The Use of Clinical Pathways in Oncology: Managing Evidence-Based Practices

The adoption of clinical pathways helps to standardize the cancer care process, and this practice is becoming increasingly popular.

With 25% of the pipeline consumed by expensive new oncology treatments, it will become increasingly difficult for commercial health plans to restrict costs in the next few years. Aside from the traditional utilization methods, such as prior authorization, payers are looking to reduce treatment variability by expanding the use of clinical pathways in oncology care.

According to a report from Campbell Alliance representing 38 managed care health plans, 29% of plans have implemented the use of clinical pathways in oncology care, and over half of those surveyed plan to employ pathway-based programs by 2014. A majority of these payers anticipate expanding the use of treatment restrictions from the largest cancer categories to additional tumor types, including prostate, lymphoma, myeloma, and renal cell carcinoma. In addition, nearly 40% of payers plan to expand the use of clinical pathway programs to new geographic regions.

The adoption of clinical pathways helps to standardize the cancer care process, and adherence to established protocols may lead to significant cost savings, noted the authors of the report. “Pathways may lead to cost savings by encouraging the use of generics, streamlining treatment choices, and reducing side effects while maintaining outcomes,” the researchers wrote.

Companies that develop cancer therapies should develop a strong “economic value proposition” for their medication so that they may justify value to payers. With pathways gaining traction, report authors suggested that drugmakers should focus their efforts on ensuring pathway inclusion of their therapy on formularies and monitoring the pathway adoption of competing products.