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Assessing and Improving Value in Cancer Care: Workshop Summary (2009)

Chapter: Appendix A: Workshop Agenda

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Suggested Citation:"Appendix A: Workshop Agenda." Institute of Medicine. 2009. Assessing and Improving Value in Cancer Care: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/12644.
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Page 125
Suggested Citation:"Appendix A: Workshop Agenda." Institute of Medicine. 2009. Assessing and Improving Value in Cancer Care: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/12644.
×
Page 126
Suggested Citation:"Appendix A: Workshop Agenda." Institute of Medicine. 2009. Assessing and Improving Value in Cancer Care: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/12644.
×
Page 127
Suggested Citation:"Appendix A: Workshop Agenda." Institute of Medicine. 2009. Assessing and Improving Value in Cancer Care: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/12644.
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Page 128

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Appendix A Workshop Agenda Assessing and Improving Value in Cancer Care A National Cancer Policy Forum Workshop Monday and Tuesday, February 9 and 10, 2009 NAS Lecture Room National Academy of Sciences Building 2100 C Street, NW Washington, DC Day One 8:00 a.m. W  elcome, Introductory Remarks: What Is Value in Cancer Care? Why Is It Important? Scott D. Ramsey, Fred Hutchinson Cancer Research Center 8:20 P  hysician–Patient Communication and Its Influence on Value Moderator: Allen S. Lichter, American Society of Clinical Oncology 8:25 Inside the Physician–Patient Discussion in Cancer Care Speaker: Anthony Back, University of Washington 8:55 Invited Comments from Diane Blum, CancerCare 9:00 C  an We Communicate Effectively with Cancer Patients About the Benefits and Risks of Cancer Treatments? Speaker: Peter A. Ubel, University of Michigan 125

126 assessing and improving value in cancer care 9:30  Invited Comments from Mary McCabe, Memorial Sloan-Kettering Cancer Survivorship Program 9:35 T  herapy for Advanced-Stage Cancer: What Do Patients Want and Expect? Speaker: Robert Erwin, Marti Nelson Cancer Foundation 10:05  Invited Comments from Ellen Stovall, National Coalition for Cancer Survivorship 10:10 Discussion 10:40 10-Minute Break 10:50 Generating Evidence About Effectiveness and Value Moderator: Steven B. Cohen, Agency for Healthcare Research and Quality 10:55 FDA Perspectives on Evidence for Regulatory Approval in Cancer Speaker: Janet Woodcock, Food and Drug Administration 11:25 What Constitutes Reasonable Evidence of Efficacy and Effectiveness? Speaker: Daniel J. Sargent, Mayo Clinic 11:55 Discussion 12:25 p.m. Lunch 1:00 Value and the Oncology Market Moderator: Jeffrey C. Lerner, ECRI Institute 1:05 D  rug Pricing and Value in Oncology vs. Other Areas in Medicine Speaker: Patricia M. Danzon, University of Pennsylvania 1:35 Industry Perspective on Pharmaceutical Pricing in Oncology Speaker: Greg Rossi, Genentech, Inc.

Appendix A 127 2:05 Cost Implications: Strategies to Enhance Value in Oncology Speaker: Deborah Schrag, Dana-Farber/Harvard Cancer Center 2:35 Discussion 3:20 10-Minute Break 3:30 Value in Cancer Practice: Health Insurer Perspectives Moderator: Scott D. Ramsey, Fred Hutchinson Cancer Research Center 3:35 Oncologists’ Perception of Value in Oncology Speaker: Peter J. Neumann, Tufts Medical Center 4:05 Paying for New Cancer Treatments: Rights and Responsibilities of Health Insurers Speaker: Lee Newcomer, United Healthcare 4:35 European Experience and Perspectives on Evaluating Value for Oncology Products Speaker: Michael Drummond, Centre for Health Economics, University of York 5:05 Discussion 5:50 Adjourned for the day Day Two 8:00 a.m. Ethical Issues for Value-Based Decision Making in Oncology Moderator: Harold L. Moses, Vanderbilt-Ingram Cancer Center 8:05 Ethical Issues When Considering Insurance Coverage Based on Value in the Treatment of Cancer Speaker: Dan W. Brock, Harvard Medical School

128 assessing and improving value in cancer care 8:35 Patient–Physician Communication on Therapy Options for Cancer: Ethical Issues Speaker: Neil S. Wenger, University of California, Los Angeles 9:05 Discussion 9:35 10-Minute Break 9:45 Improving Value in Oncology Practice: Ways Forward Moderator: Lou Garrison, University of Washington 9:50 V  alue-Based Insurance Design—Initiatives Outside of Oncology Speaker: Michael Chernew, Harvard Medical School 10:20 G  enerating Evidence of Value Post-FDA Approval: Is There a Role for Health Insurers? Speaker: Sean R. Tunis, Center for Medical Technology Policy 10:50  There Ways to Improve the Value of Cancer Care Are That May Work at the Bedside? Speaker: Thomas J. Smith, Virginia Commonwealth University 11:20 Discussion Working Lunch 12:05 p.m.  Toward a Shared Understanding of Value: Can We Agree, and Does Perspective Matter? Moderator: Peter Bach, Memorial Sloan-Kettering Cancer Center Panel: All Moderators 1:30 Meeting Adjourned

Next: Appendix B: Speaker and Moderator Biographies »
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Unlike many other areas in health care, the practice of oncology presents unique challenges that make assessing and improving value especially complex. First, patients and professionals feel a well-justified sense of urgency to treat for cure, and if cure is not possible, to extend life and reduce the burden of disease. Second, treatments are often both life sparing and highly toxic. Third, distinctive payment structures for cancer medicines are intertwined with practice. Fourth, providers often face tremendous pressure to apply the newest technologies to patients who fail to respond to established treatments, even when the evidence supporting those technologies is incomplete or uncertain, and providers may be reluctant to stop toxic treatments and move to palliation, even at the end of life. Finally, the newest and most novel treatments in oncology are among the most costly in medicine.

This volume summarizes the results of a workshop that addressed these issues from multiple perspectives, including those of patients and patient advocates, providers, insurers, health care researchers, federal agencies, and industry. Its broad goal was to describe value in oncology in a complete and nuanced way, to better inform decisions regarding developing, evaluating, prescribing, and paying for cancer therapeutics.

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