National Comprehensive Cancer Network

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2013 NCCN Oncology Policy Program

Jessica DeMartino, PhD, Manager, Health Policy Programs

In 2012, the National Comprehensive Cancer Network® (NCCN®) held three Oncology Policy Summits: Equity in Cancer Care: Pathways, Protocols, and Guidelines; Data Needs in Oncology—Clinical, Regulatory, Coverage, and Policy Issues; and Patient Advocacy: Patient Perspectives Across the Cancer Care Continuum. These policy summits were a continuation of an initiative started in 2009, allowing NCCN to bring together oncology stakeholders to discuss issues and develop recommendations around important health policy topics.

Throughout 2013, NCCN will continue to host policy summits to bring together key stakeholders in health care to discuss and revisit pertinent industry issues.

Evolving Policy Issues in Oncology – Revisiting Biosimilars and Molecular Testing
In 2011, NCCN addressed two important policy areas in oncology – biosimilars and molecular testing – by forming Work Groups that identified areas of concern and developed recommendations where possible. NCCN held corresponding policy summits during which the areas of concern and recommendations were shared. At the end of September 2011, in anticipation of U.S. Food and Drug Administration (FDA) guidance on biosimilars, JNCCN – Journal of the National Comprehensive Cancer Network published "NCCN Biosimilars White Paper: Regulatory, Scientific, and Patient Safety Perspectives," which provided  the NCCN Biosimilars Work Group's recommendations and comments about the challenges health care providers and other key stakeholders face in incorporating biosimilars into oncology practice in the United States. In December 2011, JNCCN published the "NCCN Molecular Testing White Paper: Effectiveness, Efficiency, and Reimbursement" which provided guidance regarding challenges of molecular testing in oncology to health care providers and other stakeholders.

NCCN will revisit these important policy areas in April of this year by hosting the NCCN Policy Summit: Evolving Policy Issues in Oncology – Revisiting Biosimilars and Molecular Testing. This invitation-only summit will be a forum to review NCCN's past policy work in biosimilars and molecular testing, discuss the current status of these areas, review the newest guidance documents and regulatory requirements, examine payer viewpoints and practices, and discuss where the oncology community is headed on these two important issues.

Measuring Quality in Oncology – Challenges and Opportunities
Variations in the quality of cancer care are well documented. A key element of quality monitoring is standardized measures of care, and these quality measures may include process measures and outcome measures, both of which are equally important in assessing the quality of care and determining the appropriate structure for care. Measuring outcomes, such as overall survival, can be expensive and may be complicated by existing co-morbidities—taking too long to measure to truly affect delivery of care. Adherence to process measures is often used as a proxy for long-term survival and the implicit assumption is that adherence to good processes will predict good long-term outcomes. Quality measures can be used for both self-assessment and external review of the quality of care.

Payers and purchasers of health care often utilize standardized measures as they seek to ensure their beneficiaries are receiving high-quality cancer care for a reasonable cost. Both public and private payers are placing a greater emphasis on quality, oftentimes by linking reimbursement to quality. In response to this growing trend to prove value, payers, professional organizations, and provider groups have begun to create metrics based on evidence from research literature and guidelines. Quality measures that quantify the patient experience are also becoming increasingly popular. Such measures quantify experience unique to patients, including, but not limited to, length of time away from work or family, speed and completeness of recovery, avoidance of toxicity and financial hardship; however, these experiences may or may not be considered by providers or payers in assessment of quality.

In the summer of 2013, NCCN will host an invitation-only NCCN Policy Summit that will serve as a forum for stakeholders to discuss the challenges and opportunities for measuring quality care in oncology. Invitees will examine the current efforts to develop standard quality measures, discuss the value of quality measures and whether improvement has been realized in patient care as a result of these quality measures, and consider the impact of new care/payment models on quality cancer care.

Please look for further announcements about the NCCN Oncology Policy Program, as well as published white papers and summaries, which will be posted on NCCN.org. Please send any comments or questions regarding the NCCN Oncology Policy Program to healthpolicy@nccn.org.