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The Battle between Drug Makers & Insurers Over Chemotherapy

Cancer treatment is constantly changing and it leads to fighting from drug makers and insurers in regards to coverage and the price of chemotherapy.

Drug makers want to ensure patients receive the chemotherapy drugs, but insurers want to limit coverage or require a higher co-payment for certain treatments.

In a recent case in Arkansas, drug makers won a battle in regards to chemotherapy. The governor of the state determined that private insurance providers could not charge more for chemotherapy when taken orally rather than through an infusion at the medical facility. As a result, chemotherapy taken through a pill will be more affordable to cancer patients. Arkansas was the 43rd state to sign similar legislation in regards to chemotherapy and patient groups continue to push for other states to engage similar solutions in regards to insurance coverage.

The insurance providers want to set prices for different services, even when patients take the same medications in a different form. The recent legislation brought the battle between insurance providers and drug makers into the spotlight because it pointed out a problem within insurance coverage. While it is not yet clear whether the private insurance providers or the drug makers will win cases in the states without provisions in regards to chemotherapy, it is likely that the push for similar pricing and co-pay on chemotherapy will persist into other states.

For patients, the legislation is a bright area that makes it possible to seek treatment for cancer. It gives patients hope that they will not end up spending more on their treatments when they have options in relation to their medications.

Understanding The New Oncology Bill

A recent Senate bill would encourage the use of Oncology Medical Homes, making cancer treatment more affordable and effective.

Although most people associate medical breakthroughs with advances in technology, changes in the way we apply existing tech are every bit as important.

Oncology Care Overview

The Oncology Medical Home model is a strategy designed to lower the cost and increase the effectiveness of cancer treatment. The model is based on five key principles:

  • Caregivers must engage with the patient throughout the treatment process
  • Care must be as accessible as possible
  • All treatments must be clearly based on evidence
  • Patients should have teams of care providers whenever possible
  • Caregivers should strive for regular improvements in quality

Oncology Medical Homes seek to keep patients out of hospitals and in more affordable treatment centers. Combined with facilitating more efficient, effective care, this helps keep the cost of cancer treatment low, benefiting patients, insurers, and the entire healthcare system.

Bill Basics

Introduced by senators Tom Carper (D-DE) and John Cornyn (R-TX), the Cancer Care Payment Reform Act of 2017 seeks to encourage the use of the Oncology Medical Home model. To this end, it will create a National Oncology Medical Home Demonstration Project, which will compare the costs and effectiveness of different treatments and practices over the next five years. The bill changes how Medicare covers cancer care, favoring coordinated treatment programs that minimize their patients’ hospital and emergency room visits.

The Reform Act has the support of the Community Oncology Alliance, as well as that of leading oncologists throughout the country. Combined with its bipartisan origins and the widespread demand for more affordable, effective healthcare, this gives it a strong chance of passing.

For more information on the future of cancer care, contact us today.

Lung Cancer Screening Rates Remain Low

Lung Cancer Screening Tests Among the Eligible Populations Remain Very Low!

According to a study by the American Cancer Society researchers on the rates of lung cancer screening tests, the number of people seeking the tests remains very low among the eligible populations. This is even despite efforts and recommendations that high-risk current and former smokers get to be screened. Smokers with a long history of smoking are at the highest risk of getting lung cancer and can, therefore, benefit massively from screening. The study by the American Cancer Society was published in Jama Oncology and the authors mentioned that more health-care providers and patients need to be educated on the lung cancer screening guidelines.

Who Should Get Screened?

In December 2013, the United States Preventative Services Task Force (USPSTF) went on to recommend that certain people with a high risk of getting lung cancer get yearly screening using low-dose CT scans. This included people aged between 55 and 80 with at least a 30-pack yearly smoking history.  The National Lung Screening Trial (NLST) had showed that screening this population would help reduce the lung cancer mortality by about 20%, hence prompting USPSTF to make the recommendation.

However, the study by the American Cancer Society which compared the before-recommendation lung cancer screening rates and after-recommendation screening rates found that the rates did not rise as was expected. In 2010 before the recommendation, the National Health Interview Survey found out that only 2%-4% of high-risk smokers received lung cancer screening in 2009. And from 2010 to 2015, the screening rates remained low- just 3.3% in 2010 and 3.9% in 2015. This means that only about 262,700 persons out of the eligible 6.8 million current and former smokers underwent the screening.

Why Are Screening Rates Low?

According to the lead author Ahmedin Jemal, the reasons for these low lung cancer screening rates are varied but could mostly be because of a lack of knowledge among both health specialists and smokers about screening recommendations and access to high-quality screening.

The Hurdles Minorities Face When it Comes to Cancer Trials

The Hurdles Minorities Face When it Comes to Cancer Trials

Cancer has been the focus of a substantial amount of research in recent years. This research has resulted in numerous breakthroughs that have led to life-saving treatments.

Not only do these treatments save lives but they also improve the quality of life for those dealing with the disease. These treatments are developed in clinical cancer trials where research groups assess the efficacy of new treatments against the current treatments on the market; however, these clinical trials have a dark side.

People who come from minority ethnic groups often have trouble gaining access to these clinical cancer trials.

Since 1993, all National Institutes of Health (N.I.T.) funded trials require that minority groups be represented in the clinical trial groups, they don't say what percentage of the cancer trial group should be from a minority background. Furthermore, they only fund around 6% of all clinical trials. The remainder of the trials are funded by the pharmaceutical companies themselves or outside research groups.

This leads to an under-representation of minority groups that often conceals the benefits of these treatments from these groups or might hide adverse effects of the treatment that might only affect one subset of the population.

Why the under-representation of minority groups?

There are several reasons for this issue. First, many people who come from minority backgrounds haven't received an appropriate level of education with regards to clinical cancer trials. This means that they might not know that a trial is going on or that the trial might be relevant to their form of cancer. Furthermore, many people of minority descent with cancer also have other chronic illnesses, such as diabetes, that might exclude them from the clinical trial.

This is a major issue that deserves the attention of the medical community to ensure that minority groups have access to more clinical trials in the future.

Walking May Improve Sleep with Lung Cancer

Walking May Improve Sleep for Lung Cancer Patients

Walking may improve the quality of sleep for people with lung cancer, according to a recent study published in the British Journal of Cancer. Going for walks could also help patients with breast or colorectal cancer sleep well.

111 Patients with Stage 1 Lung Cancer Studied

The researchers enrolled 111 lung cancer patients. Nearly two-thirds of the patients had Stage 1 lung cancer, meaning the cancer had not spread beyond the lungs. The participants ranged in age from late 30s to early 80s.

The scientists randomly assigned 56 of the participants into the test group. The subjects participated in a 12-week intervention that included home-based walking exercise training and weekly exercise counseling. These participants walked at moderate intensity for 40 minutes, three times each week. The subjects filled out a survey on the quality of their sleep, recorded their exercise after every session and participated in weekly exercise counseling sessions. Wrist monitors collected information about their sleep.

The 55 participants in the control group received usual cancer care. They also had the opportunity to participate in exercise counseling.

The researchers measured several outcomes at three months and again at six months after the intervention. The outcomes included:

  • Total sleep time
  • Sleep efficiency
  • Sleep onset latency
  • Wake after sleep onset
  • Quality of sleep, as experienced by the study participant
  • Rest-activity rhythms

The researchers also looked at circadian rhythms, which is that 24-hour cycle of sleeping and waking each day. Many scientists think that, in addition to sleep cycles, circadian rhythms influence heart rate, inflammation, and metabolism. Disrupting the circadian rhythms can increase the risk of several chronic diseases.

The scientists measured how consistently the participants woke up and went to sleep at the same time every day. They found a strong link between exercise and improved sleep quality. The participants without the most disrupted circadian rhythms gained the most benefit.

Researchers Found Quality of Sleep Significantly Improved in the Group That Exercised

“Walking is safe, feasible and effective for patients. Just walk!” senior author Chia-Chin Lin, a nursing professor at Taipei Medical University, told Reuters Health.

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