The Future of Cancer Care: Change Is the Only Certainty

By its very nature, oncology is rife with change, with new research resulting in treatment advances at a rapid pace. Pending federal legislation aimed at reining in prescription drug prices and an upcoming presidential election may introduce yet further changes in oncology. A discussion on these issues was presented at the 2019 AVBCC Summit in October, with a look at the oncology landscape.

Mike Kolodziej, MD, Vice President and Chief Innovation Officer, ADVI Health, queried his fellow panelists about what the future holds if a Democratic president is elected.

“Community oncology practices can’t survive in the Medicare for All world,” Dr Kolodziej said. “Community oncology would cease to exist.”

Agreeing with Dr Kolodziej, Jeffrey Patton, MD, Chief Executive Officer, Tennessee Oncology, said that Medicare for All is not economically feasible.

Cliff Hudis, MD, FACP, FASCO, Chief Executive Officer, American Society of Clinical Oncology, pointed out that most of his patients are Medicare beneficiaries, suggesting that he did not think Medicare for All will come to fruition. By contrast, Medicare for all who want it seems more feasible, Dr Hudis said.

“Buying in is very different from dismantling private insurance,” Dr Hudis said. Still, he added, although many in the United States may deride the idea of socialized medicine, if any of them tried to run a campaign in Europe on the platform of dismantling socialized medicine, they would not be received well.

“I do think we’re going to see more change in the next 3 to 7 years than in the last 25 years combined,” Dr Kolodziej asserted.

William McGivney, PhD, Managing Principal, McGivney Global Advisors, who moderated the session, pointed out that the fight over value in drug pricing will be playing out between bills in the House and Senate, along with the International Pricing Index Model pitched by the Trump Administration, as well as the established processes of the Institute for Clinical and Economic Review.

“There is no strategic plan, no mission statement, no vision for this thing,” Dr Hudis said, adding that the fundamental question remains of whether healthcare is a right or a privilege. “There’s no agreement to what we’re trying to accomplish.”

Dr McGivney asked the panelists whether they expected to see a plan take shape over the next 15 years that would make real changes to the current drug-pricing model.

“Congress is so divided that neither side wants the other to get a win,” Dr Patton said. “We can’t afford to keep going in the same direction we’re in as a society.”

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