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Zeichner SB, Kohn CG, Goldstein DA. Economics of ramucirumab for metastatic colorectal cancer. Expert Rev Pharmacoecon Outcomes Res 2016; 16:733-745. [PMID: 27828732 DOI: 10.1080/14737167.2016.1259070] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2016] [Accepted: 11/07/2016] [Indexed: 12/20/2022]
Abstract
INTRODUCTION Despite its FDA approval and incorporation into the National Comprehensive Cancer Network (NCCN) treatment guidelines, ramucirumab (RAM) is associated with a drug acquisition cost that is substantially higher than other approved options. Given its substantial cost, the presence of a viable alternative treatment option, and its minimal survival improvement, the usefulness of RAM in clinical practice has been called into question. Areas covered: In this paper, we outline the cost, benefits, and economic implications of RAM from a US perspective, as it is used in the treatment of mCRC. We also dissect its use in other tumor types and in other healthcare systems around the world, and briefly compare it with similar drugs targeting the vascular endothelial growth factor pathway. We used the search engine PubMed using the following as search terms: cost-effectiveness; ramucirumab; metastatic colon cancer; angiogenesis; and value-based medicine. Expert commentary: The use of ramucirumab in the treatment of mCRC serves as a microcosm of the worsening healthcare crisis within the US and the ongoing controversy regarding oncology drug costs, benefits, and value. Therefore, there must be a joint effort in moving towards value based pricing models.
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Affiliation(s)
- Simon B Zeichner
- a Division of Hematology & Oncology , Winship Cancer Institute at Emory University , Atlanta , GA , USA
| | - Christine G Kohn
- b Hartford Hospital Evidence-Based Practice Center , University of Saint Joseph School of Pharmacy & UConn , Hartford , CT , USA
| | - Daniel A Goldstein
- a Division of Hematology & Oncology , Winship Cancer Institute at Emory University , Atlanta , GA , USA
- c Davidoff Cancer Center , Rabin Medical Center , Petah Tikva , Israel
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Kantarjian HM. The Affordable Care Act, or Obamacare, 3 years later: A reality check. Cancer 2016; 123:25-28. [DOI: 10.1002/cncr.30384] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2016] [Accepted: 09/09/2016] [Indexed: 11/09/2022]
Affiliation(s)
- Hagop M. Kantarjian
- Department of Leukemia; The University of Texas MD Anderson Cancer Center; Houston Texas
- Health Policies, Baker Institute at Rice University; Houston Texas
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Saluja S, Zallman L, Nardin R, Bor D, Woolhandler S, Himmelstein DU, McCormick D. Support for National Health Insurance Seven Years Into Massachusetts Healthcare Reform: Views of Populations Targeted by the Reform. INTERNATIONAL JOURNAL OF HEALTH SERVICES 2015; 46:185-200. [PMID: 26536912 DOI: 10.1177/0020731415615314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Before the Affordable Care Act (ACA), many surveys showed majority support for national health insurance (NHI), also known as single payer; however, little is currently known about views of the ACA's targeted population. Massachusetts residents have had seven years of experience with state health care reform that became the model for the ACA. We surveyed 1,151 adults visiting safety-net emergency departments in Massachusetts in late 2013 on their preference for NHI or the Massachusetts reform and on their experiences with insurance. Most of the patients surveyed were low-income and non-white. The majority of patients (72.0%) preferred NHI to the Massachusetts reform. Support for NHI among those with public insurance, commercial insurance, and no insurance was 68.9%, 70.3%, and 86.3%, respectively (p < .001). Support for NHI was higher among patients dissatisfied with their insurance plan (83.3% vs. 68.9%, p = .014), who delayed medical care (81.2% vs. 69.6%, p < .001) or avoided purchasing medications due to cost (87.3% vs. 71.4%; p = .01). Majority support for NHI was observed in every demographic subgroup. Given the strong support for NHI among disadvantaged Massachusetts patients seven years after state health reform, a reappraisal of the ACA's ability to meet the needs of underserved patients is warranted.
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Affiliation(s)
- Sonali Saluja
- Department of Medicine, Cambridge Health Alliance, Harvard Medical School, Massachusetts, USA
| | - Leah Zallman
- Department of Medicine, Cambridge Health Alliance, Harvard Medical School, Massachusetts, USA Institute for Community Health, Cambridge, Massachusetts, USA
| | - Rachel Nardin
- Department of Neurology, Cambridge Health Alliance, Harvard Medical School, Massachusetts, USA
| | - David Bor
- Department of Medicine, Cambridge Health Alliance, Harvard Medical School, Massachusetts, USA
| | - Steffie Woolhandler
- City University of New York, School of Public Health at Hunter College, New York, USA Department of Medicine, Cambridge Health Alliance, Harvard Medical School, Massachusetts, USA
| | - David U Himmelstein
- City University of New York, School of Public Health at Hunter College, New York, USA Department of Medicine, Cambridge Health Alliance, Harvard Medical School, Massachusetts, USA
| | - Danny McCormick
- Department of Medicine, Cambridge Health Alliance, Harvard Medical School, Massachusetts, USA
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