The Economics of Genomic Medicine Workshop Summary (2013) / Chapter Skim
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6 Cancer Care
6 Cancer Care
Pages 49-58
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From page 49... ...
• Regulatory science needs to advance to be able to approve effective drugs with limited amounts of information. • Despite the value that genetic testing can produce, a relatively small number of patients with cancer receive such tests.
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From page 50... ...
. In discussing the second model of genomic information delivery in which targeted data plus other actionable information is provided, Offit described the Integrated Mutation Profiling of Actionable Cancer Targets screening model, which captures information on 230 cancer genes, though Sloan-Kettering is currently running this as a research arm only.
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From page 51... ...
Rather unrealistic." As an alternative, he pointed to a consent form developed at the University of Michigan that asks whether patients want to receive results "that do not have a direct impact on [the] care of my current cancer." Patients can choose to receive results "that may have significance for biological family members" or results "that are not related to your cancer but may have potential medical impact for you." Finally, Offit briefly mentioned the delivery of complete information from whole genome sequencing, including the incidentalome.
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From page 52... ...
In return, Eck said, drugs need to be used effectively in oncology, especially with so many being used off label for nonapproved indications with little to no evidence to support that use. To pay for schools, food, and other basic services, we must end the steady increases in the cost of health care, said Eck, and drug development could help control costs if it could bring drugs to market for less money.
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From page 53... ...
Drug companies and diagnostic testing companies need "to educate our doctors about all the new targeted treatments," Heimler said. "Doctors must recommend to all their cancer patients to have diagnostic testing for all available targeted treatments.
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From page 54... ...
This perception has an effect on research dollars, Heimler observed. According to the Lung Cancer Alliance, federal research funding per cancer death is $26,398 for breast cancers, $13,419 for prostate cancer, $6,849 for colon cancer, and just $1,442 for lung cancer.1 "I hope that in the years ahead we can change the perception of lung cancer in the general public, the medical profession, the government, and the media in order to generate a fair and proportionate share of research funding for this deadly disease.
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From page 55... ...
DISCUSSION A participant observed that the increasingly complex landscape of cancer genomes poses an immense informatics challenge to be able to aggregate, analyze, interpret, store, and share these data. Many cancer centers have strong data systems, but they tend to be siloed, sometimes even within centers.
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From page 56... ...
One participant proposed an economic study that would compare targeted treatment based on EGFR testing with standard approaches to therapy as a way of demonstrating the value of testing. He also observed that cancer is undergoing a paradigm shift away from a histological definition of cancer toward a molecular characterization, which makes it difficult to compare new approaches with the current standard of care.
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From page 57... ...
CANCER CARE 57 set up so that tests are done at the time of maximum value. A participant noted that CMS may accept a proposal to move toward a billing system that relies on a test-specific code, which could ease this problem.
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