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Oncology Practice Insider

ASCO’s Oncology Practice Insider provides the latest news, information, and educational tools to assist with the successful management of oncology practice and the delivery of high quality patient care. OPI offers updates on ASCO programs, services, and cancer-related health policy, Medicare news, and billing and coding best practices. To sign up for the biweekly Oncology Practice Insider newsletter, please complete this form.

Date
On November 14, 2019, the Food and Drug Administration granted accelerated approval to zanubrutinib (BRUKINSA™, BeiGene, Ltd.) for adult patients with mantle cell lymphoma (MCL) who have received at least one prior therapy. Read more. 
The Centers for Medicare & Medicaid Services (CMS) released its final rule for the 2020 Medicare Physician Fee Schedule, and other changes to Part B reimbursement policies, including proposals for the Quality Payment Program. The estimated overall impact of the rule for both the hematology/oncology and radiation oncology specialties is 0%. However, the actual impact on practices will depend on the mix of services the practice provides. ASCO is still assessing the rule and will provide more information as it becomes available.
ASCO members have identified the use of “co-pay accumulators” and “co-pay maximizers” as an area of growing concern. When these programs are in place, drug manufacturers’ co-pay assistance programs no longer apply toward patient co-pays or out-of-pocket maximums—resulting in out-of-pocket costs going up and required deductibles taking longer to reach. In response to its members’ concerns, ASCO created a new policy brief to help explain the full impact of these programs.
As payers search for ways to control the rising cost of care, “utilization management" policies such as prior authorization and step therapy have emerged as ways to restrict, limit, or deny coverage for certain treatments. ASCO recently developed a media issue brief identifying common payer-imposed utilization management practices, the impact of these policies on people with cancer, and evidence-based ways to help ensure the appropriate utilization of anti-cancer drugs and the delivery of high-quality care.
On November 15, 2019, the Food and Drug Administration approved crizanlizumab-tmca (ADAKVEO, Novartis) to reduce the frequency of vaso-occlusive crises (VOCs) in adults and pediatric patients aged 16 years and older with sickle cell disease. Read more. 
In the latest ASCO in Action Podcast, ASCO CEO Dr. Clifford A. Hudis discusses findings from the ASCO 2019 National Cancer Opinion Survey, which found that only one in four Americans are taking concrete steps to prevent cancer, even though evidence exists that as many as half of all cancer cases are preventable. Further, the survey found that while 6 in 10 adults report being concerned about developing cancer, 25% believe that there is nothing they can do to prevent cancer. The survey also revealed troubling behaviors and attitudes around e-cigarette usage and end-of-life care.
Twenty-Four practices in two countries elevated their standard of care and achieved Quality Oncology Practice Initiative (QOPI®) Certification in the third quarter of this year. ASCO commends these practices that have demonstrated their commitment to providing the highest-quality oncology care to their patients, communities, and contemporaries. Read more.
On November 1, the Centers for Medicare & Medicaid Services (CMS) released its final rule for the 2020 Medicare Physician Fee Schedule (MPFS) and other changes to Medicare Part B reimbursement policies, including proposals related to the Quality Payment Program (QPP).