Cancer care in the U.S. faces a number of challenges involving care access, delivery and cost, despite making medical strides that resulted in a record number of cancer survivors in 2014, a new report finds.
Last year saw improvement in the five-year survival rates for many types of cancer that led to more than 14 million survivors, according to the findings of the American Society of Clinical Oncology's second annual State of Cancer Care in America report. More than 68% of cancer patients are living beyond five years compared to 49% in 1975.
“Patients need us to find better ways to pay for and incentivize high-quality, value-based care,” ASCO President Dr. Peter Yu said in a statement. “ASCO is currently developing and testing an alternative payment approach that reflects the current realities of oncology practices and ensures that patients receive the full range of services that are integral to their care.”
The U.S. Food and Drug Administration approved 10 new drugs in 2014, as well as four new medical devices and tests for earlier detection of cancer. In addition, more than 770 new cancer therapies are currently being developed that experts say show promise to deliver better health outcomes.
“There's a ton of new therapies that are coming down the pike,” said Dr. Philip Stella, medical director of the oncology program at St. Joseph Mercy Ann Arbor (Mich.) hospital during a webcast Tuesday. “The work in term of mapping the human genome has been incredible, and that has opened up all different avenues.”
At the same time, the outlook is uncertain in terms of meeting an increasing demand for oncology services, driven largely by an influx of newly insured patients and a population that is getting older and living longer, according to the analysis, which projects a 45% increase in cancer cases by 2030.
The report found large disparities among racial groups in terms of availability of cancer treatment services, with African-Americans 2.5% more likely to develop cancer compared to whites, but nearly 20% more likely to die from the disease.
Access issues are further compounded by an aging oncology workforce. Nearly one-fifth of medical oncologists in the U.S. are age 64 or older, making a shortage of providers likely in the coming years.
Also, clinicians report time spent dealing with insurance companies has shortened time they have available to see patients.
In 2014, cost pressures were a major concern among oncologists, driven largely by changes in the Medicare's push to change 90% of its fee-for-service payment system to a value-based reimbursement model by 2018. Over the last decade, the monthly cost of cancer treatment has more than doubled to $10,000, with some treatment priced at more than $100,000 a year.
The report provided a number of recommended strategies for improving cancer care including the implementation of innovative payment models, as well as calling on Congress to require health information technology vendors to create systems that can work together to allow for information exchange.
“This year's report clarifies multiple stresses in our nation's cancer-care system, but there is reason to be hopeful,” Yu said. “With this knowledge and insight, we can identify ways to ensure that all patients with cancer receive high-quality care—and help oncology practices adapt, survive and succeed in today's demanding healthcare environment.”
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