January 28, 2020
On Jan. 27, 2020, the Centers for Medicare & Medicaid Services (CMS) expanded coverage of FDA-approved laboratory diagnostic tests that use next generation sequencing (NGS) for patients with germline, or inherited, ovarian or breast cancer. CMS also gave the Medicare Administrative Contractors (MACs) the ability to determine coverage of NGS laboratory tests for other inherited cancers. Read CMS Decision Memo for NGS for Medicare Beneficiaries with Advanced Cancer (CAG-00450R) . Read CMS announcement .
Posted 1/28/2020
January 15, 2020
A recent report from the Government Accountability Office (GAO) published Jan. 10, 2020, calls on the Health Resources and Services Administration (HRSA) to improve processes to reasonably assure that participating non-governmental hospitals meet 340B Drug Pricing Program eligibility requirements.
The 340 Drug Pricing Program (340B Program) is administered by the U.S. Department of Health and Human Services' (HHS) Health Resources and Services Administration (HRSA) . Under the 340B Program, certain hospitals and other qualified entities that care for many low-income and uninsured individuals receive discounted prices on outpatient drugs from drug manufacturers. About two-thirds of hospitals participating in the 340B Program (approximately 1,700) are non-governmental hospitals (i.e., private, nonprofit hospitals).
The GAO makes several recommendations for achieving greater oversight of hospital eligibility. Among these, the report recommends that HRSA:
HHS agreed with all of the GAO’s recommendations except the recommendation to implement a process to verify that all non-governmental hospitals have contracts in place. HHS says that HRSA does not have the resources to carry out the recommended verification process and it would over-burden the agency. Read the full report . Read GAO recommendations .
January 14, 2020
On Jan. 13, an updated guideline for estrogen and progesterone receptor (ER/PgR) testing in breast cancer was released jointly by the College of American Pathologists (CAP) and the American Society of Clinical Oncology (ASCO). The updated guideline reaffirms much of the original guidance and includes more specific recommendations for handling and reporting cases with low ER expression. The updated guideline was posted as online early release to the Archives of Pathology & Laboratory Medicine (Jan. 13, 2020, doi: 10.5858/arpa.2019-0904-SA) .
A CAP press release highlights the following changes: "Cases with 1-10% of cells staining for ER expression will now be reported as ER-low positive. Pathology reports for these cases should include a recommended comment that acknowledges the more limited data on endocrine responsiveness in this group. Also in such cases, pathologists should report the status of internal controls, with a special comment for specimens that lack internal positive contr ols."
The CAP press release also notes that the new guideline more clearly recommends that: ". . . ER be tested in cases of newly diagnosed DCIS (without invasion) to help estimate potential benefit of endocrine therapy to reduce the risk of a future breast cancer event. But, specifically, PgR testing in DCIS is optional."Read the CAP press release .
Access the updated Estrogen and Progesterone Receptor Testing in Breast Cancer guideline .
Posted 1/14/2020
January 10, 2020
On Jan. 9, 2020, the U.S. Food and Drug Administration (FDA) announced approval of avapritinib (Ayvakit) for the treatment of adults with unresectable or metastatic gastrointestinal stromal tumor (GIST) – harboring a platelet-derived growth factor receptor alpha (PDGFRA) exon 18 mutation. This approval includes GIST that harbors a PDGFRA D842V mutation, which is the most common exon 18 mutation. Ayvakit is a kinase inhibitor, meaning it blocks a type of enzyme called a kinase and helps keep the cancer cells from growing. Read the FDA approval announcement .
Posted 1/9/2020.
January 9, 2020
The American Cancer Society’s annual report on U.S. cancer statistics , released Jan. 8, announced the greatest one-year decline in deaths from cancer since 1930. From 2016 to 2017, overall deaths from cancer dropped 2.2 percent. Between 1991 and 2017, the U.S. has seen the overall cancer death rate drop 29 percent.
In a statement, lead study author Rebecca Siegel, MPH, attributed the record drop to improved statistics related to lung cancer. While a decrease in smoking rates has contributed to the decline, Siegel also credited recent advances in lung cancer treatment for this year's record drop. These include surgical advances, improved diagnostic screening, as well as advances in radiation therapy and anticancer therapeutics.
The U.S. continues to see increases in new cases of certain cancers including cancers of the kidney, pancreas, liver, and oral cavity and pharynx (among non-Hispanic whites), and melanoma skin cancer.
The American Cancer Society estimates for 2019, the U.S. saw approximately 1,762,450 cancers diagnosed.
Read the full report.Read Facts & Figures 2020 .
Posted 1/9/2019
January 8, 2020
On Jan. 8, 2020, the U.S. Food and Drug Administration (FDA) approved pembrolizumab (Keytruda) for the treatment of patients with Bacillus Calmette-Guerin (BCG)-unresponsive, high-risk, non-muscle invasive bladder cancer (NMIBC) with carcinoma in situ (CIS) with or without papillary tumors who are ineligible for or have elected not to undergo cystectomy. Read the FDA announcement .
Posted 1/8/2020
December 20, 2019
On December 20, 2019, the U.S. Food and Drug Administration (FDA) granted accelerated approval to fam-trastuzumab deruxtecan-nxki (Enhertu ® , Daiichi Sankyo) for patients with unresectable or metastatic HER2-positive breast cancer who have received two or more prior anti-HER2-based regimens in the metastatic setting. Read FDA announcement .
Posted 12/20/2019
December 19, 2019
On Dec. 12, 2019, the Association of Cancer Care Centers (ACCC) provided comments to the Center for Medicare and Medicaid Innovation's informal Request for Information on its potential Oncology Care First Model. Applauding CMMI for making the OCF Model voluntary and envisioning a multi-payer model, ACCC urged CMMI to:
Learn more and read comment letter .
Posted 12/19/2019
December 19, 2019
On Dec. 18, 2019, the U.S. Food and Drug Administration (FDA) granted accelerated approval to Padcev (enfortumab vedotin-ejfv), a Nectin-4-directed antibody and microtubule inhibitor conjugate, meaning the drug specifically targets cancer cells – in this case, the cell adhesion molecule Nectin-4, which is highly expressed in urothelial cancers.
Padcev is indicated for the treatment of locally advanced or metastatic urothelial cancer in adults who have previously received a PD-1 or PD-L1 inhibitor and a platinum-containing chemotherapy. Platinum-containing chemotherapy, PD-1 and PD-L1 inhibitors are standard treatments for patients with bladder cancer, the sixth most common cancer in the U.S. Urothelial cancer, which accounts for more than 90% of bladder cancers, begins in cells that line the bladder and nearby organs. Padcev is a new type of therapy for patients with advanced urothelial cancer whose disease has progressed on chemotherapy and immunotherapy. Read FDA announcement .
Posted 12/19/2019
December 18, 2019
On Dec. 18, 2019, President Trump, along with the U.S. Department of Health and Human Services (HHS) and the U.S. Food and Drug Administration (FDA), issued a notice of proposed rulemaking (NPRM) that, if finalized, would allow states to import certain prescription drugs from Canada. In addition, the administration announced a new draft guidance for industry that allows drug manufacturers to important their own prescription drugs, including biological products, that are FDA-approved, manufactured abroad, authorized for sale in any foreign country, and originally intended for sale in that foreign country.
The proposed rule applies to drugs that meet FDA labeling standards and impose no risk to health and safety. The import rule excludes controlled substances, biological products and intravenous drugs. ( FDA's Safe Importation Action Plan .)
Comments on the NPRM are being accepted for 75 days after publication in the Federal Register and comments on the draft guidance are being accepted for 60 days after publication in the Federal Register . Read the HHS press release . Read Importation of Prescription Drugs Proposed Rule . Read new draft guidance for industry .
December 17, 2019
On Dec. 16, 2019, the U.S. Food and Drug Administration (FDA) approved enzalutamide (Xtandi, Astellas Pharma Inc.) for patients with metastatic castration-sensitive prostate cancer (mCSPC).
FDA previously approved enzalutamide for patients with castration-resistant prostate cancer. Read the FDA announcement .
Posted 12/17/2019
December 16, 2019
On Dec. 16, 2019, a spokesperson for the Centers for Medicare & Medicaid Services (CMS) issued the following statement:
"In an abundance of caution, to accommodate consumers who attempted to enroll in coverage during the final hours of Open Enrollment but who may have experienced issues, starting at 3:00 PM EST today, December 16 we are extending the deadline to sign up for January 1 coverage until 3:00 AM EST December 18."
The website and the call center were open for business on Sunday, December 15, CMS says. However, due to the high volume of consumers (more than half a million) calling to enroll in health insurance on the exchange, some consumers were asked to leave their name at the call center. The agency states: "Those consumers who have already left their contact information at the call center do not need to come back and apply during this extension because a call center representative will follow up with them later this week.” Read CMS statement on Health Insurance Exchange Open Enrollment Extension .
Posted 12/16/2019
December 12, 2019
On Dec. 12, 2019, the U.S. Senate voted to confirm radiation oncology Stephen Hahn, MD, FASTRO, as the next Commissioner of the U.S. Food and Drug Administration (FDA).
Posted 12/12/2019
December 12, 2019
On Dec. 11, 2019, Inside Health Policy reported that the Centers for Medicare & Medicaid Services (CMS) "plans to repay hospitals that sued over 2019 pay cuts from the agency’s so-called site-neutral policy. The agency has also updated the 2019 pay rates for clinic visits at certain off-campus hospital facilities to remove the cut in light of a federal court decision that said the agency didn’t have the authority to implement it."
In September 2019, a Federal Washington, D.C., District Court judge found that CMS exceeded its authority in introducing these cuts in the 2019 Hospital Outpatient Prospective Payment System (HOPPS) rule. Several stakeholder organizations filed suit against CMS in response to the final 2019 (HOPPS) rule's provision that established a new reimbursement rate for off-campus hospital outpatient department clinic visits that aligned the payment rate with that under Medicare's Physician Fee Schedule. The 2019 HOPPS rule extended these payment cuts to providers that were specifically exempted from these site-neutrality reimbursement reductions by the Bipartisan Budget Act of 2015. Inside Health Policy reports that the "American Hospital Association, Association of American Medical Colleges and others that sued CMS over the cuts say in a Dec. 9 court notice that some hospitals 'recently received payments for claims processed over the past few weeks at the pre-2019 OPPS Rule payment rates for challenged services.' "Inside Health Policy further reports that: "the [court] notice says that hospitals haven’t been reimbursed for claims from previous months in 2019 and the government has not 'receded from its stated intention to continue to implement in 2020 the same plan this court already vacated.' "
CMS told Inside Health Policy that it began paying hospitals the higher reimbursement rate as of Nov. 4, and that Medicare Administrative Contractors will reprocess claims previously subject to the cut during the first few months of 2019.
ACCC's policy team will provide more information when it becomes available. Posted 12/12/2019
December 10, 2019
On Dec. 10, 2019, the American Society for Radiation Oncology (ASTRO) issued a new clinical guideline on the use of radiation therapy to treat patients diagnosed with basal cell and cutaneous squamous cell carcinomas (BCC, cSCC). The guideline suggests dosing and fractionation for these treatments.
An executive summary and full-text version of ASTRO's first guideline for skin cancer are published online in Practical Radiation Oncology . Read ASTRO press release .
Posted 12/10/2019
December 6, 2019
On Dec. 4, 2019, the National Comprehensive Cancer Network (NCCN) announced publication of updated genetic risk assessment recommendations for breast, ovarian and pancreatic cancers. Updates to the NCCN Clinical Practice Guidelines in Oncology ( NCCN Guidelines ) for Genetic/Familial High-Risk Assessment: Breast, Ovarian, and Pancreatic Version 1.2020 include new and expanded sections on risk assessment and management related to these cancer types, but retains a conservative approach toward testing practices where evidence is still lacking. Read NCCN press release .
Posted 12/6/2019
December 4, 2019
On Dec. 3, 2019, the U.S. Food and Drug Administration (FDA) approved Tecentriq® (atezolizumab) in combination with chemotherapy (Abraxane ® [paclitaxel protein-bound; nab -paclitaxel] and carboplatin) for the first-line treatment of adults with metastatic non-squamous non-small cell lung cancer with no EGFR or ALK genomic tumor aberrations. Read the corporate announcement . Read FDA announcement.
Posted 12/04/2019; updated 12/06/2019
November 27, 2019
On Thursday, Dec. 5 the Association of Cancer Care Centers (ACCC) will host a members-only webinar on the Centers for Medicare & Medicaid Services (CMS) CY2020 Hospital Outpatient Prospective Payment System (OPPS) and Medicare Physician Fee Schedule (MPFS) final rules.
ACCC's summaries of the CY 2020 OPPS final rule MPFS final rule are available here [login required].
WebinarCMS CY2020 OPPS & PFS Final Rules: What You Need to KnowThursday, December 5, 20192:00 – 3:00 PM EST
REGISTER HERE . [Login required]
Posted 11/27/2019
November 25, 2019
On Nov. 8, 2019, the U.S. Food and Drug Administration (FDA) granted approval to Reblozyl (luspatercept–aamt) for the treatment of anemia (lack of red blood cells) in adult patients with beta thalassemia who require regular red blood cell (RBC) transfusions.
REBLOZYL is not indicated for use as a substitute for RBC transfusions in patients who require immediate correction of anemia.
Beta thalassemia, also called “Cooley’s anemia,” is an inherited blood disorder that reduces the production of hemoglobin, an iron-containing protein in red blood cells that carries oxygen to cells throughout the body. In people with beta thalassemia, low levels of hemoglobin lead to a lack of oxygen in many parts of the body and anemia, which can cause pale skin, weakness, fatigue and more serious complications. Supportive treatment for people with beta thalassemia often consists of lifelong regimens of chronic blood transfusions for survival and treatment for iron overload due to the transfusions. People with beta thalassemia are also at an increased risk of developing abnormal blood clots. Read the FDA announcement .
Posted 11/25/2019
November 21, 2019
Nov. 21, 2019, the U.S. Food and Drug Administration (FDA) - as part of Project Orbis , a collaboration with the Australian Therapeutic Goods Administration (TGA) and Health Canada - granted supplemental approval to acalabrutinib (Calquence ) for the treatment of adults with chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma (SLL). This new approved indication for Calquence provides a new treatment option for patients with CLL or SLL as an initial or subsequent therapy. Read FDA announcement . Read AstraZeneca corporate press release .
Posted 11/21/2019
Re-posted 11/26/2019
November 21, 2019
The Centers for Medicare & Medicaid Services (CMS) Medicare Learning Network is holding a call on the final Hospital Price Transparency Final Rule on Dec. 3, from 1:30 - 3:30 PM EST.
During this call, learn about provisions in the final rule effective Jan.1, 2021, including:
A question and answer session follows the presentation. CMS encourages participants to review the fact sheet and final rule prior to the call. Posted: 11/21/2019
November 15, 2019
On Nov. 15, the Centers for Medicare & Medicaid Services (CMS) issued two rules that aim to increase price transparency and increase competition among all hospitals, group health plans, and health insurance issuers in the individual and group markets. The agency finalized the calendar year (CY) 2020 Outpatient Prospective Payment System (OPPS) & Ambulatory Surgical Center (ASC) Price Transparency Requirements for Hospitals to Make Standard Charges Public rule, and issued the Transparency in Coverage Proposed Rule. Both rules (final and proposed) require that pricing information be made publicly available.
The final "Price Transparency Requirements for Hospitals to Make Standard Charges Public" rule will require hospitals to make their standard charges public in two ways starting in January 1, 2021 :
CMS fact sheet on final rule . Access final rule .
CMS states that the proposed "Transparency in Coverage" rule is issued in response to an Executive Order dated June 24, 2019. The Department of Health and Human Services, the Department of Labor, and the Department of the Treasury are collectively issuing the proposed rule. As written, the rule would require that most employer-based group health plan and health insurance issuers provide up-front disclosure of price and cost-sharing information to participants, beneficiaries, and enrollees.
If finalized, the "Transparency in Coverage" proposed rule would require health plans to:
Disclose on a public website their negotiated rates for in-network providers and allowed amounts paid for out-of-network providers. Making this information available to the public is intended to drive innovation, support informed, price-conscious decision-making, and promote competition in the healthcare industry. Access a CMS fact sheet on the proposed rule.Access the proposed rule .
More details are available in the HHS press release .
Posted 11/15/2019
November 15, 2019
On November 14, 2019, the U.S. Food and Drug Administration (FDA) granted accelerated approval to zanubrutinib (Brukinsa, BeiGene, Ltd.) for adult patients with mantle cell lymphoma (MCL) who have received at least one prior therapy.
FDA granted this application priority review and zanubrutinib received orphan product and breakthrough therapy designations for treatment of MCL. Read FDA announcement .
Posted 11/15/2019
November 6, 2019
On November 5, the American College of Physicians (ACP) published a new evidence-based guidance statement that supports colorectal cancer screening for average-risk adults between ages 50 and 75 who do not have symptoms. The new guidance was published in the Annals of Internal Medicine .
The frequency of screening depends upon the screening approach selected, according to a statement from ACP, which suggests any of the following screening strategies:
Read the ACP press release .
Posted 11/06/2019