Forbes Contributor Arlene Weintraub recent sat down with Stuart Goldberg, an oncologist with Hackensack University Medical Center who specializes in leukemia and other blood cancers, to discuss CAR-T treatments, cancer care and health care costs.
“Arlene Weintraub: The rise of immuno-oncology, most recently CAR-T treatments, has sparked concerns about the cost of cancer care. How should payers and providers be thinking about these new treatments?
Stuart Goldberg: This year it’s immunotherapy. A couple of years ago it was targeted therapies. There will always be advances. The advances will make everybody’s life better, give them better quality and outcomes. But when new technology comes in, you have to first consider does it change outcomes? Then you build that into your reimbursement models.
Once you set your prices, you need to have the ability to adapt them. You should monitor the treatments to see if they’re actually working. This is what Cota is doing—we’re looking at the quality outcomes of patients who are receiving particular therapies and then determining cost effectiveness based on that.
Weintraub: What’s next for technology and controlling cost of care?
Goldberg: Decision support is very important, so we’ve partnered with IBM Watson. Cota goes into a chart, pulls out all the relevant information and hands it to Watson. It runs the Watson algorithm, which basically searches all the medical literature and says, ‘here’s what the experts think you should do.’ It then flips into the Cota system and shows how many patients with this same profile have been treated at your particular hospital—and what their outcomes were.
So you get back the textbook answer, but you also get the real-world answer. We’re piloting that right now at our hospital.
Eventually we expect that the third screen will be the insurance carrier’s view of the world. So here’s what the textbooks say, here’s what the real world is saying, and here’s what the costs are. That will allow everyone to make better decisions. We’re getting there.”