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National Comprehensive Cancer Network

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Recap of NCCN Policy Summit: Value, Access, and Cost of Cancer Care

By Jessica K. DeMartino, PhD, Manager, Health Policy Programs

Value is not a simple term to define in cancer care. Though value is often understood as benefits of treatment or quality of care weighed against the economic cost, it has been less clear which costs and benefits must be considered. The combination of increasingly unsustainable rises in the costs of cancer care, the accelerating pace of expensive innovations in oncology, and persistent hope for rescue in patients with life-threatening disease require solutions that incorporate and promote value.

To address mounting concerns about value and access in oncology care, the National Comprehensive Cancer Network® (NCCN®), as part of its Oncology Policy Program, hosted its Policy Summit: Value, Access, and Cost of Cancer Care, on September 11, 2015, at The National Press Club in Washington, DC.

Moderated by Scott Gottlieb, MD, American Enterprise Institute of Public Policy, this summit provided health care providers, government and regulatory organizations, managed care organizations, pharma-biotech companies, and patient advocacy groups with a forum to explore the convergence of access, value, and cost, and the impact of these three elements on the care of people with cancer. The summit featured three roundtable discussions following the NCCN Work Group reports on access, value, and cost.

During the summit’s opening presentation, Maggie Egan and Sharon Stranford, PhD—both cancer survivors—described their experiences as patients at City of Hope Comprehensive Cancer Center, noting the unique attributes at City of Hope that heightened their experience at City of Hope compared to local community hospitals. Among considerations for patients to make when choosing a treatment setting, Ms. Egan and Dr. Stranford noted the importance of specialized staff oncologists and radiologists, localized accommodations for out-of-town patients, and the inclusion of the patient’s complete caretaker team in treatment decision-making and implementation.

Following a presentation from Robert Diasio, MD, Mayo Clinic Cancer Center, on NCCN’s Work Group Report on Access, the day’s first panel discussion, The Impact of Access on the Treatment of Cancer, featured the following panelists: Elizabeth Carpenter, Avalere Health; Dr. Diasio; Kavita Patel, MD, The Brookings Institution; Mike Taylor, AON Hewitt Health and Benefits; and Julie Wolfson, MD, MSHS,University of Alabama at Birmingham Comprehensive Cancer Center. Mr. Taylor and panelists discussed the impact employers have on ensuring their employees have access to academic cancer centers. The need for further education of employers around the necessity for adequate cancer care in their health plans was emphasized.

Stanton Gerson, MD, Case Comprehensive Cancer Center, presented the NCCN Work Group Report on Value, followed by the second panel, The Value Proposition. Panelists included Joseph Alvarnas, MD, City of Hope Comprehensive Cancer Center; Gwen Darien, Cancer Support Community; Dr. Gerson; Mike Kolodziej, MD, Aetna; and David Rubin, Memorial Sloan Kettering Cancer Center. Ms. Darien discussed how patients view value differently and often in a very personal context compared to other stakeholders and used the Cancer Support Community’s Cancer Experience Registry to provide data on how patients view value.

The final NCCN Work Group Report on Cost, presented by Barbara Parker, MD, UC San Diego Moores Cancer Center, was followed by The Cost Conundrum, featuring the following panelists: Steve Miller, MD, Express Scripts; Dr. Parker; Gayle Petrick, Patient Advocate Foundation; Michael Rabow, MD,UCSF Helen Diller Family Comprehensive Cancer Center; and Warren Smedley, MSHA, University of Alabama at Birmingham Comprehensive Cancer Center. Much discussion focused on the high cost of drugs and the use of formularies and the future use of indication-based formularies and pricing. Panelists also examined the high cost of end-of-life care and efforts to reduce costs in this area of care.

A detailed paper about the Work Group meeting and policy summit will be published in the winter of 2016. For more information about the NCCN Oncology Policy Program, visit NCCN.org/policy.