77 Background: In recent years, several antineoplastic biosimilar products have been approved and marketed for use. We analyzed data from the ASCO PracticeNET learning network to gain insights on the adoption of biosimilar products for bevacizumab, rituximab, and trastuzumab. Methods: Our analysis included the following products: bevacizumab, bevacizumab-awwb, bevacizumab-bvzr, rituximab (excluding rituximab and hyaluronidase), rituximab-abbs, trastuzumab, trastuzumab-anns, and trastuzumab-dkst, administered from July 2019 to March 2020. 19 practices submitted their billing data; practices ranged in size from 2 to 29 hematologists/oncologists. Products were identified through use of healthcare common procedure coding system codes. The proportion of biosimilar product doses administered, as a percent of total doses for all related products, was calculated per participating practice. Results: Use of biosimilar products for bevacizumab (first biosimilar approval in September 2017) was first detected in August 2019, averaging 1.4% of administered doses (confidence intervals included in Table) with a range from 0% to 27% among participating practices; by March 2020, average use increased to 31% with a range from 0% to 100%. Use of biosimilar products for rituximab (first biosimilar approval in November 2018), was first detected in January 2020, averaging 2.6% of administered doses, with range of 0% to 30%; by March 2020, average use increased to 18%, with a range of 0% to 61%. Use of biosimilar products for trastuzumab (first biosimilar approval in December 2017) was first detected in September 2019, averaging 0.9% of administered doses with a range of 0% to 17%; by March 2020, average use increased to 35%, with a range of 0% to 98%. Conclusions: The release of biosimilar products has been identified as a potential opportunity to lower the cost of drug therapy for cancer patients. Our analysis identified an approximate 2-year lag from product approval to initial utilization followed by a steady increase in the use of biosimilar products, along with a wide range of use among practices. [Table: see text]
Introduction: During March 2020, as the emergence of COVID-19 began to influence medical and social behaviors in the United States, oncology practices reported a disruption in normal referral and patient management patterns. Participants and staff of ASCO's PracticeNET learning network sought to explore and quantify the impact of this disruption through an analysis of patient activity at multiple hematology/oncology practices. Methods: 20 practices submitted their billing data for analysis; practices were located in 14 states and ranged in size from 2 to 29 hematologists/oncologists. From this dataset we analyzed a total of 11,453 new patient and consult visits (Current Procedural Terminology codes 99201-99205, 99241-99245, 99251-99255, and 99341-99345) performed by hematologists/oncologists from February 9 to April 18, 2020. The number of visits performed from February 9 to March 14, 2020 was compared to visits performed from March 15 to April 18, 2020. A principal diagnosis was assigned to each visit following usual coding and billing practices. Results: From February 9 to March 14, practices performed an average of 70.1 (median 55.5) new patient and consult visits per week. From March 15 to April 19, practices performed an average of 44.5 new patient and consult visits per week. The average decrease in visits among practices was 35% (95% confidence interval (CI): -42%, -29%). The decline in visits per practice ranged from -61% to -13%. New patient and consult visits for solid neoplasms decreased by an average of 22% (95% CI: -31%, -13%), visits for blood neoplasms decreased by an average of 36% (95% CI: -25%, -47%), and visits for benign hematology and circulatory disorders decreased by an average of 44% (95% CI: -53%, -34%). Conclusions: Oncology practices experienced a decline in new patient and consult visits, first observed in the week of March 15. New patient and consult visits for blood neoplasms, benign hematology, and circulatory disorders experienced a greater decline than visits for solid neoplasms. The decrease in activity could be the result of prioritization of resources or changes in patient behavior in seeking care. Further study is necessary to quantify the impact of these findings on patient access and outcomes and to monitor recovery efforts. Citation Format: Brian Bourbeau, Mou Guharoy, Elizabeth Garrett-Mayer, Stephen Grubbs, Paul Unger, Barbara McAneny, Richard L. Schilsky. Impact of COVID-19 pandemic on new patient and consult visits at 20 hematology/oncology practices in the ASCO PracticeNET learning network [abstract]. In: Proceedings of the AACR Virtual Meeting: COVID-19 and Cancer; 2020 Jul 20-22. Philadelphia (PA): AACR; Clin Cancer Res 2020;26(18_Suppl):Abstract nr PO-022.
Introduction: In response to the need for social distancing and infection prevention during the COVID-19 pandemic, there has been increased use of telehealth services to manage cancer and hematology patients. Throughout March and April of 2020, the Medicare and Medicaid programs expanded coverage of telehealth services, allowing cancer and hematology patients to receive certain telehealth services from their home during the public health emergency. We analyzed data from ASCO’s PracticeNET learning network to examine the reported level-of-service for telehealth services compared to standard in-office visits. Methods: 20 practices submitted their billing data for analysis; practices were located in 14 states and ranged in size from 2 to 29 hematologists/oncologists. We analyzed a total of 33,435 established patient evaluation and management visits performed by hematologists/oncologists from March 15 to April 18, 2020. 3,062 (9.1%) visits were performed via telehealth and 30,373 were performed in a physician office or outpatient hospital department. The level-of-service of each visit was identified through the reported Current Procedure Terminology (CPT) code, where levels 1-5 correspond to CPT codes 99211-99215, respectively, and level 5 represents the highest complexity visit. Telehealth visits were identified through use of the modifiers 95, GQ, and GT, as appended to the applicable CPT code. Results: The level-of-service distribution for telehealth-based visits was level 1 (1%), level 2 (4%), level 3 (35%), level 4 (50%), and level 5 (11%). This contrasted with in-office visits: level 1 (3%), level 2 (2%), level 3 (27%), level 4 (51%), and level 5 (18%). Differences were greatest in level 3 visits (35% vs. 27%) and level 5 visits (11% vs. 18%). Differences in level-of-service persisted when exploring various disease cohorts, including patients with solid neoplasms, blood neoplasms, benign hematology disorders, and circulatory disorders. Conclusions: Analysis of established patient visits showed that telehealth visits were reported at lower level-of-service as compared to in-office visits. This finding may be related to directing straightforward visits to be performed via telehealth or due to limitations in using telehealth by patients with complex medical problems. Citation Format: Brian Bourbeau, Mou Guharoy, Stephen Grubbs, Elizabeth Garrett-Mayer, Kevin Olson, Richard L. Schilsky. Differences in level-of-service for telehealth visits as compared to in-office visits for cancer and hematology patients seen in practices within the ASCO PracticeNET learning network [abstract]. In: Proceedings of the AACR Virtual Meeting: COVID-19 and Cancer; 2020 Jul 20-22. Philadelphia (PA): AACR; Clin Cancer Res 2020;26(18_Suppl):Abstract nr PO-015.
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