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NCCN Holds Fifth Annual State Oncology Society Forum to Discuss Value in Cancer Care, Best Practices

By Caitlin Donnelly, Business Insights Specialist, NCCN

On Saturday, April 2, 2016, the fifth annual National Comprehensive Cancer Network® (NCCN®) State Oncology Society Forum was held in conjunction with the NCCN 21st Annual Conference: Advancing the Standard of Cancer Care™.  A topic of focus at this year’s Forum was how best to create and measure value in oncology care.  With rising costs, the current health care climate is calling for indication of quality – validation that the most effective treatment is being utilized for people with cancer while, at the same time, mitigating escalating costs.  The challenge stakeholders face today is how to reconcile the subjectivity involved while discussing value.  

Updates from NCCN

The Forum began with words of welcome from Samuel M. Silver, MD, PhD, FACP, University of Michigan Comprehensive Cancer Center, Chairman Emeritus and current member of the NCCN Board of Directors.  Dr. Silver spoke about the heart of NCCN – the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®).  Former President of the Michigan Society of Hematology and Oncology (MSHO), he emphasized the importance of the work of State Oncology Societies and of community practitioners’ feedback to NCCN in ensuring the NCCN Guidelines® remain relevant.

Dr. Silver introduced Robert W. Carlson, MD, Chief Executive Officer, NCCN, who spoke about NCCN, its mission, and strategic direction.  Dr. Carlson provided an update on the NCCN Guidelines, including scope of recommendations across the continuum of care, the process for development, and continuously growing utilization, as well as current and planned derivative products.  Dr. Carlson discussed plans to expand NCCN’s family of compendia over the next year to include the NCCN Imaging Appropriate Use Criteria Compendium™ and the NCCN Radiation Therapy Compendium™.  He also provided an overview of the NCCN Guidelines with NCCN Evidence Blocks™, which were released last year for Chronic Myeloid Leukemia and Multiple Myeloma and currently cover nine tumor types.  NCCN Evidence Blocks™ are visual representations of five key measures – Efficacy, Safety, Quality & Quantity of Evidence, Consistency of Evidence, and Affordability – and are intended to be a starting point for shared decision-making between physicians and patients considering the patient’s own value system.

Accountability for Value in Cancer Care

Following Dr. Carlson’s update, Lee Newcomer, MD, MHA, Senior Vice President, Oncology, Genetics, UnitedHealthcare, and Michael Kolodziej, MD, National Medical Director, Oncology Solutions, Office of the Chief Medical Officer, Aetna,  further expounded on value in oncology during their session titled, “Payer Perspective:  Models for Quality.”  Dr. Newcomer spoke about the rising price of health care against average household incomes in the United States, noting that the status quo could not continue and that, ultimately, the cost of U.S. health care would exceed annual household incomes.  He offered four strategies for solution: 1) Prior authorization, 2) Comparative effectiveness, 3) Performance contracting for specialty drugs, and 4) Episode payment for oncologists.  He pointed out that outcomes measures will be the most effective measures of quality in oncology.

Dr. Kolodziej outlined two challenges that payers face today—expense and delivery—stating that the problematic escalation of cancer care delivery costs is, in part, the fault of the system of approval and coverage of required treatment regimens.  Dr. Kolodziej stated that current state mandates require coverage of all cancer drugs approved by U.S. Food and Drug Administration (FDA); however, he believes the same mandates do not account for quality and are, therefore, requiring coverage for drugs that do not warrant their expense.  He also discussed what value should mean – that the patient receives the appropriate treatment at the appropriate time, and that patient experience and outcome are optimized.

Best Practices in Community Oncology

A second round of speakers and discussion was dedicated to State Oncology Societies’ best practices from the field.  Pavan Reddy, MD, former President, Kansas Society of Clinical Oncology, spoke about the Society’s efforts to increase community clinical trials and widen the demographic these trials generally see as the norm.  Moreover, he discussed common barriers to entry into clinical trials and emphasized the role that physicians play in encouraging and facilitating patient recruitment.  Additionally, he introduced the National Cancer Institute (NCI) Community Oncology Research Program (CCOP) and discussed how community physicians and hospitals can help patients enroll for clinical trials through it, noting that the state has been taking part in this through Wichita CCOP and the Cancer Center of Kansas.   

Joseph Uberti, MD, PhD, President, Michigan Society of Hematology and Oncology, introduced the Reimbursement e-Bulletin, an educational resource provided by MSCO.  This PDF newsletter is sent via e-mail and through the MSHO website the first and third Wednesday of every month, and its goal is to help keep its readers informed and to facilitate discussions between physicians, payers, and policy-makers.

Patient Advocacy Resources

For the first time, this year’s State Oncology Society Forum featured available patient resources offered by patient advocacy groups.  Jennifer King, PhD, Director, Science and Research, Lung Cancer Alliance, discussed her organization’s work to increase lung screening in people at risk for lung cancer, as well their support of the Lung Screening Requirement issued by Centers for Medicare & Medicaid Services (CMS) in 2015.  Lung Cancer Alliance launched successful campaigns titled, “No one deserves to die” and “Do you smoke?” to dispel stigmas surrounding lung cancers and their connection to smoking.  The Lung Cancer Alliance provides “360° lung cancer support”, including a mobile app designed to assist patients with monitoring their treatments and Clinical Trial Matching Service–a prescreening and referral service that identifies clinical trial options.

Dr. King was joined at the podium by Marcie R. Reeder, MPH, Executive Director, NCCN Foundation®, who discussed NCCN Foundation and its patient resources, specifically the NCCN Guidelines for Patients® for Non-Small Cell Lung Cancer and Lung Cancer Screening, two patient-friendly publications available free-of-charge on NCCN.org/patients (http://www.nccn.org/patients/default.aspx) , which were supported, in part, by Lung Cancer Alliance.

Catherine Ormerod, MSS, MLSP, Vice President, Programs and Partnerships, Living Beyond Breast Cancer (LBBC), discussed the organization’s efforts and resources available to help those who have been affected by breast cancer, either as a patient, survivor, or caregiver.  Explaining the organization’s motto, “With you, for you,” she encouraged the State Oncology Society members to think of it as a message to them, as well.  She spoke about LBBC’s efforts to provide education on treatment and support, and how they want to be considered a partner in the breast cancer health care sphere.  

Throughout the discussions there was call for increased patient engagement and education.  Following these presentations, C. Lyn Fitzgerald, MJ, Senior Vice President, U.S. & Global Development, NCCN, encouraged attendees to work with patient advocacy organizations as a means of promoting patient education regarding treatment options as well as support program and clinical trial availability.   

The forum concluded with a self-declared call to action for the State Oncology Societies.  Members declared the need to stand up and be a voice in the conversation in dealing with the issues the health care community currently faces.  They expressed a desire for increased communication and collaboration between stakeholders.

For more NCCN 21st Annual Conference coverage, visit NCCN.org/news.