June 2, 2016 – Curant Health COO, Marc O’Connor, in Specialty Pharmacy Times – Signs point to cancer becoming a chronic condition in the near future.
According to a study by Wei Zheng, MD, PhD, and others, published in the Journal of the American Medical Association as reported by Reuters in 2015, “For men and women ages 50 to 64, who were diagnosed in 2005 to 2009 with a variety of cancer types, the risk of dying from those cancers within five years of diagnosis was 39 to 68 percent lower than it was for people of the same age diagnosed in 1990 to 1994, researchers found.”
Increasing survival rates are a leading indication that the future of cancer treatment may start to mirror the treatment of chronic conditions. Such a shift will have massive effects on payers, and will accelerate incredibly difficult conversations and decisions about the value of extending life. Oncology patients on new immunotherapies are demonstrating 3- to 5-year survival rates and 30% remissions.
However, not nearly enough is known about when it is safe for many patients to stop treatment. There exists a massive difference for the continuum between paying $120,000 or more for 1 year of therapy with 6- to 12-month survival rates for cancer patients compared with the same $120,000 per year for an indefinite number of years as treatment efficacy grows.
As long as immunotherapy requires infusion, the payment responsibility remains, for the moment, on the medical side. This provides the opportunity for oncologists to have close eyes on patients. But oral immunotherapeutics will eventually enter the market; what then?
Payers and pharmacy benefit managers run the greatest risk of bearing the brunt of the financial burden, as cancer shifts toward a chronic condition treated increasingly by oral oncolytics, and eventually, oral immunotherapies. The consequences for payers could be enormous.
To read Marc’s full article, visit Specialty Pharmacy Times.
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