Oncology Practice Management Issues

February 2019, Vol 9, No 2

Do No Financial Harm: How to Improve Cost Transparency in Cancer Care

Chase Doyle

Financial Toxicity

We’ve heard the figures before: the price of cancer drugs has risen by orders of magnitude per month over the past decades, deductibles have tripled in the past 6 years, and employer contribution to premiums has increased by nearly 300% over the past 15 years. In addition to cancer treatment becoming more expensive, insurance design and drug formularies have changed, resulting in a greater financial burden for patients. [ Read More ]

To Risk or Not to Risk? Or Is Risk Contracting Too Risky?

Dawn Holcombe, MBA, FACMPE, ACHE

From the Editor

The word on the street is that value-based, or risk-based, oncology contracts for physicians are the inevitable wave of the future. But are they? I had a conversation late last year with someone in the federal government. We were discussing whether oncology practices should be accepting the modified alternative risk model that has recently been offered to them under the Oncology Care Model (OCM) program. This individual felt very strongly that payment programs that put oncologists at full risk for their patients’ treatment costs (including drug costs) were so imminent that it would be irresponsible for practices to not accept the modified alternative risk model as soon as possible so that they can be prepared. [ Read More ]

Explosive Development of BCMA CAR T-Cell Therapy for Multiple Myeloma

Phoebe Starr


A dizzying array of new chimeric antigen receptor (CAR) T-cell therapies targeting the B-cell maturation antigen (BCMA) designed specifically for the treatment of multiple myeloma was presented at the 2018 American Society of Hematology (ASH) annual meeting. BCMA-targeted CAR T-cell therapies are designed to improve T-cell persistence, depth of response, and tolerability. Response rates reported at ASH 2018 range from 70% to 100%, depending on the patient population and the use of previous regimens. [ Read More ]

The Quality-Cost Connection in Cancer Care: Lessons from Oncology Practices in Washington State

Meg Barbor, MPH

Quality Care

Although many quality measures exist in oncology, few efforts have been undertaken to prioritize, measure, and report quality and costs for an entire region. A recent multiyear, multistakeholder effort to characterize quality of care and costs for Washington State oncology practices revealed that increased quality may be associated with a reduced cost of care in oncology. [ Read More ]

Supervised Exercise During Chemotherapy Improves Cardiovascular Function in Women with Breast Cancer

Phoebe Starr

Breast Cancer

A 12-month supervised exercise program improved cardiovascular function in women receiving adjuvant chemotherapy for breast cancer, including anthracyclines and taxanes. By contrast, cardiovascular function decreased among women with breast cancer who did not exercise according to the program guidelines. These results of a randomized clinical trial were presented at the 2018 San Antonio Breast Cancer Symposium. [ Read More ]

Pathologic Complete Response to Neoadjuvant Chemotherapy May Guide Escalation and De-escalation Treatment Strategies in Localized Breast Cancer

Phoebe Starr

Breast Cancer

Achieving pathologic complete response (pCR) after neoadjuvant chemotherapy correlates with significantly improved event-free survival (EFS) and overall survival (OS) in patients with localized breast cancer, according to the results of a large comprehensive meta-analysis presented at the 2018 San Antonio Breast Cancer Symposium. [ Read More ]

Patient-Reported Physical Symptoms More Likely to Be Addressed by Oncologists Than Depression or Anxiety

Meg Barbor, MPH

Symptom Management

Providers are more likely to respond to and act on patient-reported physical symptoms than they are to psychosocial symptoms, according to data presented at the 2018 ASCO Quality Care Symposium by Lisa Catherine Barbera, MD, MPA, Senior Scientist, Odette Cancer Centre, Department of Radiation Oncology, Sunnybrook Health Sciences Centre, Toronto, Canada. [ Read More ]

First-Line Ibrutinib Improves Outcomes Compared with Current Standard of Care in Older Patients with Chronic Lymphocytic Leukemia

Wayne Kuznar


Front-line ibrutinib (Imbruvica) therapy results in a lower rate of disease progression or death than the current standard-of-care chemoimmunotherapy with bendamustine (Bendeka) and rituximab (Rituxan) in older patients with chronic lymphocytic leukemia (CLL). Adding rituximab to ibrutinib did not improve outcomes compared with ibrutinib alone, reported Jennifer A. Woyach, MD, Associate Professor, Ohio State University Comprehensive Cancer Center, Columbus, at ASH 2018. [ Read More ]