What Caught Our Eye (WCOE), May 4, 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

“Making Heath Insurance Enrollment As Automatic As Possible”

Via Health Affairs BlogIn December 2017, the Republican Congress, working with the Trump administration, repealed the tax penalties enforcing the Affordable Care Act’s (ACA) individual mandate, effective in 2019. Although the degree of the mandate’s efficacy is uncertain, its repeal is sure to lead to additional Americans going without coverage, exacerbating the instability that now affects the individual insurance markets of many states.

In this context, it is incumbent on federal and state policymakers to enact replacement policies for the ACA’s individual mandate. More fundamentally, the individual market’s core dysfunction remains in place: Many young and healthy consumers remain outside the market, increasing average risk levels and premiums, and leaving millions of people needlessly uninsured. Those enrollment choices involve the perception and the reality of unaffordable coverage, but they also reflect burdens of enrollment and plan selection that have an outsize impact on program participation.
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Cancer Policy

“The Forgotten Piece of Continuum of Care”

Via CURE MagazineIn 2005, the National Research Council and Institutes of Medicine published “From Cancer Patient to Cancer Survivor: Lost in Transition,” the first comprehensive document on cancer survivorship, which included 10 recommendations. First, it called for health care providers and patient advocates to recognize survivorship as its own, distinct phase of cancer care. The second recommendation advised that a survivorship care plan (SCP) be provided for all patients.
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“CDC Eyes Review of Gynecological Cancer Screens”

Via Wall Street JournalThe Centers for Disease Control and Prevention plans to review whether gynecologists should conduct more cancer screening before common procedures such as hysterectomies, according to people familiar with the agency’s plans.
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“Paying For Value: Lessons From The Medicare Hospice Benefit”

Via Health Affairs BlogThe reimbursement system and the pathway of least resistance are aligned with “doing more” instead of focusing on in-depth conversations or formulating and executing plans of care that promote person- and family-centered care.
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Coping with Cancer

“Love Your Cancer Doctor? Get a Second Opinion”

Via New York Times Well BlogYou don’t think twice about getting multiple bids for a construction or plumbing project, so why hesitate on multiple “bids” for your health?

I learned the value of a second opinion a year and a half ago when two breast cancer surgeons presented me with very different treatment options.
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“The ‘Ross-Wonders’, Cancer’s New Superheroes”

Via ForbesYou’ve likely never heard the story of how three young women, who call themselves “ROS1ders” from a rare form of lung cancer they share, may be turning the nation’s 46-year-old war on cancer on its head. The women were diagnosed with a gene mutation called a ROS1 fusion. Less then 2 percent of lung cancer patients have that trait. They soon found out there was little research being conducted because of the difficulty in finding and collecting tissue samples. In other words they were stuck with existing treatments and a drug designed for other types of lung cancers. Their future did not look bright.
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“The Latest Look at FDA’s Breakthrough Designation Finds No Benefits from Cancer Meds”

Via STAT NewsThe idea of a breakthrough therapy was promoted to speed approvals of medicines that held promise for treating a life-threatening disease and demonstrated substantial improvement over existing drugs. However, a new study finds that while cancer drugs considered to be breakthroughs were approved more quickly, they were not safer, more novel, or more effective than drugs not given this designation.

The study examined 58 new cancer medicines that were approved by the Food and Drug Administration between 2012 and 2017. Of these, 25 — or 43 percent — received breakthrough therapy designation. The median time to a first FDA approval was 5.2 years for drugs that given a breakthrough designation versus 7.1 years for cancer medicines that were not considered to be breakthroughs.
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“Corners of the Immunotherapy Space are Getting Crowded. Is that a Problem?”

Via STAT NewsThere’s an overabundance of copycat drugs in the cancer immunotherapy space, with companies pouring millions into developing drugs that add only incremental value to patients.

That was the general consensus from a panel of biotech experts who spoke here Monday at the Milken Institute Global Conference — a commingling of Wall Street titans, policy wonks, industry leaders, and Hollywood elites. While excitement around harnessing the immune system to attack cancer is justifiable, they said, the way in which company resources are allocated in the immunotherapy space is skewed.

“The immuno-oncology field is too crowded,” said Pablo Legorreta, CEO of Royalty Pharma, a New York-based venture capital firm. “We don’t need 30 similar drugs, because a lot of them will become me-too drugs. And that’s not OK for patients.”
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