more frequently stated goal is to improve value, typically defined as outcome (numerator) relative to cost (denominator). Alternative payment models are challenged to assess the value of transformational improvement in cancer care.
Click on the PDF icon at the top of this introduction to read the full article.
Progression-free survival, patient-reported outcomes, and the Holy Grail
In oncology clinical trials, overall survival (OS) remains the gold standard for clinical benefit. However, because there are so many available treatment options for most types of cancer, survival analysis in clinical trials is often confounded by subsequent therapies. Progression-free survival (PFS) is an endpoint not so confounded, and one that requires fewer patients and less time to arrive at a conclusion about a new therapy. As a result, an ever-increasing number of oncology clinical trials are launched in which PFS is used as the primary endpoint. Several years ago, Pazdur1 emphasized that the time-to-progression endpoint must use the same evaluation techniques and schedules for all treatment arms and he recommended blinding of trials or at minimum, the use of an external blinded radiographic review committee. He also noted that improvement in disease-related symptoms qualifies as clinical benefit and may therefore be an appropriate endpoint for drug approval.
Click on the PDF icon at the top of this introduction to read the full article.
In oncology clinical trials, overall survival (OS) remains the gold standard for clinical benefit. However, because there are so many available treatment options for most types of cancer, survival analysis in clinical trials is often confounded by subsequent therapies. Progression-free survival (PFS) is an endpoint not so confounded, and one that requires fewer patients and less time to arrive at a conclusion about a new therapy. As a result, an ever-increasing number of oncology clinical trials are launched in which PFS is used as the primary endpoint. Several years ago, Pazdur1 emphasized that the time-to-progression endpoint must use the same evaluation techniques and schedules for all treatment arms and he recommended blinding of trials or at minimum, the use of an external blinded radiographic review committee. He also noted that improvement in disease-related symptoms qualifies as clinical benefit and may therefore be an appropriate endpoint for drug approval.
Click on the PDF icon at the top of this introduction to read the full article.
In oncology clinical trials, overall survival (OS) remains the gold standard for clinical benefit. However, because there are so many available treatment options for most types of cancer, survival analysis in clinical trials is often confounded by subsequent therapies. Progression-free survival (PFS) is an endpoint not so confounded, and one that requires fewer patients and less time to arrive at a conclusion about a new therapy. As a result, an ever-increasing number of oncology clinical trials are launched in which PFS is used as the primary endpoint. Several years ago, Pazdur1 emphasized that the time-to-progression endpoint must use the same evaluation techniques and schedules for all treatment arms and he recommended blinding of trials or at minimum, the use of an external blinded radiographic review committee. He also noted that improvement in disease-related symptoms qualifies as clinical benefit and may therefore be an appropriate endpoint for drug approval.
Click on the PDF icon at the top of this introduction to read the full article.