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Analysis

ASCO: Cancer Deaths Down, But Costs 'Unsustainable'

By Tinker Ready  
   March 17, 2016

Good news: Mortality rates for many cancers are dropping. The challenge: Hospitals and health systems will be serving a new kind of patient—older, sicker, and harder to treat—says a report from the American Society of Clinical Oncology.

When it comes to the quality of cancer care, an oncologist is the person to consult. For anyone looking for advice about the high cost of cancer drugs, a doctor is probably not the first option.

But the American Society of Clinical Oncology's exhaustive 2016 "The State of Cancer Care in America" has a lot to offer on that front.

The report, presented at a Tuesday Capitol Hill congressional briefing, will disappoint those expecting another rant against $140,000, bankruptcy-inducing cancer drugs. Instead, while ASCO calls cancer costs "unsustainable," it makes the pharmaceutical industry's argument that notoriously expensive new meds are not the only element of care fueling the dramatic increases.

Despite the generic name, this is the state of cancer according to practicing oncologists—not patients, payers, or hospitals. So, if you are looking for an update on the state of cancer care and delivery, this is where you'll get the doctors' view.

The result: There's a lot of good news and a lot of bad news—sometimes in the same package. There's a lot going on with cancer.

"Cancer care in the United States remained a mixed picture in 2015. Declining mortality rates, growing numbers of survivors, and exciting progress in treatment were set against the backdrop of increasingly unsustainable costs and a volatile practice environment," the report states.

 One example:

"Precision medicine offers notable advantages to patients in need of expanded treatment options. However, physicians and patients are struggling to manage overwhelming amounts of

information about risks and benefits of genetic testing—and its role in selecting treatment.'

The report is an important document, says Randall Holcombe, MD, the chief medical officer for cancer at the Mount Sinai Health System. He was not involved in the report's preparation, but says he is impressed with its scope.

"It is a really fantastic report," Holcombe says. "It has a ton of information in it that is really timely and essential reading for hospital leadership, as well as practicing oncologists."

Here are some of the key quality messages in the report:

  • Care is getting more complex and some oncologist are not equipped to deliver the complicated new treatments.
  • Demands on oncologists will grow, as demographics leave more Baby Boomers on oncology's doorstep.
  • But, since oncologists are aging as well, there may be fewer of them to treat patients.  
  • And, as patients get older, they have more comorbidities.
  • Oncologists are struggling with their HIT systems, as well as variations in "cancer pathway" treatment guidelines.

"These trends… raise concerns about how the US cancer care system will be able to respond to the projected surge in demand for cancer care in the coming years, driven by the aging of the US population," says Julie Vose, MD, the president of ASCO, and an oncologist at the University of Nebraska Medical Center in Omaha. She spoke at the briefing Tuesday.

More Survivors; Unique Care Needs
In a way, the cancer care delivery system needs to adjust to meet the needs of its own success. Good news: mortality rates for many cancers are dropping. The challenge: hospitals and health systems with be serving a new kind of patient, who has been treated for and survived cancer. The report cites research that estimates the number of cancer survivors will grow to 14.5 million from 9 million by 2024.

Tinker Ready is a contributing writer at HealthLeaders Media.


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