Author: Paul Crowe
This year, experts estimate that around 78,000 new cases of primary brain tumors will be diagnosed; 25,000 of them will be malignant. While these statistics are daunting, there is hope on the horizon for the diagnosis and treatment of brain cancer in the form of precision medicine.
Precision medicine is an approach to treatment which utilizes genetic variables (an individual’s unique genetic code) to tailor treatment to a specific patient. Precision medicine uses our DNA to target the specific abnormalities that make us sick. For example, tools like Gamma Knife® (stereotactic radiosurgery) can be used to precisely target tumors in the brain without the need for invasive surgery. Precision medicine recently received a stamp of approval from the U.S. government which approved the 21st Century Cures Act, a $4.8 billion federal funding initiative aimed at matching patients to treatment based on their genes. Healthcare experts anticipate far greater use of precision medicine in the near future for many types of cancer, including brain cancer.
In recent years, the costs of cancer treatment have skyrocketed: treatment with a newer cancer medication may reach over $100,000 per year for each patient, according to a study published in the journal Cancer. In 2014, spending on oncology medication surpassed $100 billion worldwide. As health insurance plans move towards a model where patients pay a larger share of expenses, through deductibles or co-insurance, cancer patients are increasingly responsible for covering enormous medication bills and are, likewise, more aware of escalating costs. According to a survey by Premier, Inc., 56% of C-suite hospital executives plan to invest more on cost-cutting avenues to meet patient demand.
Traditional cancer therapies are not only expensive but often ineffective or unnecessary. Chemotherapy and radiation work by poisoning the body and may eventually lead to heart problems, lung disease and increased risk of other cancers among other conditions. These treatments are decades old and do not utilize the significant genetic knowledge and data we have gathered in recent years. In effect, radiation and chemotherapy represent a “throw everything against a wall and see what sticks” solution, rather than a personalized and targeted approach.
Medical providers and patients alike are interested in the potential precision medicine has to lower costs while simultaneously improving the patient experience. By targeting the specific genetic abnormalities that cause cancer, precision medicine can diagnose and treat with much greater accuracy. As patients receive specialized precision medication within days of diagnosis, they are more likely to be able to forego the more toxic treatments (e.g. chemotherapy and radiation) that result in hospitalization, intravenous lines, complications of those, steroids and other medication to lessen side effects, and nursing, saving money and significantly bettering their experience. For example, where the Gamma Knife treatment option is utilized, brain tumors are successfully treated during one minimally invasive, out-patient appointment in many cases.
While excitement about precision medicine grows in the medical community, insurance providers are hesitant about the cost of treatment. As precision medicine is often made from biological materials instead of synthesized chemicals, the upfront costs of producing therapies is initially more expensive. However, a cost analysis reveals that, because patients can often skip months or years of chemotherapy, radiation and other medication when on a precision medicine regimen, the overall cost of therapy is less. A report by PriceWaterhouseCooper, for instance, 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.
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 52%, reduce visits to the emergency department by 42% and decrease deaths by 85%.
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 ability to fund more genetic sequencing, we can develop new treatment and diagnostic approaches for a wide range of cancers.
Photo – Copyright: sudok1 / 123RF Stock Photo
About Paul Crowe
Paul Crowe is CEO of NuView Life Sciences and Managing Partner of San Diego Gamma Knife Center. Mr. Crowe is an experienced healthcare 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 lower healthcare costs.