The focus of this article, primarily was to review the possibility and feasibility of having pre-approved pathways when treating certain cancers. Meaning that when a patient is diagnosed with cancer they apply for pre-approved treatment plans for that specific cancer. Medicare have developed piolet programs to see the feasibility of such programs. Overall, these pre-approved pathways would cut down on drug costs for the insurance company. It would decrease the need for the often time consuming process of pre-authorization. Many cancer patients face the issue of having to wait for an insurance company to approve a drug or treatment plan. The process often involves a lot of paper work as the patient needs to prove to the insurer that they need this drug or treatment plan and there are no alternative, cheaper methods. This process often can elongate a treatment for a patient and often influences the overall recovery of a patient. These pathways would also allow for a degree of variation from the pathways at a predefined value such as 20%. Thus, allowing for a degree variation to better serve a specific patient. These plans would also incentivize drug companies to lower the cost of drugs. For example, if two drugs are both shown to be effective in treating a specific cancer but one costs less than the other. Within these set oncological pathways often clinicians would utilize the cheaper drug. Leading drug companies to be competitive when pricing. Not only does the article talk about the pros of oncology pathways, but it discusses the cons as well.
One of the major cons is who decides what is approved in oncology pathways. Should it be the insurers we create these pathways, or should these pathways be designed by a group of physicians. Another issue presented was should physicians be allowed to utilize pathways that are accepted across all insurers, or should each individual insurer have their own unique approved pathways. The article went in to great detail about how physicians should control these oncology pathways. Yet, I think these pathways would greatly benefit by having input from a wide range of health professionals, including but not limited to pharmacists. More research needs to be done in terms of cost effectiveness of these oncology pathways. But, I think these pathways show promise in how healthcare is moving towards a more patient center focus.
Polite BN, Page RD, Nabhan C. Oncology Pathways—Preventing a Good Idea From Going Bad. JAMA Oncol. Published online February 04, 2016. doi:10.1001/jamaoncol.2015.5778.