Published: Friday, June 8, 2012, 12:01 a.m.
In our view / Insurance decisions
Let physicians do their job
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Seemingly every day we read of new discoveries, advancements and treatments in the field of cancer research, particularly breast cancer.
This week brought news of doctors who successfully dropped the first "smart bomb" on breast cancer, using a drug to deliver a toxic payload to tumor cells while leaving healthy ones alone, the Associated Press reported.
Other researchers have developed a tool that helps the immune system attack a broad range of cancer types, Fox News reported. Treatments are being developed that are aimed at newly discovered genes and cancer pathways, including better tests to predict which patients will benefit from them.
"I see major advances being made in big diseases" such as breast and prostate cancers, said Dr. Richard Pazdur, cancer drug chief at the FDA, which on Wednesday announced a new policy intended to speed breast cancer drugs to the market. More are expected to hit the market this year, Reuters reported.
These are encouraging steps. Especially the recognition that no two cancers are really alike, and treatments must be individualized for patients to get the most benefit from them. The patient's doctor is the only person qualified to decide what specific treatment is right for each individual patient.
What is extremely discouraging is that under our current system (and there's no indication the new health care law would help, hurt or affect this problem), insurance companies continue to have too much say -- that is, the ability to deny -- over the very treatment a physician recommends for her patient.
When an insurance company insists on a "protocol" for treatment of a reoccurrence of breast cancer, for example, rather than the physician's recommendation, it's based on the current science available to them, which is always going to lag behind an oncologist's knowledge gained through ongoing experience with individual patients.
So the oncologist and the patient are put in the position of "fighting" the insurance company for the best treatment. This costs time and money, and causes ongoing stress for the patient, who is waiting to continue cancer treatment. The physician might know the side effects from the treatment the insurance company is insisting on could actually harm her patient more than help, which may be why she recommends something newer, and better. We're not talking about experimental treatments, but already FDA-approved ones.
Often, "newer" means costlier. But when the evidence also shows it's "better," no one should have to worry one second about their cancer treatment being covered. Too often, when someone needs it the most, our "health insurance industry" insists on getting between them and their doctor. Which sounds like malpractice.
This week brought news of doctors who successfully dropped the first "smart bomb" on breast cancer, using a drug to deliver a toxic payload to tumor cells while leaving healthy ones alone, the Associated Press reported.
Other researchers have developed a tool that helps the immune system attack a broad range of cancer types, Fox News reported. Treatments are being developed that are aimed at newly discovered genes and cancer pathways, including better tests to predict which patients will benefit from them.
"I see major advances being made in big diseases" such as breast and prostate cancers, said Dr. Richard Pazdur, cancer drug chief at the FDA, which on Wednesday announced a new policy intended to speed breast cancer drugs to the market. More are expected to hit the market this year, Reuters reported.
These are encouraging steps. Especially the recognition that no two cancers are really alike, and treatments must be individualized for patients to get the most benefit from them. The patient's doctor is the only person qualified to decide what specific treatment is right for each individual patient.
What is extremely discouraging is that under our current system (and there's no indication the new health care law would help, hurt or affect this problem), insurance companies continue to have too much say -- that is, the ability to deny -- over the very treatment a physician recommends for her patient.
When an insurance company insists on a "protocol" for treatment of a reoccurrence of breast cancer, for example, rather than the physician's recommendation, it's based on the current science available to them, which is always going to lag behind an oncologist's knowledge gained through ongoing experience with individual patients.
So the oncologist and the patient are put in the position of "fighting" the insurance company for the best treatment. This costs time and money, and causes ongoing stress for the patient, who is waiting to continue cancer treatment. The physician might know the side effects from the treatment the insurance company is insisting on could actually harm her patient more than help, which may be why she recommends something newer, and better. We're not talking about experimental treatments, but already FDA-approved ones.
Often, "newer" means costlier. But when the evidence also shows it's "better," no one should have to worry one second about their cancer treatment being covered. Too often, when someone needs it the most, our "health insurance industry" insists on getting between them and their doctor. Which sounds like malpractice.
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