Patient Access to Cancer care Excellence

A Global Vision

Faster steps forward: towards cures for cancer and access to best treatment and care for individual patients.

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A cancer diagnosis will directly impact 1 in 2 men and 1 in 3 women in the United States in their lifetime. What's more, the number of new cases is projected to double by 2050. To better inform people about something that hits so close to home for many, I recently discussed the value of cancer care in a three-part blog series.

Part 1 covered patient viewpoints in value assessments, acknowledged the innovation that's improved lives and accounted for the evolution of a medicine's value over time. Part 2 examined patient-reported outcomes and how they impact the analysis of new treatments for cancer and other diseases. Now, in the third and final blog in the series, I'll discuss how value plays an important role when patients consider treatment options.

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Rheumatoid arthritis, lupus, multiple sclerosis, breast cancer, cervical cancer, ovarian cancer. What do all of these have in common? Each disproportionately affects women. Men and women actually experience differences in health risks, disease rates and life expectancy. The medical community understands some of these, but doctors and researchers don't have enough documentation or data to determine differences in sex-based responses to treatments.

With a balanced representation of men and women in clinical trials, companies would better understand how factors like dosage and efficacy contribute to the gender difference.

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If you're battling cancer, you want to arm yourself with every tool necessary to fight the disease. You want to know what to expect each step of the way, including treatment options, side effects, and timelines. And you want to learn from other patients, and hear first-hand accounts to help inform your own treatment decisions.

Last week, I discussed the patient's perspective in evaluating a cancer treatment's value. This week, I want to talk about why it's important to include patient-reported outcomes in the value equation. Patient-reported outcomes include details of a person's treatment, symptoms or condition status that they share directly--without clinical interpretation. They include accounts that only the patients themselves experience, such as fatigue, nausea, depression or pain.

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Gabrail Headshot 3.jpgToday's guest blog comes from Nashat Gabrail, MD. He is board certified in internal medicine and oncology. Nashat operates the Gabrail Cancer Center in Canton, Ohio, and is a board member of the Coalition for Clinical Trials Awareness. A version of this post originally appeared on the Campaign for Modern Medicines blog.

During medical society meetings and presentations by colleagues, I often see PowerPoint slides on recommended courses of care. The slides inevitably look the same: First line of care--therapy A, second line of care--therapy B, third line of care--therapy C. And then, at the very bottom--clinical trials.

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I've often discussed the relationship between value and cost of new medicines--specifically, that cost isn't the only factor to consider when attempting to measure the value of a cancer treatment. After all, people with cancer may define value differently, since they have their own personal perspective. The value and impact of a medicine also changes over time, as it may become effective in new scenarios or in combination with other treatments.

That being said, we can't ignore the cost of medicines when discussing how new treatments impact people with cancer. In a recent article on Medscape, Dr. Brandon Smaglo of Washington, D.C. shares how a visit with one of his patients - who completed her treatments - turned into a dialogue about the cost of that cure. "She is, by all of our assessments, cured of her cancer," Dr. Smaglo writes. "But the ongoing financial debt of her treatment has overwhelmed her."

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