Several recurring themes surfaced during the meeting that participants identified as important policies issues in cancer. These themes included

  • providing IT to support a learning healthcare system;

  • determining new and financially sustainable models for cancer care;

  • facilitating patient-centered cancer research and care, including research that documents patient quality of life and care that consid­ers pain management and the support needed by caregivers;

  • restructuring the research, clinical, and regulatory arenas to address current challenges;

  • fostering precompetitive collaboration;

  • taking a global approach to both health research and regulation;

  • adopting standards of care and essential health benefits in the imple­mentation of the Affordable Care Act (ACA);1 and

  • advancing successful cancer risk reduction and prevention efforts.

Many of the panelists also put forth suggestions for policy actions to address the needs and challenges they had identified. For example, it was pointed out that although a goal of healthcare reform legislation was to reduce healthcare disparities, some provisions are not consistent in this regard. The ACA prohibits health insurers from denying an individual access to an “approved” clinical trial (including those funded by the National Institutes of Health [NIH]) and requires coverage for routine patient care costs in those trials; but the legislative provisions pertaining to Medicaid do not include such language, so low-income patients could still be denied access to novel therapies in clinical trials. Several panelists suggested that this could easily be remedied. However, Medicaid is administered at the state level, and many of the healthcare reform provisions will be implemented at the state level, so there likely will be 50 different approaches to healthcare reform and Medicaid coverage policies.

Participants identified several major challenges again and again, and offered similar potential solutions. For example, combination therapies that target multiple key pathways in cancer cells are increasingly seen as the primary hope for new breakthroughs in cancer treatment. Yet the


In this workshop summary, the Affordable Care Act refers to the final version of the healthcare reform law, including the Patient Protection and Affordable Care Act (P.L. 111-148) signed into law by President Barack Obama on March 23, 2010, and amended by the Health Care and Education Reconciliation Act of 2010 (P.L. 111-152) on March 30, 2010.

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