Transparency lacking in oncology clinical pathways

February 13, 2018|Hematology and Oncology

Health plans push back

The California Association of Health Plans had opposed the bill because the proposal “unnecessarily sought to regulate voluntary clinical guidelines developed by health plans,” said Charles Bacchi, president and CEO for the group. “AB 1107’s so-called push for transparency was a veiled attempt by drug companies and others to gain access to the names of independent providers in order to influence the process,” Mr. Bacchi said in an interview. “In this case, more transparency would have done more harm to patient care than good. The names of participating third-party panelists are purposely not shared in order to protect these panelists from lobbying or other pressure by numerous entities, including drug companies, in their efforts to create bias in the clinical evidence review process.”

America’s Health Insurance Plans (AHIP) spokeswoman Cathryn Donaldson said health plans are being unfairly targeted in the drive toward more transparency. The recent efforts are an attempt to single out clinical care pathways developed by health plans as needing additional oversight standards while ignoring pathways that are developed by drug distributors, hospital systems, academic institutions, and others, Ms. Donaldson said in an interview.

“Hospital systems, medical centers, pharmaceutical distributors, and academic centers all create their own pathways but have not been subject to these transparency efforts,” she said. “Given all the various relationships in the system, we strongly believe that if additional oversight to voluntary clinical care pathways is added, then the oversight should apply to all pathways.”

ASCO’s Dr. Zon stressed that the criteria her task force created for pathways is aimed at all types of developers.

“In other words, we felt that the criteria should apply across all the pathway program developers whether they were provider or payer facing,” Dr. Zon said. “We also did not differentiate between not-for-profit and for-profit entities. Standards for high-quality criteria should apply to any pathway program being developed regardless of the source.”

Dr. Daly added that every entity that develops a pathway should have some policy around conflict of interest and how to address any transparency issues that may arise. Despite the recent debate over transparency, Dr. Daly said he believes the future of pathways is bright.

“I think the future is that pathways hold a lot of promise,” he said. “But I think we really need to ensure that the pathways that are being employed are of high quality because they influence how patients are treated.”

Dr. Daly serves as a director of Quadrant Holdings Corporation and receives compensation from this entity. This news organization is a subsidiary of Quadrant Holdings Corporation.

agallegos@frontlinemedcom.com