On August 16, the Journal of Oncology Practice (JOP) published a joint guidance statement from ASCO and the American Academy of Hospice and Palliative Medicine (AAHPM) regarding high-quality palliative care as delivered as part of routine cancer care. PHAR supported the development of this important guidance by moderating a meeting of experts using the RAND/UCLA modified Delphi panel process. With this method, over 900 potential palliative care services were rated by more than 20 participants on multiple dimensions. Those services which were both highly ranked and which had a high level of agreement were included in the final guidance. Read the full study here.
News
PHAR’s Study Finds that Drug Sales Predictions are Overestimated by Billions of Dollars
A new PHAR study compared predictions of health care costs made prior to the introduction of new drugs to the actual sales of the drugs. Fourteen drugs were examined: two cholesterol lowering drugs; three drugs to treat various forms of cancer; three for hepatitis C; two for obesity management; and one each for cystic fibrosis, heart failure, psoriasis, and diabetes. In many cases, sales predictions were dramatically overestimated, sometimes by billions of dollars. In one example, the Institute for Clinical and Economic Review (ICER) predicted the one-year cost of the two PCSK9 inhibitors would be $7.2 billion. Based on the initial quarters of reported sales, PHAR found that the actual number will be closer to $83 million, an overestimate of $7.1 billion. Asked to comment on the findings, Dr. Broder said, “Overestimating drug costs by so much cannot lead to good decision making… it is likely that patients feel the negative effects of such predictions in the form of early access restrictions and higher copayments.” More details about the study are available here.
Strong Research Presence at ATS 2016
In association with the researchers at Genentech, Inc., studies conducted by PHAR were a strong presence at the American Thoracic Society Conference (ATS) 2016. One was selected as an oral presentation and three were presented as posters. The study chosen for oral presentation reported on the overall in-hospital mortality, length of stay (LOS), and hospitalization cost in patients with IPF admitted to hospitals in the US, and the posters presented a more in-depth set of data on the mortality and resource utilization of IPF. A study on whether allergic status is associated with increased number of asthma exacerbations was also presented. The posters can be accessed on the PHAR website here.
PHAR Finds New Oncology “Value Frameworks” May Not Be Reliable
In response to the rise of effective but expensive new cancer treatments, several organizations have put forth “value frameworks” for oncology. These frameworks, produced by organizations including the American Society of Clinical Oncology (ASCO), the European Society for Medical Oncology (ESMO), and the Institute for Clinical and Economic Review (ICER), are tools designed to help doctors, patients, and insurance companies determine how much value a treatment provides relative to its cost. Researchers at PHAR, Tufts, UCLA, and Memorial Sloan Kettering Cancer Center, collaborating on the first published evaluation of the reliability of these frameworks, found only fair to good consistency between different individuals using the same framework to evaluate the same drug. They also found that using each of the three different frameworks could lead to significantly different conclusions about the relative value of cancer treatments. These findings suggest it may be premature to use these value frameworks in treatment decision-making without further evidence of their reliability and validity. The study results were presented at the 2016 ASCO meeting.
PHAR Poster on Cystic Fibrosis Awarded Bronze Medal at AMCP 2016
This retrospective study used insurance claims data to examine the extent of twice-daily use of dornase alfa among cystic fibrosis patients. The study was done in partnership with researchers at Genentech, Inc. and presented at Academy of Managed Care Pharmacy Managed Care & Specialty Pharmacy Annual Meeting in San Francisco. See the full poster here.
PHAR Studies on a Variety of Conditions Presented at AMCP 2016
Five studies conducted by teams at PHAR were presented at the Academy of Managed Care Pharmacy Managed Care & Specialty Pharmacy Annual Meeting in San Francisco. These studies cover a wide range of diseases and methods including cost effectiveness study of treatments for peripheral t-cell lymphoma, an analysis of insurance claims among cystic fibrosis patients, and an examination of patients with idiopathic pulmonary fibrosis using the National Inpatient Sample. The five posters can be found here.
Cushing’s Disease Research Selected for Oral Presentation at ENDO 2016
A study conducted by the researchers at PHAR was selected for oral presentation at Endocrine Society’s 2016 Annual Meeting in Boston in April. The study used data from medical records at 8 US endocrine centers to describe treatment outcomes for Cushing’s Disease patients . The findings of the study can be viewed here. Including this one, there were 5 poster presentations of studies by PHAR. All posters presented at ENDO can be accessed here.
Abstract Highlighted in ASH Daily Report
An abstract submitted by researchers at PHAR and Jazz Pharmaceuticals was highlighted by the American Society of Hematology (ASH) at their 57th Annual Meeting. The study estimated the total 100-day and one-year costs associated with inpatient hematopoietic stem cell transplantation, stratified by type of conditioning regimen and other potential contributors to cost. Researchers found that total per patient healthcare costs ranged from $182,000 to $409,000 in the one-year period post transplant. The poster can be accessed here.
PHAR Study Takes AMCP Silver Medal 2 Years in a Row
For the second year in a row, PHAR was presented with a Silver Medal by the Academy of Managed Care Pharmacy. This year, the award was for a study on health care resource use and costs associated with high OCS use in patients with asthma, conducted by researchers at PHAR and Genentech, Inc., The retrospective claims analysis found that high OCS use was associated with significantly higher costs than no OCS use, especially in patients with possible side effects in the high OCS use cohort. The study can be viewed here.
Economic Impact Study on Carcinoid Syndrome Presented at NANETS
Carcinoid syndrome describes the hormonal effects of carcinoid tumors, including the secretion of serotonin into the systemic circulation causing episodic diarrhea. Despite the frequent occurrence of this symptom, the healthcare costs and utilization associated with non-infectious diarrhea has not been elucidated. The researchers at PHAR and Novartis Pharmaceuticals Corporation presented their study on the economic impact of Non-Infectious Diarrhea in Patients with Carcinoid Syndrome at the 2015 North American Neuroendocrine Tumor Society’s Annual Symposium. They found that non-infectious diarrhea in newly-diagnosed carcinoid syndrome patients is associated with a significantly increased annual healthcare utilization and an additional $30,000 in total annual healthcare costs. The poster can be viewed here.