scout

April 2016

A newly proposed drug reimbursement plan from The Centers for Medicare & Medicaid has oncology associations up in arms, whereas a well-known patient advocate and oncologist says he sees method in the payment scheme.

A profusion of so-called “liquid biopsy” tests that extract circulating tumor cells, cell-free DNA, or exosomes from blood and urine are under investigation at research institutions and startup firms, and in some cases are already being used to supplement or replace traditional biopsies.

The ongoing value transition got a bit more real in March when The Centers for Medicare & Medicaid Services introduced a proposal for Medicare Part B drug payment changes that would even out the margins that physicians make on drug sales.

Oral parity legislation for getting newer drugs to patients under similar coverage terms as for older drugs often involves a battle that doesn’t stop when a law is passed.

A mandate enacted after the 2010 Patient Protection and Affordable Care Act was supposed to improve health coverage for patients enrolled in clinical trials; however, nearly 63% of cancer centers and organizations that responded to a recent survey reported insurance denials of routine care costs associated with patient involvement in clinical trials during 2014.