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Cancer Doctors Develop Tool to Weigh Drug Benefits, Costs

By Kerry Young, CQ Roll Call

June 23, 2016 -- The nation's cancer specialists are stepping into an intensifying debate over the cost of treatment, with the American Society of Clinical Oncology (ASCO) recently announcing a plan to help patients better assess the value of different options.

The framework is meant to help build user-friendly, standardized tools to help doctors in their talks with patients.

"Our goal is to help oncologists and their patients weigh potential treatment options based on high-quality scientific evidence and a thoughtful assessment of each patient's needs and goals," said Julie M. Vose, the president of ASCO and a University of Nebraska doctor, in a statement. "In publishing this initial version of the framework, just the beginning of the process, we hope to drive discussion and debate about a critically important issue."

Newly approved cancer drugs can cost more than an average of $10,000 a month, with some exceeding $30,000 per month, according to ASCO. The expenses are difficult for consumers. Many insurance plans are shifting an increasingly large share of payments for medicine directly to their customers through higher co-pays.
"Even well-insured patients are often unprepared for the high out-of-pocket cost of some cancer therapies. Too often, that leads to severe financial strain and even bankruptcy," said Lowell E. Schnipper, chair of ASCO's Value in Cancer Care Task Force, in a statement.

The trade group for drugmakers, Pharmaceutical Research and Manufacturers of America (PhRMA), said it intends to work with ASCO.

"Judgments about treatment value are highly individualized and vary over time as new research and new treatment options emerge," said Lori Reilly, executive vice president, policy and research at PhRMA, in a statement.

In recent weeks, there have been several high-profile calls for a re-examination of how cancer drugs are priced and sold.

The Medicare Payment Advisory Commission last week told Congress to consider overhauling the Part B outpatient program of the federal health plan for the elderly and disabled, which covers much of the cancer treatment provided in the United States. Medicare now pays a premium of roughly 4 percent on the cost of medicine that doctors purchase to administer to patients in their office, an approach that generates profits when more expensive products are used and when more treatment is given.

A "60 Minutes" news program on June 21 featured interviews with doctors who are leaders in efforts to curb rising cancer drug costs, including Memorial Sloan Kettering Cancer Centers physicians Leonard Saltz and Peter Bach. Saltz last month questioned the rising costs in a widely reported speech at ASCO's annual meeting. Bach is a frequent speaker on this topic and appeared an April briefing for congressional staff.

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