What Caught Our Eye (WCOE), March 9, 2018
What Caught Our Eye is our week-in-review blog series, where we recap the cancer policy articles, studies, and stories that caught our attention.

Affordable Care Act

“Trump Administration Blocks Idaho’s Plan to Circumvent Health Law”

New York TimesWhile rejecting Idaho’s plan in its current form, Ms. Verma encouraged the state to keep trying, and she suggested that, “with certain modifications,” its proposal might be accepted.
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“Azar hints ACA health plans could see laxer regulation”

Modern HealthCareHHS Secretary Alex Azar told a crowd of insurers on Thursday that the Trump administration will do what it can “within the law” to let insurers offer plans that go beyond what is allowed under the Affordable Care Act.
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“A Connecticut proposal could charge up to $10,000 for not carrying health insurance”

Vox.comConnecticut is considering a proposal to create a super-charged individual mandate — one that could charge state residents a big chunk of their income for not carrying coverage.
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Coping With Cancer

“The Price They Pay”

New York TimesThe burden of high drug costs weighs most heavily on the sickest Americans.

Drug makers have raised prices on treatments for life-threatening or chronic conditions like multiple sclerosis, diabetes and cancer. In turn, insurers have shifted more of those costs onto consumers. Saddled with high deductibles and other out-of-pocket costs that expose them to a drug’s rising list price, many people are paying thousands of dollars a month merely to survive.
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“Symptom Burden Highest 1 Month After Cancer Dx”

Med Page TodayMost cancer patients experience clinically significant symptoms in the first year after diagnosis and require tailored supportive care, according to a retrospective observational study of over 120,000 patients in Canada.

The analysis of patient-reported outcomes (PROs) showed that moderate-to-severe symptoms affected “well-being” in 55% of patients with all cancer types, particularly in the first month after diagnosis.
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Cancer News

“FDA commissioner to health insurers: You’re doing it wrong”

CNBC.comInsurance is designed, theoretically, to protect against the catastrophic: tornadoes, floods, hurricanes — or, where our health is concerned, cancer or another devastating disease.To make that financial protection affordable, many pay into the system: the healthy are supposed to subsidize the sick. But at a conference Wednesday organized by the health insurance industry, FDA Commissioner Scott Gottlieb delivered a startling message: You’re doing it wrong.
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“Vinay Prasad on the NCCN’s cancer treatment guidelines: The US system needs an audit”

BMJ OpinionWhat level of evidence should we have before costly, toxic cancer drugs are given to patients?
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“FDA approves first direct-to-consumer test for breast cancer risk”

STAT NewsFederal regulators approved the first direct-to-consumer test for the BRCA genes, which increase the risk of breast and ovarian cancer.
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“All Cancer Patients Should Have Access To Genomic Testing”

Forbes.comThe novelty of Foundation’s approach—like that of a few other companies leading the field of cancer diagnostics—is the scope of testing. These laboratories examine hundreds of genes by a method called next-generation sequencing (NGS). For a price of $5800, in two weeks’ time, Foundation reports on tumor mutation burden (TMB), microsatellite instability (MSI), and mutations in any of 324 genes that may indicate sensitivity—or resistance—to oncology drugs.
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“Race/Ethnicity and Age Distribution of Breast Cancer Diagnosis in the United States”

JAMA SurgeryThe US Preventive Services Task Force (USPSTF) currently recommends initiating breast cancer screening at 50 years of age in patients at average risk.1 However, we hypothesize that these guidelines may not be sensitive to racial differences and may be inappropriately extrapolating data from largely white populations for use in racially diverse populations. This process could result in underscreening of nonwhite female patients.
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