Thousands of cancer experts from around the world have been meeting in Chicago since Friday for the annual conference of the American Society of Clinical Oncology. The meeting brings together leading researchers and practicing clinicians to discuss trends in the field, from treatment breakthroughs to the dramatic differences among patients who might share certain demographic traits but whose personal circumstances — physical, emotional, social and otherwise — demand individualized approaches to care.
There have been a number of discussions focused on how to control costs while improving quality, something that's top of mind for providers in every health care sector. "Just about everybody accepts the idea that health care is about value," said Harvard Business School Professor Michael E. Porter. "We've won the intellectual battle. Now, it's the execution."
Defining value in oncology is especially complicated given the many forms cancer can take, the many treatment options available and the many variables that must be considered when making care decisions.
Diane Blum, senior vice president of social services at the National Executive Service Corps, notes that the cost of cancer treatment is expected to hit $158 billion a year by 2020, spurred to a significant degree by soaring drug costs. Previously, Blum was executive director of CancerCare, CEO of the Lymphoma Research Foundation and editor-in-chief of Cancer.Net.
Bringing patients into the decision-making process is an important step toward improving value. Research shows that effective patient engagement not only improves things like medication adherence and satisfaction scores, it often leads to lower-cost treatment choices.
In an editorial in the ASCO Daily News, which is distributed during the conference, Blum points out the complexity in discussing value with oncology patients. She cites the "triple whammy" described by Peter Ubel, M.D., of Duke University, which involves "a combination of high emotional intensity that accompanies talking about a cancer diagnosis, the unusual situation of discussing money with a physician, and the need to balance personal and family financial security with the opportunity for a positive medical outcome and survival."
Clinicians must hone their communication skills so they can discuss with their patients the value of treatments directly, honestly and with sensitivity to their emotional states, Blum says.
One big factor that is increasingly a challenge in oncology, including in the effort to enhance value, is the aging of the American population. Over the weekend, I sat in on a wide-ranging and fascinating discussion on the subject. I'll talk about that in tomorrow's H&HN Daily.