Notes & Links: October 23, 2013

Austin Frakt writing in The Incidental Economist shares a chart from NY Magazine article by Stepen Hall on the cost of cancer drugs. Here is the chart showing the rising price of oncology drugs since 1966 at the time of FDA Approval. Austin implored readers to read the article to the end. I am such a compliant (PC incorrect term) reader (patient too) I read the article. Here is the link to the charts are MSKCC and PowerPoint slides.

I fully agree with Frakt read the excellent and telling article to the end. There is so much there to cull, learn, and act on. For my reading I came to this having worked on Adriamycin and other cancer drugs going back to 1985. With that particular history I can’t help but look at this this article and wonder if Zaltrap is being used as part of initial therapy with some off label messaging? The firewall for that is clearly the oncologist but we know that:

And because the economics of cancer drugs have always been colored by emotion, where patients facing a grim prognosis are desperate to try anything (as are their doctors)

This is a very powerful and telling quote 

Kantarjian has brought a rhetoric to the price debate that is unusual for such a prominent figure in oncology. He accuses the pharmaceutical industry of “greed” in its pricing of CML drugs, argues that “there is zero correlation—zero—between how effective a drug is and the cost of the drug,” and becomes especially indignant when pharmaceutical-industry spokespeople suggest that any effort to contain drug prices will curtail innovation, calling it a form of “blackmailing” against the national interest. He’s pretty exasperated with his fellow oncologists, too. “In the last decade, we have become glorified employees of the drug companies,” he says.

Again read this and consider what we need to do not just to bend the cost curve but to deliver better patient care. In light of this article and the indictment of oncology drug pricing we need to consider what palliative care delivers and not solely on a cost analysis but a quality of life basis. Studies need to be done. I would like to see a trial to compare palliative care to cure and measure outcomes of both survival and Q0L. 

Pediatric Caregiver Attitudes Toward Email Communication: Survey in an Urban Primary Care Setting
Dudas and Crocetti published and original paper in JMIR. There have been much discussion regarding the usage of email communications between patients and HCP and how it will drive major change. The authors performed a survey to measure pediatric caregiver access to and attitudes toward the use of electronic communications. 

We hypothesize that parents bringing their children to a pediatric primary care clinic have access to the Internet and email and would be interested in communicating with their health care providers by these modalities. The aim of this study is to document pediatric caregiver attitudes toward and access to these technologies in an urban pediatric primary care clinic.

The authors concluded:

Caregivers of children in an urban pediatric primary care practice have access to email and would be interested in communicating with health care providers by this method. African-American caregivers and those in lower socioeconomic groups hold less favorable views toward email communication; thus, the use of email may exacerbate existing disparities in health care delivery. Future studies should examine the reasons for these attitudinal differences.

Why is the right question and do we have time to wait?

Awesome Video from the Children’s Hospital at Dartmouth-Hitchcock (CHAD)
The Healthcare Marketer shares this emotionally powerful video from Children’s Hospital at Dartmouth-Hitchcock. Tear alert… you will tear up. Powerful. Let’s get the number of views up. 

This has to be the idea from the agency because it works so well. Not your usual in house effort. And I am right the agency is Sublime Eye.  

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