Medicare is putting a new policy in place regarding the use and coverage of Avastin that will sharply curtail the use of the drug used for the treatment of eye diseases.

While Avastin costs thousands of dollars a month as a cancer treatment, when used in tiny portions, such as for the treatment of eye diseases, the medicine is just $30 to $40 an injection. But Medicare has now introduced a special reimbursement code just for the smaller doses of Avastin. And starting Thursday, the reimbursement of Avastin dropped to about $7.20 for the dose typically used in the eye.

Doctors who administer the drug will now be losing money on the drug. Medicare apparently calculated the reimbursement rate for the tiny eye doses based on the average sales price of Avastin for cancer. But it did not take into account the markup charged to eye doctors by compounding pharmacies — the chemists that divide up the Avastin into tiny doses under sterile conditions.

Now payers and insurance companies are going to be footing the bill which could potentially cost patients and subscribers more money.

To read the full article, click here: http://www.nytimes.com/2009/10/02/business/02avastin.html?scp=6&sq=October+2+2009&st=nyt

The number of diagnosed cases of melanoma has been on the rise over the years but a recent British study reports that the "the epidemic may be due to diagnostic drift."

The report defines diagnostic drift as "the growing tendency to identify and treat benign lesions as malignant cancers," the New York Times reports.

"The study, published in the September issue of The British Journal of Dermatology, examined a cancer registry with 3,971 cases of melanoma and found that incidence increased 48 percent from 1991 to 2004, similar to the 44 percent increase reported by the Centers for Disease Control and Prevention over the same period for American whites. The disease is almost 20 times as common in whites as in blacks."

However, the research group found that almost all of the increase in diagnoses was in the earliest stage of the disease.

 “A lot of dermatologists will argue that they’re getting better at diagnosing melanoma, but I don’t think that’s very likely,” Dr. Marianne Berwick, a professor at the University of New Mexico said in the New York Times. “They’re taking a lesion that would not be diagnosed as melanoma 20 years ago and calling it melanoma.”

To read the full article and the implications of "diagnostic drift," click here: http://www.nytimes.com/2009/09/29/health/29mela.html?scp=20&sq=September+29+2009&st=nyt

In results from a widely watched clinical trial, Genentech's Avastin failed to show a significant effect on preventing the occurence of colon cancer, the New York Times reported.

This is the third finding in the past five weeks showing that commonly-believed and oft-practiced cancer treatments and screening processes are actually not beneficial, and in some cases harmful, to cancer patients.

Genentech and its sister company, Roche, did not release any of the specific data from the clinical trial on account that full data will be presented at the American Society of Clinical Oncology meeting in late May.

The trial had 2,700 patients who received six months of the standard chemotherapy or six months of the standard chemotherapy plus Avastin. The trial studied how many patients were alive and cancer free after a period of time.

Although Avastin is already a best-selling cancer drug, a successful trial could have paved way for a new use of the drug.

Clinical trials are obviously an important step in understanding the best uses of a drug. However, pharmaceutical companies must ensure that clinical trials are accurate so that the use of a drug is evidence-backed before it becomes a billion dollar drug.

To read the full article, click here: http://www.nytimes.com/2009/04/23/health/23avastin.html?ref=health

No person in the medical field needs to be told that cancer is tricky. The illusive cure is the elixir of life that researchers, politicians and patients have been trying to find for decades. Long has Nixon's vow of curing cancer by 1976 passed, nearly forgotten as cancer cases continute to erupt throughout the world.

A New York Times article focuses on this very issue: The costs, both monetary and emotional, of curing cancer.

The piece, whether you're a payer, hospital employee or blogger, is a solid read that can't help but make you think what more could be done, when so much has already been tried.

To read the full article, click here: http://www.nytimes.com/2009/04/24/health/policy/24cancer.html?_r=1&ref=health

In all the old movies and sitcoms we tend to see someone peddling or selling the miracle drug; that tiny little pill that can make all of your pains and problems go away (or at least ease up a bit since usually those pills were nothing more than alcohol-laden sugar pills) and didn't cost all that much.

According to a recent article in the New York Times, pills and capsules are the newest rage in cancer treatment, expected to account for 25 percent of all cancer medicines in a few years.

While these wonder pills do indeed sound wonderful, considering they could replace expensive and harsh chemotherapy, they come with a tiny glitch: Most insurance companies won't pay for them.

Stated the article: "With oral cancer drugs, “the technology has outstripped the ability of society to integrate it into the mainstream in a smooth fashion,” said Carlton Sedberry, a pharmacy expert at Medical Marketing Economics, a consulting firm."

This is a classic case of technology outrunning the current standards and protocols that hospitals, physicans, patients and payers are used to following. However, with the right research and knowledge of up-to-date practices, new technologies in medicine -- such as the use of 'cancer pills' -- can become standard in practice. An independent review organization like AllMed can help you, whether you're a payer, hospital, physician or patient, know what's the most up-to-date protocol in healthcare.

To read the full article in the New York Times, click here: http://www.nytimes.com/2009/04/15/business/15pill.html?_r=1&ref=health 

The trust in new technology is under fire again as researchers claim that a single DNA test outperforms a Pap smear in finding the virus that causes cervical cancer, the New York Times reports. The study, founded by the Bill and Melinda Gates Foundation and published last week in the New England Journal of Medicine, is the first to show that a single screening with the DNA test beats all other method at preventing advanced cancer and death.

Not only could the new test for human papillomavirus, or HPV, save lives; scientists say that women over 30 could actually drop getting their annual Pap smears in lieu of a single DNA test once ever 3, 5 or 10 years.

Even that minute bit of uncertainty – the length of time that could or should pass between tests – is making some doctors and gynecologists weary about completely abandoning Pap smears, since they have been remarkably effective.

Perhaps some are also weary about advancing technologies, especially in light of a slew of recent so-called miracle cures and tests that have reported false promises and data. Before gynecologists and doctors really begin to accept the new DNA test and change the old Pap smears for the new, $5 test, they need to be able to understand and trust the evidence-based medicine and practice that backs the use of the DNA test up. At AllMed, we are up to date with all of the best practices and evidence-based medicine to make sure that payers and hospitals can provide the most efficient and effective medicine to their patients.

To read the full article, click here: http://www.nytimes.com/2009/04/07/health/07virus.html?_r=1&em

Cancer is not a word anyone likes to hear, especially when statistics like the fact that 1.4 million new cases of it will be diagnosed this year, float around the media. A New York Times article featuring a Seattle, Wash. woman whose colon cancer puzzled her doctors. 

Karen Pasqualetto was, admittedly, frustrated over the multiple diagnoses and prognoses she received. In the article, Pasqueletto stated, "I don't feel I have a doctor who is looking out for my care. My oncologist is terrific, but he's an oncologist. The surgeon seems terrific, but I have found through my own diligence. I have no confidence in the system."

When patients don't have confidence in the medical system, there are obvious systemic problems within the medical world, especially the oncological one. Cancer is undoubtedly hard to treat, as it requires a minimum of three doctors. Treatment decisions are tough, too. Furthermore, the quality of cancer care varies among doctors and hospitals, muddling the ability to distinguish what is the best treatment.

The inability to choose a best treatment is even admitted by government and medical groups. A 1999 report by the Institute of Medicine in Washington stated that, "There is a wide gulf between what should be construed as the ideal and the reality of one's experience with cancer care."

One avenue hospitals and doctors can travel down to ensure the best practices for cancer treatment is by referring cases to independent review organizations. IROs, like AllMed, can use their clinical expertise to decide what is the best practice for the patient, every time. Moreover, referring difficult-decision cases to IROs helps hospitals establish a consistent treatment plan. 

To read the full article, click here:

Cancer Patients, Lost in a Maze of Uneven Care

Cancer is not a word anyone likes to hear, especially when statistics like the fact that 1.4 million new cases of it will be diagnosed this year float around the media. A New York Times article featured a Seattle woman whose colon cancer puzzled her doctors.

Karen Pasqualetto was, admittedly, frustrated over the multiple diagnoses and prognoses she received. In the article Pasqualetto claims, “I don’t feel I have a doctor who is looking out for my care. My oncologist is terrific, but he’s an oncologist. The surgeon seems terrific, but I have found him through my own diligence. I have no confidence in the system.”

When patients don’t have confidence in the medical system, obviously there are systemic problems within the oncological medical world. Cancer is undoubtedly hard to treat, as it requires a minimum of three doctors. Treatment decisions are tough, too. Furthermore, the quality of cancer care varies among doctors and hospitals, muddling the ability to distinguish what is the best treatment.

The inability to choose a best treatment is even admitted by government and medical groups. A 1999 report by the Institute of Medicine in Washington stated that, “There is a wide gulf between what could be construed as the ideal and the reality of [one’s] experience with cancer care.”

One avenue hospitals and doctors could travel down to ensure the best practices for cancer treatment is referring cases to independent review organizations. IROs like AllMed can use their clinical expertise to decide what is the best practice for the patient, every time. Moreover, referring difficult-decision cases to IROs helps hospitals establish a consistent treatment plan.
To read the full article, click here:
http://www.nytimes.com/2007/07/29/health/29Cancer.html?_r=1&oref=slogin