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Differences Over Pathways Developed by Oncologists and MCOs May Create Conflict Over Prescribing Decisions in Early-Line Treatment
Date:8/28/2013

finds that clinical pathways developed by oncologists tend to focus on the more advanced stages of cancer, such as stage IV NSQ and squamous NSCLC. MCOs, however, are focusing their efforts on less advanced NSCLC and prostate cancer. MCOs that do have pathways in place for more advanced cancer tend to present narrower lists of permitted therapies, which could create conflict among oncologists who wish to prescribe off pathway. In fact, this concern over their prescribing was listed among the key challenges for oncologists currently taking part in pathways.

The report also finds that bundled payments and accountable care organizations (ACOs) appear to be growing in prominence as MCOs seek to control costs. Often tied to chemotherapy and other therapies, bundled payments also commonly cover physician visits, hospitalizations and radiology. Surveyed payers believe that bundled payments can achieve reduced drug spending of 16 percent and medical spending of 17 percent, likely stemming from a focus on more cost-effective treatment.

"Payers want to control their costs in NSCLC and prostate cancer and these strategies will likely affect prescribing decisions. Across clinical pathways, bundled payments and ACOs, we see that payers see substantial potential to reduce costs without hurting outcomes," said Decision Resources Senior Director Roy Moore. "To achieve these goals, oncologists will likely be urged to change their prescribing decisions, particularly around the use of branded therapies and generics. Marketers of branded therapies must therefore cater their marketing strategies to these themes or risk reduced prescribing from oncologists."

About Decision Resources
Decision Resources (www.decisionresources.com) is a world leader in market research publications, advisory services and consulting designed to help clients shape strategy, allocate resources and master t
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