The development of new cancer treatments has created an opportunity to turn some cancers into chronic, manageable diseases and allow many people to return to work.
That was one of the key messages at the 2016 Employers Cancer Care Summit as an expert panel discussed the rise and implications of the new treatments for the workforce.
The panel included Dr. Peter Anglin, medical director at CAREpath; Dr. John Bell, scientific director at BioCanRx; Dr. Christine Brezden-Masley, head of the division of hematology/oncology at St. Michael’s Hospital; Lizann Reitmeier, national health practice leader at Xerox HR Services; Dr. Mark Vincent, medical oncologist with the London regional cancer centre in the department of oncology at Western University; and Joan Weir, director of health and dental policy at the Canadian Life and Health Insurance Association.
“I think the big trend in the last 10 to 15 years has been a move from drugs that we would give that killed all cells, including normal cells, to a more targeted approach where we’re focusing on the cancer cells,” said Anglin.
A particular type of treatment the panellists discussed in depth is immuno-oncology that targets the immune system to help fight the cancer.
“Not only can these new treatments help people live longer; they can also impact a plan member’s ability to return to work or stay in the workforce because the treatments are designed to not have the same debilitating side-effects as traditional treatments,” said Bell, acknowledging that there are still side-effects to some new therapies as they’re in the early stages of development. “We know that we’re not there yet.”
As the new treatments are expensive, many plan sponsors are moving to managed formularies in which the formulary manager decides what to cover as a way to contain costs and increase sustainability. Some insurance companies have policies with the same goal through so-called watch-and-wait programs in which they place drugs that are expected to have a significant financial impact on watch and subject them to further review before adding them to a plan.
“We have drug plans that are increasing in cost substantially and so insurers are looking at every opportunity to manage those costs,” said Weir.
Panellists cautioned that such approaches could have medical implications. Brezden-Masley, for example, noted the health risks that can emerge due to treatment delays caused by funding issues.
Reitmeier noted there could be financial implications, too. “You may be limiting your drug cost but you may be shifting over to a disability cost as a person takes longer to get back to work because of a delay in the treatment,” she said.
A potential way to reduce costs is to perform diagnostic testing for biological markers that can help determine if a treatment will be successful. “That’s going to be absolutely essential to actually get costs down because we won’t treat people we shouldn’t treat and we will treat the people who actually have a chance to respond,” said Bell.
With the rapid developments in treatment, it’s important for employers to stay current. Weir said most insurers have case managers who can provide resources to help. Another source of assistance is a new web resource in the works called Cancer and Work that will provide materials and practical tools geared toward plan sponsors. It will launch in the spring of 2016 at cancerandwork.ca.