As initial gene and cellular therapies come to market, debate is growing as to the best ways to evaluate the associated economic impact, specifically in the context of the shift to value-based reimbursements.
Health systems increasingly have an inpatient, health plan, and now outpatient formulary, each with their own rules, priorities, and application. These differences and complexities are important to consider to optimize clinical pathway outcomes.
It is an exciting time in oncology care as innovative cellular and gene therapies come to market, with many more to come in the near future.
While clinical pathways have been narrowly focused historically, steps can and should be taken by providers and stakeholders to ensure that patients and their individual preferences are adequately represented in pathway development.
With the arrival of clinically validated software technologies designed to treat disease, or “digital medicines,” comes a plethora of uncertainties related to how stakeholders will value these products relative to traditional medicines and how they will fit into today’s health care system.
More comprehensive clinical pathways may be one way to address the aging health care workforce and high burnout rate due to increasing administrative responsibilities, decreasing compensation, and more demands from patients and payers.
Together, the articles in this issue emphasize the continued importance of not getting so carried away with technology, pre-approved plans, or theoretically ideal outcomes that the human aspect of medical care and care providers is lost.
Our analysis across multiple tumor types has demonstrated that health systems are wielding a growing influence on how care is delivered in the local markets in which they operate.
For professionals creating a clinical pathway for a disease state, it is important to understand the various stakeholder biases in real-world contexts, so that appropriate prompts may be integrated into the pathway in order to achieve the best outcomes.
Collectively, this issue of JCP presents how market dynamics are changing in relation to oncology practices, what providers are doing to evolve with these changes, and how clinical pathways are advancing these changes to achieve better care for patients.