Workshop Statement of Task and Agenda
STATEMENT OF TASK
An ad hoc committee will plan and host a 1.5-day public workshop that will feature panel discussions and invited presentations. Workshop participants will examine patient access to cancer therapies, with emphasis on cancer drug pricing, inflation in the cost of cancer drugs, differences among practice settings, and insurance benefit design. Participants will be invited to discuss topics that may include
- Structural factors influencing drug pricing, such as patents (regulated monopolies), the role of health insurance, and information asymmetries between patients and providers;
- Policy factors, such as cancer drug reimbursement and cost-sharing policies (e.g., co-pays and coinsurance), Medicare reimbursement policies and the legislative limitations on those policies, and state laws prohibiting restrictions on oncology drug prescribing;
- Cancer drug distribution channels and access programs, such as the 340B program and co-pay assistance programs; and
- Changing economics of oncology practice and the historic reliance on office-based drug prescribing for revenues.
The committee will develop the agenda for the workshop sessions, select and invite speakers and discussants, and moderate the discussions. An
individually authored workshop summary will be prepared by a designated rapporteur based on the information gathered and the discussions held during the workshop in accordance with institutional policy and procedures.
AGENDA
June 9, 2014
7:30 am | Registration |
8:00 am | Welcome from the Institute of Medicine’s National Cancer Policy Forum |
Michael Caligiuri, The Ohio State University Comprehensive Cancer Center | |
Chair, National Cancer Policy Forum | |
Overview of the Workshop | |
Peter B. Bach, Memorial Sloan Kettering Cancer Center | |
Planning Committee Chair | |
8:15 am | Session 1: Trends in Oncology Care |
Moderator: Barry Fortner, ION Solutions | |
Escalating drug prices | |
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Consolidation of practices into hospital partnerships/changing landscape of oncology practice | |
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The financial toxicity of cancer treatment: Can patients cope with costs? | |
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Drug shortages | |
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CMS reimbursement policies in oncology | |
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Panel Discussion | |
10:45 am | Break |
11:00 am | Keynote Address: Pharma pricing practices and the case for market self-correction |
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11:30 am | Lunch Break |
12:15 pm | Session 2: Paradoxes of Cancer Drug Reimbursement |
Moderator: Jeffery Ward, Swedish Cancer Institute | |
Brand name drugs vs. generics | |
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Oral vs. IV drugs | |
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340B vs. everyone else | |
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Private practice vs. hospital-based care | |
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Variable co-insurance and premiums | |
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Panel Discussion | |
2:45 pm | Break |
3:00 pm | Session 3: Value and Policy Options |
Moderator: Scott Ramsey, Fred Hutchinson Cancer Center | |
The patient perspective | |
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Value-based insurance design | |
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Bundling of payments | |
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Value-based drug pricing | |
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Lessons from the Health Evidence Review Commission, Oregon Health Authority | |
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Panel Discussion | |
5:30 pm | Adjourn |