The Daily Rise: Friday, May 20

Innovation Delivers for Melanoma Patients

Melanoma patients are receiving new hope from a study that shows the success of immunotherapy.

Roughly 40% of patients with advanced melanoma that received Merck’s Keytruda in a clinical trial lived three years after starting their treatment, a Merck-funded study published by the American Society of Clinical Oncology recently found. Other treatments for advanced melanoma have a three-year survival rate that ranges from 10% to 20%.

Keytruda may sound familiar. It’s the same treatment that garnered headlines late last year for helping former President Jimmy Carter treat melanoma that had spread to other parts of his body. He’s now cancer-free.

“Patients with advanced melanoma are often very reasonably scared about the diagnosis, based on reading old statistics about long-term survival probabilities,” Michael Postow, a medical oncologist at Memorial Sloan Kettering Cancer Center in New York, told the Wall Street Journal. “All of these statistics are now being rewritten in a favorable way with these new drugs.”

The potential of immunotherapy treatments, such as Keytruda, proves the value of innovation.

Stroke Awareness Month

May is Stroke Awareness Month, which makes it a great time to remind the public of the symptoms that a person’s having a stroke.  Dr. David Brown, the program director of Orange County’s Hoag Hospital Stroke Program, says that it’s all about thinking FAST.

  • Face – Face drooping
  • Arm – Arm weakness
  • Speech – Speech difficulty
  • Time – Time to call 911 to get to a certified stroke hospital. Check the time last seen normal.

“For every minute a stroke goes untreated and blood flow to the brain is blocked,” Dr. Brown warns, “a person loses about 1.9 million neurons, affecting speech, movement and memory.”

Patients in Orange County can benefit from Hoag’s investment in the most innovative, cutting-edge care available for stroke patients. Hoag patients “receive an initial triage assessment, lab testing and neuro-imaging within 20 minutes of their arrival, surpassing the national benchmark of 30 minutes.”

Funding Girl

It’s not often that Billboard magazine shares the latest in patient-related news. This week, we’re reading Gil Kaufman’s piece on Barbra Streisand and Ronald Perelman’s work to achieve sex and gender equity in medical research.

“Women’s bodies are different than men’s, which can result in health differences,” Streisand and Perelman, the co-founders of the Women’s Heart Alliance, wrote in an op-ed piece published at The Hill. “Yet for too long, women have been absent from or overlooked in clinical studies.”

The entertainment industry moguls remind the public that, although we’ve been making strides in sex and gender equity, more can be done to improve reporting and analysis of how women are impacted by diseases. As evidence of the need for more sex-based research, the pair point to a recent study on atrial fibrillation. By separating patients based on sex, “they were able to show that physical activity was associated with an increased risk of AFib in men while significantly reducing the likelihood of AFib in women.”

“The value proposition is clear,” Streisand and Perelman explain. “The personal toll of diseases like Alzheimer’s, cancer and cardiovascular disease is incalculable, but the economic cost of missed research opportunities is apparent every day.”

Problems with Pay-for-Performance

Forbes contributor John LaMattina, president of Pfizer Global Research and Development, says that pay-for-performance might slow down research that could leave patients without necessary treatments.

The new payment model allows payers to get reimbursed when a drug proves ineffective for an individual patient. One in seven medical payers in the United States now have at least one “pay-for-performance” deal. These arrangements are great when a treatment delivers a specific, measurable outcome. But, as we stress over and over again, neither innovation nor treatment success deliver produce linear results.

LaMattina points out that some treatments, such as those for diabetes, could perform in the short-term but not succeed in curing patients.

“If a diabetes drug is supposed to lower plasma glucose and it fails in some patients, then a rebate is justified. But, such drugs are not cures for diabetes,” LaMattina writes. “Expecting rebates for diabetics that eventually progress to complications like diabetic nephropathy is unreasonable and impractical to administer.”

That raises a question of ethics. Does pay-for-performance shift providers’ focus from a goal of helping patients to a motive of achieving specific data outcomes?

Patients aren’t the sum of print-outs and spreadsheets. We’re more than a white blood cell count. Our health care system must be designed in a way that provides every party with an incentive to work towards the overall health of a patient. We wonder if pay-for-performance narrows the focus in a way that jeopardizes patients’ health.

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