Transitioning to the “New Normal”: What This Means for Oncology Care

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Dr. Burt Zweigenhaft, Co-founder of the Association for Value-Based Cancer Care, joined me for a discussion around the importance of patient-centricity in cancer care, current barriers to value-based care in the US and Canada, innovative cancer therapies, and how COVID-19 has affected oncology care delivery and research.

Here is a sneak peek of our conversation:

Q: Let’s get into the story of you Co-Chairing and Co-Founding the Association for Value-Based Cancer Care. What exactly are you doing with this association?

A: Next to Swim Across America, or in concert with Swim Across America, it’s the most important thing I’m doing today. I was invited to speak at an ONS (Oncology Nursing Society) meeting 13 years ago and the two nurses before us were talking about pre-rehabilitation at Johns Hopkins. One of them was Lillie Shockney, who is one of the founders and principals of the Academy of Oncology Nursing (AON). Lillie was talking about pre-rehabilitation at Hopkins and what would that mean?

So, Natalie, you got the three words you don’t want to hear, “You have cancer” as opposed to three words you would like to hear. When you hear that you have cancer, your head’s going to spin. Actually, in Swim Across America, we would answer, “You have hope”. Those are our three words. Unfortunately, you’ll go home and you think, “Oh my life is going to end. How can I afford this? What am I going to do? What are my options?”. At Hopkins, they didn’t let you go home. They sat you down right away. They talked about your nutrition, exercise, sexual function, faith, and whatever you needed. The ones who got that type of consultation, guess what? They were 40% better outcomes on the therapy because they know what to expect and stay on it. They needed 65% fewer pain medications.

I’m sitting there with Dr. Gary Owens from Independence Blue Cross and I’m looking at him because we’re speaking next. I said, “Gary, I’m a drug guy. I go to drug meetings. I wouldn’t have gone to a nursing meeting if we weren’t invited to speak.” But, by listening to them, I realized how important collaboration would be in cancer because I was outside my silo of just pharmacy, delivering drugs, getting into patients, and what we do. It became very apparent that not only could nursing play a great role with the oncology facilities I have, but it could help with the hospitals and the community practice. We need to involve radiation, the advocacy companies that helped get the funding, these oncology nurse navigators, and oncology nurses.

It became very clear to me that, including personalized medicine and digital health tools, we can basically monitor patients from home i.e. telehealth. When you start to think about delivering healthcare, it’s complex and you need an ecosystem in which everybody collaborates, shares, and works in the best interest of the patient on the same team – united.

In speaking with Gary, I said, “Look we’re the drug people and you’re the medical director. You go to your meetings, why don’t we create a meeting? Because no one has the time to go to 30 meetings a year with all the different groups, no one can do that. In which, within two days, everything that happens in the ecosystem of cancer will be discussed and you will go back with that knowledge, take that and incorporate that into your business process.” That’s what I did when I went home from the ONS meeting.

Back to Onco360, I said, “We’re going to marry these oncology nurses with oncology pharmacists.” Guess what? We did a better job. We improved on everything we did. We weren’t doing a bad job, we just got better. We can do the same thing here so that’s why the Association of Value-Based Cancer Care is so important. Because in two days, you will sit down and meet all the key decision-makers and all the ecosystems that play a role in cancer care from start to finish. You will take those ideas, that collaboration, that networking, and go back to your particular silo and incorporate that to make cancer care better. That’s been our goal.

We run it as a 501(c) so we don’t have to charge an arm and a leg to come to our meeting. We try to keep it to all of the KOLs (key opinion leaders) and knowledge leaders who are driving these changes in the ecosystem. Besides the great speakers, you’re also going to get some great sidebars. If you’re a medical director in Humana, wouldn’t it be nice to talk to the medical director from Aetna or United Healthcare while you’re sitting there? If you’re with a drug company like Takeda, would you want to talk to Genentech and Amgen to see what’s going on?

“What are you thinking about value-based care?”, “What is this OCM that the government is going to be doing?”, “What’s the alternative payment models in radiation going to our industry?”, “What’s this IPI (intentional price index) that the Trump administration wanted to put in?” or “How is the 340b program affecting or not affecting us in our business models?”. There are some new things about the white bagging industry. White bagging is where a drug is provided by the insurance company to the hospital or practice to take them out of the drug dispensing business while they still have all the expenses with that. These are the conversations that we have.

We get deep, some of them are uncomfortable but they have to be had and I think it makes our industry better. The goal has been to do that. We do this once a year. COVID last year has affected us like everyone so we went virtual and we were still able to do a great job. This year, I think we will be live without a doubt. We’ll be here in New York City, October 13, 14, and 15 and we have about 160 speakers, who are great speakers, have great content, great passion for what we’re doing. Disruptive conversations will be held and discussing the future of cancer care. We do bring in patients because the voice of cancer patients usually is important to hear too. You want to walk a mile in someone’s shoes, be a patient for a couple of weeks and see how much fun that is, and cancer it’s not a lot of fun.

The goal is to improve cancer care and collaborate. Again, it’s the same theme I’ve learned and we’ve talked for a little while. How many times did I say collaboration? How many times have we talked about bringing the young people in, taking older people like myself with the young and digging in and really working on hard solutions, addressing the tough problems that we have to face?

For more of our discussion, you can watch the whole Fireside Chat with Dr. Burt Zweigenhaft, or listen to the podcast version, below.

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