For Drugs Targeting Colorectal Cancer and Renal Cell Carcinoma, Managed Care Strategies Shift the Payment Dynamics for Physicians and Create New Challenges

March 4, 2014

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
    --  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."

Additional information:

    --  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.

Upcoming webinar:

    --  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

About Decision Resources Group

Decision Resources Group is a cohesive portfolio of companies that offers best-in-class, high-value information and insights on important sectors of the healthcare industry. Clients rely on this analysis and data to make informed decisions. Please visit Decision Resources Group at www.DecisionResourcesGroup.com.

All company, brand, or product names contained in this document may be trademarks or registered trademarks of their respective holders.

For more information, contact:

Decision Resources Group

Christopher Comfort



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SOURCE Decision Resources Group

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