National Comprehensive Cancer Network

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Oncology Pathways and Perceptions of Impact in Cancer Care

Jake B. Guinto, PhD, Manager, Oncology Drugs & Biologics

Oncology pathways, programs that implement treatment protocols for patients with cancer, are being deployed in many practices across the nation. Whether oncology pathways can improve the quality of care and/or decrease costs associated with cancer therapy are questions that have garnered much attention among oncology stakeholders.

To gain a better understanding of the perception of oncology pathways, the National Comprehensive Cancer Network® (NCCN®) conducted an NCCN Trends™ Survey from March 14-17, 2012 at the NCCN 17th Annual Conference in Hollywood, FL. The survey respondents included a mix of oncology stakeholders (e.g., physicians, nurses, pharmacists, and others [n=66]) and focused on understanding their perceptions of the quality and costs of cancer care as a result of these programs.

According to the results, 59% of respondents said that they have implemented or are considering implementing a pathways program in their hospital or practice. Of those respondents, 74% are utilizing or considering utilizing a pathways program developed by their practice or hospital. When asked how they felt about pathways and the effect on patient care, 77% of the respondents felt that pathways increase the quality of care versus 12% who thought there was no change in the quality of care (about the same). Eleven percent responded that they were not sure how a pathways program affects the quality of care for patients and none of the respondents thought pathways decrease the quality of care for patients (Figure 1).

To determine the relationship between pathways and cost of clinical care, we asked respondents how their overall cost for drugs and biologics has been impacted as a result of the use of a pathways program. As shown in Figure 2, 58% of the respondents answered "not sure," 17% thought costs decreased, and 9% thought costs increased (Figure 2).

Although the survey represented a small sample size, as noted above, the majority (77%) of oncology stakeholders surveyed believes that pathways increase the quality of care for patients; however, the true effects associated with pathways on oncology clinical care remain unclear. NCCN will host an invitation-only policy summit in the spring of 2012 to discuss the impact of pathways on various aspects of cancer care including, but not limited to, effects on public and private insurance design, variability in care, and how data are utilized to design pathways. The summit will bring together patients, providers, policy-makers, industry, payors, government, and other stakeholders for an in-depth discussion of equity in cancer care.