/ Print /

  • linkedin
  • Increase Font
  • Sharebar

    Four things payers need to know about acute myeloid leukemia

    It’s always an acute scenario when a patient presents with acute myeloid leukemia (AML), and it’s important for payers to keep that in mind, says Bruno Medeiros, MD, associate professor of medicine (hematology) at the Stanford University Medical Center and director of Cancer Center Infusion Area Treatment Services at the Stanford Cancer Center.

    “These patients are arriving at the hospital with a life-threatening illness, and their survival could be measured in weeks. That means they need a complete workup so their care team can gain a complete understanding of their disease process in a rapid manner.”

    That means physicians need to be able to move quickly to care for patients with AML, and they need to have payers on board with the ability to make real-time decisions about treatment plans, adds Medeiros.

    Here are four more things payers need to be aware of about the treatment of AML:

    1. There are many comorbidities in older adults

    Philip Kuriakose, MD, senior staff physician at Henry Ford Cancer Institute and assistant professor at Wayne State University Medical School, says that since AML presents at an older age, patients with the condition may be struggling with other chronic conditions such as diabetes, hypertension, heart failure, or kidney disease.

    Because AML patients must also manage those conditions, Kuriakose, who is also a member of the American Society of Hematology’s committee on practice, says it’s difficult to prototype this disease. Thus, treatment is very different from patient to patient, he adds.

    2. Treatment differs significantly from other cancer types

    Treating AML is also different from treating other types of cancer. With AML, chemotherapy is often delivered to patients in an inpatient setting—and, often, hospitalizations are prolonged or patients have to return to the hospital if there are complications.

    Medeiros says that inpatient hospitalizations for AML patients can be as long as four to six weeks, and physicians may have to decide to refer a patient for a bone marrow transplant, which can add additional complexity and require additional resources.

    Payers should look to bone marrow transplant pathways for guidance on covering appropriate treatment paths for AML.

    As is the case with the treatment of bone marrow transplants, payers could rely on working closely with Centers of Excellence, such as with Boston’s Dana-Farber Cancer Institute and Arizona’s Mayo Clinic for bone marrow transplants, says Medeiros.

    In his ideal treatment approach for AML, only Centers of Excellence would be able to treat such patients, which would allow specific healthcare facilities to work collaboratively with payers to optimize and standardize care, he says. On a practical level, the Centers of Excellence for AML would be regional, meaning, for example, that a location in Omaha, Nebraska, would treat patients in Nebraska and a Boston location would treat New England patients.

    3. Clinical trials hold promise for AML patients, but costly

    Clinical trials can be a good option for patients with AML, says Medeiros. Sponsored by the government or the pharmaceutical industry, patients involved in clinical trials are treated with experimental drugs in centers based on clinical trial protocols. And often, these clinical trials are done in conjunction with other clinical therapies for AML.

    However, since clinical trial drugs may not be “fruitful” and indeed “toxic,” he adds that these patients may need to be admitted to the hospital more frequently, which also adds cost.

    4. Many tests may be needed

    Kuriakose notes that many patients with AML are potentially curable. That means many patients will have to endure a variety of tests, and payers should be aware of this as decisions are made about appropriate treatment paths.

     

     

     

    Aine Cryts
    Aine Cryts is a freelancer based in Boston. She is a frequent contributor to Managed Healthcare Executive on topics such as diabetes, ...

    1 Comment

    You must be signed in to leave a comment. Registering is fast and free!

    All comments must follow the ModernMedicine Network community rules and terms of use, and will be moderated. ModernMedicine reserves the right to use the comments we receive, in whole or in part,in any medium. See also the Terms of Use, Privacy Policy and Community FAQ.

    • [email protected]
      am writing this comment to inform the general public about the power of traditional herbs, way more effective than tablets, although it may not sound convincing, but believe me its the last resort in getting free from std stigma and pain .i had gonorrhea some few months back and tried so many ways to get healing but to no avail until i was told to get traditional medicine , its the only way to get rid of it permanently without re-occurrence so i had to searched the internet for a good traditional herbal doctor. i came in contact with dr.kpomosa a traditional doctor a very faithful one, he made me herbal medicine that healed me within 3 weeks of medication. now i text negative of Gonorrhea all thanks to dr.kpomosa. Publishing his work on internet is one of my way of saying THANK YOU dr.kpomosa for helping me with my health need. he also has effective herbal mixture that can cure stds like herpes, syphilis,hiv/aids etc. i will recommend Dr.kpomosa for those that are reading this post right now, trust me you wont regret it. its cheaper and faster than tablets, his mail is ;[email protected] .. in case you want to get more info from me,i will be glad to hear from anyone. you can reach me on [email protected] regards Brian Roland

    Follow Us On Twitter

    Find us on Facebook

    Latest Tweets Follow