By Kate Barker, Communications Coordinator
As the availability of new and innovative health care technologies increases, so too does the need for more concrete information regarding the relative effectiveness of these different treatment options. This reciprocity has led major constituencies to call for the application of comparative effectiveness (CE) analysis in developing clinical policy and to the emergence of CE Research (CER) as a priority topic in larger health care reform. National Comprehensive Cancer Network (NCCN) explored the issue of CER, as it relates to oncology, in last month’s “Preliminary Report: The Development of the NCCN Comparative Therapeutic Index™ as a Clinical Evaluative Process for Existing Data in Oncology,” a supplement to JNCCN — Journal of the National Comprehensive Cancer Network. 
Based on the discussions of an NCCN CER Work Group, comprised of NCCN physicians and other key stakeholders, the report examines the importance of CER and the specific challenges of CER application in oncology practice. It also proposes a draft paradigm for a clinical evaluation process, the NCCN Comparative Therapeutic Index (CTI), an evaluative method that communicates the ratio of the effectiveness of a proposed treatment versus its potential toxicity. The full report includes the logic behind the CTI scoring tools, methods for displaying the CTI, associated challenges, the scope of such an index, and its future potential.
In November 2009, the NCCN CER Work Group drafted a white paper to introduce the CTI. That December, following a month-long comment period for this white paper, a group of expert clinicians, methodologists, patient advocates, and payors convened at the NCCN Oncology Summit: Comparative Effectiveness in Cancer Care to make recommendations regarding the appropriate use of comparative effectiveness in oncology. The August 2010 JNCCN supplement incorporates feedback obtained from the comment period and the CER Oncology Summit.
NCCN policy initiatives extend to other priority topics in oncology. In response to concern among stakeholders regarding the ramifications of Risk Evaluation and Mitigation Strategies (REMS) in cancer care, NCCN convened an NCCN REMS Work Group. The REMS Work Group, which includes various thought leaders and stakeholders in the field of oncology, was charged with gathering information, addressing how REMS should be applied to cancer care, and providing direction for relevant constituents.
On May 7, 2010, the NCCN Oncology Summit: Recommendations for REMS Stakeholders (NCCN Oncology Summit) was held in Washington, DC. The NCCN Oncology Summit served as a medium for the presentation of the REMS Work Group’s recommendations and as a forum for further discussion of issues surrounding the development and implementation of REMS in oncology. The recommendations derived from the collaborative effort of the REMS Work Group and from relevant discussion at the NCCN Oncology Summit are incorporated into the 44-page REMS White Paper, a finalized version of which will appear in a special pharmacy edition of JNCCN at the end of September.
Further, NCCN will host invitation-only Oncology Policy Summits on the topics of Patient Advocacy and Issues in Off-Label Use and the Applications of Compendia later this year.
To ensure receipt of the Fall special edition of JNCCN, contact us.