Resources for Medical Directors from Purchasers (Employers), Plans and Provider Systems

   

We have put together a list of web links that are helpful to medical directors from Purchasers (Employer), Plans, and Provider Systems. These links will be useful in the management of oncology patients and developing benefits and medical policies in Oncology. NAMCP, and /  or this website, does not provide medical advice, diagnosis or treatment. NAMCP does not endorse or imply endorsement of the content on any linked website. This website is to be used as an informational resource. With any health-related concern, consult with your physician or healthcare professional.

The 340B Drug Discount Program: A Review and Analysis of the 340B Program
Congress created the 340B program in 1992 to help uninsured indigent patients gain better access to prescription medicines. To achieve that goal, Congress created a program that requires pharmaceutical manufacturers to provide discounts on outpatient prescription drugs to entities that serve high numbers of uninsured indigent patients. This program, as originated, provided discounts to outpatient facilities for the purpose of sustaining certain services to this population. 340B is important today and going forward for the many patients who are dependent on this program. This white paper examines the history and original intent of the program as well as highlights key findings to help policymakers ensure that the 340B program meets its stated purpose and to provide a roadmap for next steps to be considered.
Click here to access the white paper. The white paper is a publication of the following organizations: the Biotechnology Industry Organization (BIO), the Community Oncology Alliance (COA), the National Community Pharmacists Association (NCPA), National Patient Advocate Foundation (NPAF), the Pharmaceutical Care Management Association (PCMA) and the Pharmaceutical Research and Manufacturers of America (PhRMA). Avalere Health performed supporting research and data analysis and compiled findings. The views expressed herein are those of the sponsoring organizations.

A Tactical Tool for the Oncology Nurse Navigator
Eisai launched the NSider Patient Education Tool (NSider®) in 2010. Eisai created NSider with a team of oncology nurses who had in-depth professional and, in some cases, personal experiences with cancer. NSider® is an online nursing resource designed to help nurses provide patients and their caregivers with information tailored to their needs and situations associated with living with cancer. The objectives of NSider® were to create a program that was at once comprehensive, but not overwhelming or impersonal, and to support the relationship between patients and nurses and underscore Eisai’s commitment to humanizing healthcare. Nurse navigators can register at
www.nsidernurses.com Click here to access the white paper by the Academy of Oncology Nurse Navigators.

 

An Employer's Guide to Cancer Treatment and Prevention: Executive Summary
Over the course of three years, the National Business Group on Health, in coopera­tion with the National Comprehensive Cancer Network® (NCCN®), is addressing the growing impact of cancer in the workplace by developing An Employer’s Guide to Cancer Treatment & Prevention (The Guide). The Guide is a comprehensive set of tools designed to help benefit managers deal effectively with the many issues about cancer that arise in the workplace. The Practice Recommendations represent a fusion of NCCN’s evidence-based clinical guidelines with employer-sponsored health care benefits, programs and practice recommendations.
 http://www.businessgrouphealth.org/pdfs/CancerSummary.pdf

 

An Employer’s Guide to Cancer Treatment and Prevention: Tool 1: Quick Reference Guide and Assessment
Today, more than ever before, employers are facing the growing impact of cancer in the workplace. This change is the result of several factors: an increased incidence of cancer among employees because of an aging workforce and delayed retirement; an increase in the number of employees assuming caregiving roles for family members; and reduced productivity during treatment and recovery for employees with cancer and for those caring for loved ones. With the rising direct and indirect costs associated with cancer, financial impacts also have increased. At times, too, employers must deal with the potential loss of valued employees.
 

Cancer casts a wide net, affecting not only those diagnosed with the disease, but those who care about that individual: family members, friends, managers and co-workers. The impact on a company’s culture and even its viability can be profound.  

To address these growing needs, a clear, comprehensive strategy for employees with cancer and their caregivers must be considered. Through careful design and implementation of benefits and astute selection of vendors, employers can meet these needs and have a positive impact on all those affected by cancer in their workforce.
http://businessgrouphealth.org/pdfs/Quick%20Reference%20Guide%20and%20Assessment.pdf

 

 An Employer’s Guide to Cancer Treatment and Prevention: Tool 2: Plan Design & Assessment Tool   http://businessgrouphealth.org/pdfs/CancerTool2.pdf

           

Employer’s Guide to Cancer Treatment and Prevention: Tool 3, Part I: Request for Proposal (RFP) Questions and Requested Evidence for Vendors 
http://businessgrouphealth.org/pdfs/CancerTool3PartI.pdf

           

An Employer’s Guide to Cancer Treatment and Prevention: Tool 3, Part II: Request for Proposal (RFP) and Response Evaluation for Employers 
http://businessgrouphealth.org/pdfs/Tool%203%20Part%20II.pdf

 

An Employer's Guide to Cancer Treatment and Prevention: Tool 4: Summary Plan Description (SPD) Guidance  http://businessgrouphealth.org/pdfs/CancerTool4.pdf

 

An Employer’s Guide to Cancer Treatment and Prevention: Tool 5: Vendor Contracting and Administration  http://businessgrouphealth.org/pdfs/CancerTool5.pdf

           

An Employer's Guide to Cancer Treatment and Prevention: Tool 6: Evaluation and Plan Reporting 
http://businessgrouphealth.org/pdfs/CancerTool6.pdf

  

Pathways to Managing Cancer in the Workplace
As the U.S. workforce ages, more working-age adults are being diagnosed with cancer. At the same time, as early detection and treatment methods for some cancers have improved, the num­ber of people surviving cancer has increased, and for many individuals cancer has become more like a chronic disease. This is good news for cancer patients and their families. It also bodes well for employers, since increased survivorship means they are able to retain valuable employees in the workplace for longer periods of time.  

However, this scenario has its challenges, too. Increased survivorship means that both employ­ers and employees must bear the cost of cancer treatment for a greater length of time. Since the expense of treating cancer is often very high, this may present both parties with serious financial costs. A recent study showed that in a typical commercial population only 0.68% of members have claims for cancer in a year. Yet these claims account for about 10% of all medical costs.  

Cancer also affects those close to the patient, such as family members and caregivers, who will be challenged to deal with sadness and feelings of help­lessness when a loved one is seriously ill. This may have consequences for the workplace, too, since seven in ten caregivers report making changes such as cutting back on their hours, chang­ing jobs, stopping work entirely or taking a leave of absence as a result of their caregiver role. 

This guide provides employers with practical ways to support employees who have cancer as well as those who are taking care of family members with the disease. The guide will assist employers as they implement a full spectrum of benefits and programs. http://businessgrouphealth.org/pdfs/FINAL_Pathways_Managing_Cancer_2011.pdf

           

A Guide for Employers: Using Comparative Effectiveness Research 
This guide provides actions for employers who want to use comparative effectiveness research (CER) findings about breast biopsy in their health plans and programs. It is based on research funded by the federal Agency for Healthcare Research and Quality (AHRQ).

Core-Needle Biopsy for Breast Abnormalities
http://businessgrouphealth.org/pdfs/FINAL_BreastBiopsy_NBGH_AHRQ_June2011.pdf 

Treatments for Clinically Localized Prostate Cancer
http://businessgrouphealth.org/pdfs/FINAL_Prostate%20Guide_NBGH_AHRQ_June2011.pdf

Health Tips: Childhood Cancer: How Employers Can Help Meet the Needs of Parents and Children
When a child of one or more employees is diagnosed with cancer, it can have a devastating effect on the workplace. Medical costs may rise, and the productivity and emotional well-being of employees may decline. In fact, both the direct and indirect costs associated with a childhood cancer diagnosis can be staggering. 

In addition to a heavy financial burden placed on parents with a child with cancer, a diagnosis can significantly disrupt daily lives and work schedules. Parents may frequently need to take time off from work to take a child for treatments and they may need extended leave to stay with the child receiving treatment at a pediatric cancer center. 

Employers are in a position to provide support to employees with a child facing a diagnosis of cancer. By implementing some of the following measures, employers can offer employees emotional and financial support during a time of tremendous stress and emotional upheaval.
http://businessgrouphealth.org/pdfs/Pediatric%20cancer%20fact%20sheet%20_Final.pdf
 

Oncology Clinical Tools and Resources for Purchasers (Employers), Plans, and Providers
The American Society of Clinical Oncology (ASCO) Cancer Portals are a resource for physicians to discover the latest findings in various areas of cancer research through scientific abstracts, videos, links, and other materials.
http://www.asco.org/ASCOv2/Research+Resources/Cancer+Portals?intcmp=cportals-topnav 
 

National Comprehensive Cancer Networks (NCCN) Chemotherapy Order Templates
NCCN is developing a library of chemotherapy order templates to improve the safe use of drugs and biologics in cancer care. NCCN Chemotherapy Order Templates (NCCN Templates®) are intended for personal and practical use only. The information contained in the NCCN Templates is based on the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) and the NCCN Drugs & Biologics Compendium (NCCN Compendium®). The NCCN Templates include chemotherapy, immunotherapy, supportive care agents, monitoring parameters, and safety instructions. Special instructions for self-administered chemotherapeutic agents are also provided.
.http://www.nccn.org/ordertemplates/default.asp

 

There are two generally accepted sets of clinical guidelines for the treatment of cancers. Below are the links for Guidelines from ASCO and NCCN

ASCO Clinical Guidelines
http://www.asco.org/ASCOv2/Practice+%26+Guidelines/Guidelines/Clinical+Practice+Guidelines

NCCN Clinical Guidelines
http://www.nccn.org/professionals/physician_gls/f_guidelines.asp#site
 

NCCN Compendium
The NCCN Drugs & Biologics Compendium (NCCN Compendium®) lists appropriate uses of agents as defined in and derived from the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®). As such, the uses listed in the NCCN Compendium® are based upon the evaluation of evidence from scientific literature, integrated with expert judgment in a consensus-driven process. The NCCN Compendium is indexed by drug or biological agent whereas the NCCN Guidelines® are indexed by disease. The NCCN Compendium identifies the pharmacologic characteristics of each drug or biological and includes information on route of administration, as well as the recommended uses in specific diseases. The indicated uses are categorized in a systematic approach that describes the type of evidence available for and the degree of consensus underlying each recommendation. All recommendations (at all category levels) in the NCCN Compendium constitute appropriate, medically-necessary care.

The accelerating pace and productivity of biomedical research, the resultant advances in therapeutic approaches, and the exigencies of serious and life-threatening illnesses present clinical professionals with both significant challenges and opportunities in the selection of treatment regimens for patients with cancer. NCCN is committed to providing sound, scientific recommendations for the appropriate management of a wide range of oncologic conditions. The NCCN Compendium is part of a series of evaluative information products intended to optimize the clinical decision-making process with a view toward improving the care available to patients. The NCCN Compendium contains authoritative, scientifically derived information designed to support decision-making about the appropriate use of drug and biologic therapy in patients with cancer.

Clinical professionals should apply independent medical judgment in their decisions about treatment that meets the clinical characteristics and needs of individual patients with cancer. Also note that the NCCN Compendium's listings represent the conclusions of the NCCN Guideline Panels as of the date of finalization of the relevant NCCN Guideline. NCCN Guidelines are updated continuously. The NCCN Compendium is updated in conjunction with the NCCN Guidelines on a continual basis. A subscription is required to access the NCCN Compendium ®
http://www.nccn.org/professionals/drug_compendium/content/about.asp
 

NCCN Oncology Outcomes Database
The NCCN Oncology Outcomes Database contains expansive data on drug/biologic and diagnostics utilization and trends; specific indications and sequencing; toxicity and reasons for discontinuation; complications and medical events; progression free and overall survival; comparative effectiveness and resource consumption; and payor-specific data.
http://www.nccn.org/network/business_insights/outcomes_database/outcomes.asp

 

NCCN Glossary of Cancer Terms
http://www.nccn.com/glossary.html
  

National Cancer Institute and Clinical Trials

Information for all audiences describing what clinical trials are and why they’re important. Learn about paying for clinical trials http://www.cancer.gov/clinicaltrials/learningabout/payingfor) and how patient safety (http://www.cancer.gov/clinicaltrials/learningabout/patientsafety) is protected.
http://www.cancer.gov/clinicaltrials

 

NCCN Website for Patients, Caregivers and their families
http://www.nccn.com/