Precision-based medicine improves outcomes and drives down costs
June 14, 2017
By Paul Crowe
As health care costs continue to skyrocket, oncologists are looking for ways to effectively treat their patients without the added burden of enormous medical bills.
According to the National Cancer Institute, the U.S. spends approximately $157 billion on cancer care per year. In 2014, spending on oncology medication surpassed $100 billion worldwide. As patients are footing the bill for more of their medical expenses, they are increasingly aware of these escalating costs. According to a survey by Premier, Inc., 56 percent of C-suite hospital executives plan to invest more in cost-cutting avenues to meet patient demand.
Despite the exorbitant price tag, traditional cancer screenings and therapies are often ineffective or unnecessary. Cancer screenings may involve the potential for serious complications (perforation with colonoscopy) or result in false positives, which unnecessarily lead to anxiety and further invasive testing. Chemotherapy and radiation poison the body and may eventually lead to heart problems, lung disease and increased risk of other cancers, among other conditions. These treatments and diagnosis tools are decades old and do not utilize the significant genetic knowledge and data we have gathered in recent years. In effect, radiation and chemotherapy is a “throw everything against a wall and see what sticks solution,” rather than a personalized and targeted approach.
As patients demand less invasive and less costly diagnosis and treatment, innovators in the health care system are turning to precision-based medicine. By targeting the specific genetic abnormalities that cause cancer, precision medicine can diagnose and treat with much greater accuracy. In a study of juvenile brain cancer, researchers discovered that 56 percent of the tumors studied had genetic abnormalities that could influence how the disease was diagnosed or treated by drugs already in the market or in clinical trials. Research and testing using new technology have been successful in clinical feasibility studies reporting > 90 percent accuracy in diagnosing impacted males.
Unfortunately, the insurance industry has hesitated in covering some of the genetic tests available. This may be because precision medicine is often made from biological materials instead of synthesized chemicals, which makes it more expensive to initially develop. But, as precision medicine becomes part of the standard of care over the next five years, that is likely to change.
Insurers may be more apt to approve precision medicine techniques when considering a cost-benefit analysis. For cancer patients, expenses will drop as they receive targeted medication within days of diagnosis, and are able to skip more toxic treatments that result in hospitalization, intravenous lines, complications of those, steroids and other medication to lessen side effects and nursing. For example, a report by PricewaterhouseCoopers indicates that a genetic test on breast cancer patients could save an estimated $1,900 per patient because it can reduce chemotherapy use between 20 and 35 percent. Likewise, increased diagnostic accuracy for cancer screenings will reduce the costs and morbidity associated with false positive tests.
In hospitals, where insurance reimbursement rates depend upon patient experience and satisfaction, and expenditures are always closely monitored, precision medicine is already improving outcomes. In one study, precision medicine was shown to reduce readmissions by 52 percent, reduce visits to the emergency department by 42 percent and decrease deaths by 85 percent. Hospitals have a responsibility to their patients (and shareholders) to proactively promote new advancements in medicine. They should utilize their considerable clout to support research and development companies during FDA trials to ensure their physicians have access to the latest precision therapies once approved.
With the passage of the 21st Century Cures Act, precision medicine has received the backing of the U.S. government. The bill, which provides $4.8 billion in funding to initiatives aimed at matching patients to treatments based on their genes, signals a shift toward creating new health care standards. With the ability to fund more genetic sequencing, it is my hope that we can develop new treatment and diagnostic approaches for a wide range of cancers.
About the author:
Paul Crowe is chairman and CEO of Nuview Life Sciences. Crowe is an experienced health care executive who, over the past 40 years, participated in the commercialization of new diagnostic imaging technologies such as diagnostic ultrasound, magnetic resonance imaging and positron emission tomography (PET). These technologies provided physicians with better tools to more effectively diagnose, and subsequently treat, chronic human diseases, improved patient outcomes and lowered health care costs.