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Not surprisingly, given the rate at which new FDA approvals are granted, the majority of clinicians prescribed a newly FDA-approved drug in the previous year, with 20% prescribing at least ten new drugs, according to OBRs Oncology Drug Report 2022. The latter metric demonstrates how quickly the world of cancer care is evolving, which has a number of important implications for oncology practice.

According to a survey conducted by the Association for Clinical Oncology, the majority of respondents (96%) said prior authorization has led to delays in cancer treatment, with 80% claiming prior authorization has enabled disease progression, and 36% of them saying prior authorization has led to patient deaths. 300 ASCO members who work in academic or university (29%) settings, private practice (34%), or community or hospital-based health network/systems (35%), completed the survey.

A video conversation between a senior advisor at ADVI, a physician from Texas Oncology, and the division director of practice health for ASCO discuss the main provisions of the Inflation Reduction Act (IRA) and its implications for oncologists and oncology practices. The panel discusses why practices may have to bear a larger share of the cost of drugs and be ready for utilization cuts by focusing on two important aspects of the IRA: the $2,000 cap on patients’ out-of-pocket expenses and Medicare price negotiation. All three concur that if the act isn’t changed, it might slow down the development of medicines for some indications.

“The perfect storm of lazy MDs, an incompetent ASA and the dramatic taming of the traditionally wild surgical procedures and advances in anesthesia have set up the perfect stage for the aggressive takeover of the specialty by the nursing realm, where it all started in the first space. Today’s MD anesthesiologists have ceded control of the specialty and are rightly a footnote in history—not ‘misunderstood’ at all, as Dr. Sherer would have us believe.”

Mikkael A. Sekeres, MD, currently Chief of the Division of Hematology at the Sylvester Comprehensive Cancer Center at the University of Miami, worked on the decision to remove Avastin’s indication for the treatment of HER2-negative metastatic breast cancer in 2008. As a result of the hearing, Dr. Sekeres poses the following question in his most recent book, Drugs and the FDA: Safety, Efficacy, and the Public’s Trust: “Had the FDA made a mistake in initially approving the drug?” Dr. Sekeres discussed with OBR the rise of accelerated approvals, progression-free survival as an endpoint, and the consequences of the Avastin hearing.

In a study of parenteral cancer drug pricing at 61 NCI-designated cancer centers, median price markups on 25 commonly used drugs ranged from approximately 120% to 630% over acquisition cost. The paper’s authors recommend public policy prohibiting excessive markup on parenteral chemotherapies as a means to reduce unnecessary financial burden on patients.