The demand for economic models that evaluate cancer treatments is increasing, as healthcare decision makers struggle for ways to manage their budgets while providing the best care possible to patients with cancer. Yet, after nearly 2 decades of cultivating and refining techniques for modeling the cost-effectiveness and budget impact of cancer therapies, serious methodologic and policy challenges have emerged that question the adequacy of economic modeling as a sound decision-making tool in oncology.
Disruptive Innovation, Uncertain Value, and Economic Modeling in Oncology
The clinical and economic burden of chronic obstructive pulmonary disease (COPD) is significant and is increasing. COPD is now the third leading cause of death in the United States, after heart disease and cancer. COPD reached this rank in 2008, more than a decade earlier than projected by the Global Burden of Disease Study. In the United States, mortality due to COPD is the only one among the 5 leading causes of death that showed an increasing rate between 2010 and 2011.
Chronic Obstructive Pulmonary Disease Remains a Growing Population Health Concern
Schizophrenia is a serious public health problem that affects approximately 1% of the US population.1 Schizophrenia is a leading cause of disability, and is associated with an economic burden of more than $60 billion annually in direct and indirect costs in the United States.2 Schizophrenia is a severe form of mental illness broadly characterized by 3 domains of psychopathology, including negative symptoms (ie, social withdrawal, lack of motivation, and lack of emotional reactivity), positive symptoms (ie, hallucinations and delusions), and cognitive deficits (ie, working memory, attention, and executive function).3-6 In addition, serious medical conditions, such as type 2 diabetes, obesity, hypertension, and dyslipidemia, are more common in patients with schizophrenia than in the general population; in turn, these conditions may increase the risk for cardiovascular disease and lead to increased morbidity and mortality.7 Notably, the estimated prevalence of diabetes in patients with schizophrenia is 13% to 15%; dyslipidemia, 25%; obesity, 42%; and hypertension, 19% to 58%.8
Schizophrenia: “The Forgotten Illness”?

Rare diseases have recently been identified as a major source of concern for health insurance companies, with some states seeking to shift a portion of the fiscal burden of orphan drugs to patients, much to patients’ concern.1 Rare diseases and orphan drugs, which have also been referred to as “orphan medicine,” “high-cost drugs,” and “rare medicine,” are subjects of increasing and intense study in pharmacoeconomics and cost-effectiveness analysis (CEA).2-4 By current estimates, between 25 million and 30 million Americans (8%-10% of the US population) have 1 of the more than 6800 diseases deemed rare, because they affect less than 200,000 people, which is the threshold used to define a “rare disease.”5

Breakthrough Therapy, or Breakthrough Pricing?

Pain is a global health problem that affects 1 of 5 adults in the community1 and occurs in 43% to 77%2-4 of the approximate 35.1 million patients who are hospitalized annually in the United States.5 Pain is ubiquitous among the nearly 30.2 million people who undergo inpatient surgery annually in the United States.5 Opioid analgesics are a mainstay of postsurgical pain management,6 but are often associated with treatment-limiting gastrointestinal (GI), central nervous system, and respiratory adverse events (AEs).7 Of these, opioid-related GI AEs are the most common,8-10 with an incidence rate of 10% to 32% for nausea and/or vomiting and 15% to 41% for constipation.7,11-14 These GI AEs are particularly troublesome after surgery, because they can exacerbate anesthesia-induced nausea and decreased GI motility, sometimes resulting in ileus.7 Furthermore, GI AEs are associated with increased healthcare resource utilization because of additional medications used to manage the GI AEs and an increase in hospital length of stay (LOS).7,10,15-17

Can Substituting Generic Drugs with Brand-Name Agents for Acute Pain Postsurgery Help to Deliver Cost-Effective, Quality Care?
The high cost of pharmaceuticals, especially biologics, has become an impor­tant issue in the battle to control healthcare costs. The Hatch-Waxman Act encourages generic competition but still provides incentives for pioneers to develop new drugs. The Biologics Price Competition and Innovation Act is intended to do the same for biologics and biosimilars.
Modeling the Future Economic Impact of Biosimilars’ Entry into the US Market
Community-acquired pneumonia (CAP) is frequently associated with the very young and the elderly but is a largely underrecognized burden among working-age adults. Although the burden of CAP among the elderly has been established, there are limited data on the economic burden of CAP in the employed population.
CAP Is a Burden for All Ages—Prevention Strategies Are Key
The incidence and prevalence of type 2 diabetes continue to grow in the United States and worldwide, along with the growing prevalence of obesity. Patients with type 2 diabetes are at greater risk for comorbid cardiovascular (CV) disease (CVD), which dramatically affects overall healthcare costs.
Innovation in Patient Engagement and Management Is Critically Needed to Change Current Trends in Type 2 Diabetes
The American population’s diversity continues to grow, and its racial and ethnic mixes are changing. The US healthcare system must confront this changing reality. The introduction of isosorbide dinitrate/hydralazine hydrochloride (BiDil) to the US marketplace was a move toward recognizing these changing consumer needs. BiDil was approved specifically as a secondary treatment for heart failure in African-American patients. It remains the first and only drug approved by the US Food and Drug Administration for a race-based indication. To ensure commercial success, a drug must be made “visible” to healthcare providers and to consumers.
Much More than Biomarkers: Sociodemographic Variables in Personalized Medicine

Prostate cancer is the most frequently diagnosed noncutaneous malignancy in males and is a leading cause of cancer-related morbidity and mortality among men in the United States.1,2 The American Cancer Society has estimated that approximately 238,600 new cases of prostate cancer will be diagnosed in 2013, and that approximately 29,700 men will die of the disease.3

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  •  Association for Value-Based Cancer Care
  • Value-Based Cancer Care
  • Value-Based Care in Rheumatology
  • Oncology Practice Management
  • Rheumatology Practice Management
  • Urology Practice Management
  • Inside Patient Care: Pharmacy & Clinic
  • Lynx CME