For Drugs Targeting Colorectal Cancer and Renal Cell Carcinoma, Managed Care Strategies Shift the Payment Dynamics for Physicians and Create New Challenges
Incentives for Pathway Compliance, Reduced Hospitalization are Changing Treatment, According to Findings from Decision Resources Group
BURLINGTON, Mass., March 4, 2014 /PRNewswire/ — Decision Resources Group finds that the increasing use of clinical pathway programs, accountable care organizations (ACOs) and bundled payments is changing the prescribing of oncology drugs in the treatment of colorectal cancer and renal cell carcinoma. As more payers and oncology practices adopt pathways, participate in ACOs and negotiate payment bundles, specific branded agents will benefit or suffer depending on how each agreement is designed and structured.
Other key findings from the U.S. Physician & Payer Forum report entitled Managed Care Strategies in Oncology: US Payer and Prescriber Insights on the Impact of Clinical Pathways, Bundled Payments, and ACOs on Brand Uptake in Colorectal Cancer and Renal Cell Carcinoma:
-- Clinical pathways: The impact of clinical pathways depends heavily on who designs them. For example, clinical pathways led by managed care organizations (MCOs) rely more heavily on chemotherapy combinations such as FOLFOX in early stage IV treatment of colorectal cancer, where oncologist-led pathways place Roche's Avastin and Bristol-Myers Squibb's Erbitux as first-line treatment. -- Prescribing decisions: ACOs compensation to oncologists is tied to several hospitalization measures, and ACO participant oncologists report that their prescribing decisions weigh the likelihood of hospitalization more heavily as a result. -- Bundled payments: MCOs and oncologists expect greater use of bundled payment arrangements for care of colorectal cancer and renal cell carcinoma, and surveyed MCOs projected winners and losers among various agents. -- Shaping pathway decisions: Clinical pathways are regularly updated, and both MCOs and oncologists say they want more clinical evidence to shape pathway decisions.
Comments from Decision Resources Group Analyst Paula Wade:
-- "Many large oncology groups have been working with clinical pathways of some sort for years, taking great care to construct pathways that provide latitude to physicians in the practice, to gain buy-in from them. Not surprisingly, as MCOs are trying to design pathways, their paths are both shorter and narrower: they feature a smaller array of agents and call for drug treatment to end earlier in stage IV."
-- In this report, Decision Resources Group surveyed 100 clinical oncologists and the pharmacy director or medical director of 40 MCOs about their adoption of these incentive models, and these models' impact on prescribing of specific oncology drugs.
-- Media members are welcome to attend our upcoming webinar based on this report entitled Clinical Pathways and ACOs--Impact of Dynamic Trends on Prescribing for Colorectal Cancer and Renal Cell Carcinoma. This presentation will be held on Tuesday, April 8, 2014. For more information, please contact Christopher Comfort at firstname.lastname@example.org.
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