Health-Care Policy
President’s Cancer Panel Report: Closing Gaps in Cancer Screening for All Americans
John P. Williams, MD, FACS
Much progress has been made in the past 50 years since the signing of the National Cancer Act of 1971, which included the establishment of the President’s Cancer Panel. Nevertheless, there remain significant opportunities to make improvements across the cancer spectrum, perhaps none more pressing ...
Leaders of the PROMISE Study Address Racial Inequities in the United States
In 2018, researchers from Dana-Farber Cancer Institute launched a large, ambitious screening study called PROMISE (ClinicalTrials.gov identifier NCT03689595). The objectives of the study were to identify people with premalignant precursor conditions of multiple myeloma, understand the molecular sign...
CMS Finalizes Decision to Cover CAR T-Cell Therapy for Medicare Beneficiaries
The ASCO Post
ON AUGUST 7, the Centers for Medicare & Medicaid Services (CMS) finalized the decision to cover U.S. Food and Drug Administration (FDA)-approved chimeric antigen receptor (CAR) T-cell therapy among recipients of Medicare benefits. FDA-approved CAR T-cell therapies are approved to treat patients ...
Rising Costs of Cancer Care: It's More Than Drugs
Ronald Piana
All parties—the government, payers, and consumers—agree that, left unchecked, rising health-care costs will eventually hamstring vital portions of our delivery system. For example, Medicare, which covers more than 50% of the nation’s patients with cancer, is marching headlong toward insolvency. Larg...
Congressional Hearing Highlights Oncology Drug Shortages
Margot Fromer
Some oncology drugs are in such short supply that the situation is now critical, with almost 200 drugs affected—triple that of 2003. This was the background described by speakers at a July 2011 congressional briefing sponsored by the Association of Community Cancer Centers (ACCC), ASCO, and other ca...
Oncology Drug Shortage: An Unintended Consequence of the Medicare Modernization Act and Free-market Forces?
Ronald Piana
Oncology has a drug shortage problem, and the FDA says that it is getting worse. Drug shortages are not a new phenomenon, but over the past few years we have seen a rapidly growing number of shortfalls that are limiting providers’ ability to care for their patients. In 2004, the FDA reported 58 drug...
Developing Targeted-agent Combinations: Business and Regulatory Issues, and Legal Obstacles
Margot J. Fromer
The Institute of Medicine’s National Cancer Policy Forum recently convened a public workshop, “Facilitating Collaborations to Develop Combination Investigational Cancer Therapies,” to address the promises and challenges involved in the development of combination oncologic drug therapies. In the Sept...
ASCO Issues Policy Statement to Reduce Cancer Care Disparities
Last August, ASCO issued the policy statement, “Opportunities in the Patient Protection and Affordable Care Act to Reduce Cancer Care Disparities” in the Journal of Clinical Oncology.1 The statement builds on ASCO’s policy on disparities in cancer care released in 2009. It calls on both the oncology...
Tobacco Remains the Dominant Global Risk Factor Underlying Cancer
Margot Fromer
Despite clear evidence that tobacco causes at least 18 types of cancer, as well as many other diseases, many people all over the world smoke or chew tobacco, or are exposed to secondhand smoke. Although smoking among Americans has declined slowly but steadily over the past 40 years, it remains the l...
AACR Issues Landmark Report on Cancer Progress
Ronald Piana
At a recent press conference in Washington, DC, the American Association for Cancer Research (AACR) assembled luminaries from the cancer research and care communities to discuss the salient points of the association’s newly released progress report on the current and future state of cancer research ...
New Technologies Are Driving Up Costs: Are They Worth the Price?
Ronald Piana
Expensive new cancer therapies and technologies are alluring for both physicians and their patients. Prostate cancer, because of the sheer volume of cases and the variability of treatment options, serves as a dynamic disease model in the ongoing debate over how to curb spending and maintain high-qua...
Do We Need the USPSTF?
Derek Raghavan, MD, PhD
Like most of the folks reading this commentary, I’m a taxpayer. Although I sometimes become impatient with the strategic games on Capitol Hill, I basically appreciate that government helps many things to work, and some of them even work well. However, there are aspects of government function that d...
ASCO Supports the United Nations Political Declaration on Noncommunicable Diseases
Jo Cavallo
In September, government leaders from around the world as well as representatives from civil society, the private sector and academia gathered at the United Nations in New York for the first-ever summit on the growing economic and human crisis posed by noncommunicable diseases (NCDs), especially in ...
Improving Quality and Safety with Health Information Technology
Ronald Piana
A well-documented flaw in paper-based health care is the propensity for medical errors. According to Blackford Middleton, MD, MPH, MSc, implementing clinical decision support software can decrease medical error, improve outcomes, and lower the costs of care. Presenting a session titled “Improving Qu...
Oncologists Need Hands-on Approach in Developing Next Generation of EHRs
Ronald Piana
The electronic health record system offered by vendors is more like a filing cabinet, not the sophisticated, interactive database needed by busy oncologists, according to Kevin S. Hughes, MD, FACS, Co-Director, Avon Comprehensive Breast Evaluation Center, Massachusetts General Hospital, who presente...
Need for Data Capture Crucial, Now and After ‘Meaningful Use’
Cindy Chavez
It’s never enough. Whether it is the Centers for Medicare & Medicaid Services (CMS), other payers, pharmaceutical manufacturers, or specialty companies, one can never provide enough data. When will it all end? The problem, or the opportunity for many, is that it won’t end. The need for discrete ...
Medicare Reimbursement to Physicians: Déjà Vu All Over Again
Nora Janjan, MD, MPSA, MBA, and John Goodman, PhD
In February 2011, The ASCO Post published an opinion piece (“Congress and the ‘Doctor Fix’: Looking Back, Looking Ahead”) about the ping-pong of legislative continuing resolutions to avert a 21.3% cut in physician reimbursement. These continuing resolutions were necessary because the Affordable Care...
A Conversation with Ezekiel J. Emanuel, MD, PhD
Jo Cavallo
Last September, Ezekiel J. Emanuel, MD, PhD, a leading scholar in bioethics and health-care policy, was named the Diane v.S. Levy and Robert M. Levy University Professor and Vice Provost for Global Initiatives at the University of Pennsylvania in Philadelphia. His appointment will be shared between ...
The Newly Diagnosed Patient with Cancer and Access to Care
Caroline Helwick
A study presented at the 2011 ASCO Annual Meeting raised concerns that newly diagnosed cancer patients are having trouble seeing an oncologist. Interviews with several cancer centers and community practices, however, suggest that the process runs smoothly, for the most part. Majority of Patients Co...
Shortening the Learning Curve of the U.S. Health-care System
Ronald Piana
If we are able to harness the full potential of digital technologies, computerized registries, databases, and the Web, could we solve many of the current woes of our sluggish and costly health-care system? Yes, according to Lynn Etheredge, a consultant with the Rapid Learning Project at the George W...
Drug Shortages Hit Oncology Hard: Experts Weigh in on Challenges and Solutions
Ronald Piana
Periodic drug shortages are an unavoidable reality in our complicated pharmaceutical supply chain; however, over the past several years, drug shortages have expanded to crisis levels, putting vulnerable patients at risk. In 2010, there were 178 drug shortages reported to the FDA, 132 of which were s...
Cost of Care: A Multidisciplinary Responsibility
Daniel A. Vorobiof, MD
I read the interview with Dr. Ezekiel Emanuel (The ASCO Post, December 15, 2011) with much interest, as the health-care policy problems that America is currently experiencing have plagued other countries for some time. Despite proactive measures and attempts to amend those situations elsewhere, litt...
A Visionary Call for the ‘Creative Destruction’ of Medicine
According to nationally regarded cardiologist and geneticist Eric Topol, MD, Chief Academic Officer of Scripps Health, the next frontier of the digital revolution can create exponentially better health care. Dr. Topol, who is also Director of the Scripps Translational Science Institute and Professor...
AACR Urges Congress to Maintain, Preferably Increase, Cancer Research Funding
Margot J. Fromer
December 23, 2011, marked the 40th anniversary of the National Cancer Act. To mark that occasion, on February 2, the American Association for Cancer Research (AACR) held a Congressional briefing, attended by about 100 legislative aides, to remind Congress that the war on cancer is far from over. Sig...
Rising Costs in Radiation Oncology Linked to Medicare Coverage
In the ongoing debate over how to control rising cancer care costs, it is vital to identify usage patterns of expensive new technologies. A recent study examined the relationship between Medicare reimbursement and the increasing use of intensity-modulated radiation therapy (IMRT).1 The ASCO Post spo...
ACCC Releases Survey on ‘Oncology Medical Home’
The ASCO Post
The Association of Community Cancer Centers (ACCC) released findings from a survey that explores how community-based cancer care programs view the concept of the “oncology medical home”—a patient-centered model for coordinated care, whereby payers would reimburse physicians for services that keep pa...
ACCC Meeting Focuses on Affordable Care Act: Its Future, and What It Might Accomplish
Margot J. Fromer
The Association of Community Cancer Centers (ACCC) mid-March Annual Meeting devoted several sessions to the Patient Protection and Affordable Care Act: Will it still be here after the Supreme Court decides its fate? If so, how much of it will survive, and how will it affect oncology practice? In la...
Nearly 800,000 Lung Cancer Deaths Averted during 1975–2000 Due to Decline in Smoking Rates
The cumulative impact of changes in smoking behavior that started in the mid-1950s averted approximately 795,851 U.S. lung cancer deaths, 552,574 among men and 243,277 among women from 1975 to 2000, according to a report in the Journal of the National Cancer Institute. The researchers also estimated...
Novel Initiative to Address Oncology Drug Crisis
Much has been written about the oncology drug shortage crisis in the United States. In the spirit of being part of the solution to that problem, a group of oncologists has formed the Citizen’s Oncology Foundation (COF). The goal of the start-up not-for-profit association is two-pronged: to find solu...
Update on Oncology Drug Shortage: Better for Now, But Permanent Solutions Must Address Underlying Issues
Over the past few years, drug shortages in the United States have been on the rise, involving hundreds of agents, many of which are lifesaving medications for patients with cancer. In recent months, the FDA has taken steps to alleviate some of the most critical oncology drug shortages. “We should a...
ASCO President Michael P. Link, MD, Makes Statement on Passage of FDA Safety and Innovation Act
ASCO President Michael P. Link, MD, recently issued the following statement in response to the Senate Health, Education, Labor and Pensions Committee’s Passage of the FDA’s Safety and Innovation Act: “ASCO commends the Senate Health, Education, Labor and Pensions Committee for taking steps to addre...
Untreated Cancer Pain Remains a Significant Global Problem
“Physicians are afraid of morphine … Doctors [in Kenya] are so used to patients dying in pain … they think that this is how you must die. They are suspicious if you don’t die this way — [and feel] that you died prematurely.” —Human Rights Watch interview with Dr. John Weru of Nairobi Hospice, Kenya...
ASCO Reexamines the Oncology Workforce Shortage
A study commissioned by ASCO in 2006 predicted a significant shortage of medical and gynecologic oncologists in the United States by 2020. As a result, the organization created the Workforce Implementation Group to develop recommendations to stem the projected workforce shortfall and ensure ongoing ...
The Affordable Care Act Stands: Now What?
On March 23, 2010, President Obama signed the Patient Protection and Affordable Care Act into law—a hotly contested bill that enacted sweeping changes to the U.S. health-care system. The debate over the Affordable Care Act continued all the way to the Supreme Court, spearheaded by the case Florida v...
Three Experts Weigh In on the Health-care Reform Legislation
In light of the Supreme Court ruling, The ASCO Post asked three nationally regarded experts about how the Affordable Care Act will affect the practice of oncology. Ezekiel J. Emanuel, MD, PhD, Professor and Vice Provost for Global Initiatives, University of Pennsylvania: This is an overwhelmingly p...
Senate Legislation Urges Federal Research Support to Improve Early Detection of Prostate Cancer
The ASCO Post
U.S. Senator John F. Kerry (D-MA) led unanimous passage of Senate Resolution 493 to recognize prostate cancer as an epidemic striking African American men disproportionately, with 250% higher mortality and 60% higher incidence. This bipartisan legislation urges federal agencies to support research f...
As Conflicting Guidelines Evolve, Experts Continue to Debate the Merits of Cancer Screening
In the 1930s and 1940s, when the American Cancer Society [ACS] first brought forth the message that early cancer detection saves lives, it was a broad brushstroke and an appropriate message. The problem now is that new technology enables us to find [tumors that would never progress to invasive cance...
Biomedical Research Faces Imminent $2.4 Billion Budget Cut Unless Congress Acts
The ASCO Post
The National Institutes of Health (NIH) faces a significant budget reduction in January 2013 due to automatic across-the-board cuts, known as sequestration, required under the federal Budget Control Act of 2011. The estimated $2.4 billion NIH cut could result in 700 to 2,300 fewer research grants fu...
Despite Progress, Chemotherapy Drug Shortages Still Vex the Oncology Community
Ronald Piana
During the first week of November 2011, President Obama signed an Executive Order directing the FDA to take steps to help resolve the drug shortages that were affecting patient care across the country. The oncology community was hit especially hard; many of the drug shortfalls were generic chemother...
Viral Infection and Liver Cancer: A Global Health Crisis
Ronald Piana
It is estimated that at least 15% of all cancers worldwide can be attributed to infectious etiologies, mostly viral infections. At this year’s ASCO Annual Meeting, an intriguing session on virally induced cancers provided critical clues that could be of real practical value in advancing our battle a...
AACR’s Cancer Progress Report 2012 Highlights Advances, Challenges, Opportunities
Margot J. Fromer
The American Association for Cancer Research (AACR) recently released its Cancer Progress Report for 2012,1 providing a snapshot of the major advances in cancer research, and highlighting the great need for continued funding for the field. “It is a new day for cancer research and cancer patients,” ...
Health-care Crisis Reconsidered
Jonathan Schwartz, MD
As an oncologist in private practice, I usually read with great interest the many articles in The ASCO Post on issues regarding the politics of oncology practice. These articles deal with the major topics of the day, ranging from the high cost of oncologic care to shortages of generic drugs, to alle...
The Ethics of Rationing Cancer Care
Jo Cavallo
Should cost be a consideration when deciding on treatment for patients with cancer, and if so, what kind of ethical dilemma does that pose for oncologists? With U.S. spending on oncology drugs expected to climb more than 20% annually over the next decade—reaching $173 billion by 2020, according to t...
President Obama Signs High-mortality Cancer Bill into Law
The ASCO Post
Just hours before the end of the 112th Congress, constitutional deadline for approval of a bill passed by that Congress, President Barack Obama signed into law the first legislation requiring comprehensive plans of research action for high-mortality cancers, with lung and pancreatic cancers given pr...
NCI Director Assesses Barriers to Faster Progress in Cancer Research
Ronald Piana
At a National Press Club media event in Washington, DC, on September 25, 2012, National Cancer Institute (NCI) Director Harold E. Varmus, MD, addressed a group of 75 reporters and officials. His discussion focused on impediments—biologic, economic, institutional, and cultural—to faster cancer resear...
Does Health-care Quality Translate to Value?
Ronald Piana
On March 23rd, 2010, President Obama signed into law the Patient Protection and Affordable Care Act, enacting sweeping change in our health-care system. An underlying theme of the legislation is the realignment of our payment system so that it places value over volume of services. At ASCO’s first Qu...
Last-minute ‘Fiscal Cliff’ Deal by Congress Again Averts Medicare Cuts to Physicians
The ASCO Post
A last-minute patch to the sustainable growth rate formula included in the “fiscal cliff” deal averted massive cuts to oncologists who care for and treat Medicare patients. “This end-of-year crisis management once again demonstrates the critical need for fundamental reform of the Medicare reimbursem...
Health Insurance Issues for Young Cancer Survivors
The latest addition to Cancer.Net’s video series for young adults, Moving Forward: Perspectives from Survivors and Doctors, deals with the health insurance issues young adult cancer survivors may face. This video series is a collaboration between Cancer.Net and LIVESTRONG. Each set of videos in the ...
The Doctor Who Championed Patient Navigation in Harlem
Ronald Piana
After completing his residency at Memorial Sloan-Kettering Cancer Center, Harold P. Freeman, MD, arrived at Harlem Hospital Center in 1967, where the overwhelming majority of his patients presented with late-stage disease. That early experience with underserved patients would shape his career as one...
Study Finds Young Cancer Survivors Often Skip Checkups
Athough the majority of the more than 69,000 adolescents and young adults (AYAs) diagnosed with cancer each year will survive their disease, many of them will experience interruptions in their education and a derailment in their career tract, curtailing their lifetime earning potential and reducing ...
