J Manag Care Spec Pharm. 2018 Jun;24(6):572-578. doi: 10.18553/jmcp.2018.24.6.572.
Cancer is one of the most costly medical conditions to treat in the United States due in part to increasingly innovative, but expensive, chemotherapeutic, immuno-oncologic, and biologic treatments. At the same time, health insurance in the United States is increasingly shifting a larger part of the costs to patients through higher premiums, deductibles, and coinsurance and copayment rates. These shifts are driving the need for quality measures and value measurements in oncology that assess the total effect on care and can be used to develop payment models. Measures that consider the patient's experience are emerging as important factors for evaluating value in cancer care. To address these issues, the Academy of Managed Care Pharmacy (AMCP) convened a stakeholder forum, Driving Value and Outcomes in Oncology, on November 14-15, 2017, in Arlington, Virginia. The goals of the forum were to (a) understand which oncology-specific quality measures are important for managed care decision makers; (b) prioritize the gaps related to the use of pharmaceuticals in measuring oncology outcomes; (c) develop a list of recommendations for how a collaboration of payers, providers, and AMCP may drive improvements in oncology care; and (d) define solutions for addressing causes of patient financial burdens for cancer care. More than 30 national and regional health care leaders representing health plans, integrated delivery systems, pharmacy benefit managers, pharmacists, employers, patient advocates, national professional associations, and biopharmaceutical companies participated in the forum.
This AMCP Partnership Forum and the development of this proceedings report were supported in collaboration with Abbvie, Amgen, AstraZeneca, Foundation Medicine, Genentech, Gilead, Eli Lilly, Merck, Sanofi, Takeda Oncology, and Xcenda.
在美国,癌症是治疗费用最高的医疗条件之一,部分原因是化疗、免疫肿瘤学和生物治疗越来越创新,但费用也越来越高。与此同时,美国的健康保险通过提高保费、免赔额、自付额和共付额,将越来越多的成本转嫁给患者。这些转变推动了肿瘤学领域需要进行质量措施和价值测量,以评估对护理的总体影响,并可用于开发支付模式。考虑患者体验的措施正在成为评估癌症护理价值的重要因素。为了解决这些问题,管理式医疗药剂师协会(AMCP)于 2017 年 11 月 14 日至 15 日在弗吉尼亚州阿灵顿召开了一次利益攸关方论坛,题为“推动肿瘤学的价值和结果”。该论坛的目标是:(a)了解对管理式医疗决策者而言,哪些特定于肿瘤学的质量措施很重要;(b)确定与使用药品衡量肿瘤学结果相关的差距;(c)制定关于支付方、服务提供方和 AMCP 如何合作改善肿瘤学护理的建议清单;(d)确定解决癌症护理患者经济负担的方法。超过 30 名代表健康计划、综合交付系统、药品福利管理公司、药剂师、雇主、患者权益维护者、国家专业协会和生物制药公司的全国和地区卫生保健领导人参加了该论坛。
此次 AMCP 合作论坛及其相关报告的编写工作得到了 Abbvie、Amgen、AstraZeneca、Foundation Medicine、Genentech、Gilead、Eli Lilly、Merck、Sanofi、Takeda Oncology 和 Xcenda 的支持与合作。