Improving Clinical Research and Cancer Care Delivery in Community Settings: Evaluating the NCI Community Cancer Centers Program

Clauser, Steven B.; Johnson, Maureen; O’Brien, Donna M.; Beveridge, Joy; Fennell, Mary L.; Kaluzny, Arnold D.

doi:10.2139/ssrn.2239641

Cited by 10 publications

(11 citation statements)

References 21 publications

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“…2 In 2007, the National Cancer Institute (NCI) established the NCI Community Cancer Centers Program (NCCCP) with a goal of expanding cancer research capacity to more community settings and delivering the latest cancer care to Americans in the communities in which they live. 3 community hospitals and hospital systems committed to contributing to basic, clinical, and population-based research initiatives. Six goals were established: to reduce disparities in cancer care, increase patient participation in clinical trials, improve the quality of cancer care, enhance survivorship and palliative care services, expand the use of electronic health records, and promote collection of high-quality biospecimens for genomic research.…”

Section: Introductionmentioning

confidence: 99%

Experience of the National Cancer Institute Community Cancer Centers Program on Community-Based Cancer Clinical Trials Activity

Hirsch

Locke

Abernethy

2016

JOP

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SUMMARY ANSWER: Despite the short duration, the NCCCP pilot resulted in an increase in the number of open trials and patient accrual at a faster rate than that observed nationally. These results, coupled with insights into the relative success of sites with varying sophistication at the outset, provide promise that lessons learned can be applied more broadly to increase research participation.METHODS: Self-reported data from 2007 to 2010 were aggregated from NCCCP sites and supplemented by data from the NCI Cancer Therapy Evaluation Program, which were then analyzed to assess the impact of the NCCCP on key metrics. RESULTS (OR WHAT WE FOUND):Trial availability and accrual improved more quickly at NCCCP sites when compared with national trends. Phase III trial availability increased 8% nationally versus 16% across NCCCP sites. Accrual to phase III trials increased by 30% nationally versus 133% across NCCCP sites. Accrual of racial and ethnic minorities rose 82%, from 83 to 151 patients, and accrual of patients age $ 65 years rose by 221%, from 200 to 641 patients. Change in trial portfolio and accrual differed by sites' sophistication and prior experience in conducting clinical trials. BIAS, CONFOUNDING FACTOR(S), DRAWBACKS:Ideally, there would be the opportunity to generate this analysis in a randomized, controlled fashion. Unfortunately, no national data set exists and it was not the purpose of the NCCCP approach. Three years is a short timeframe and a relatively small number of sites were involved. REAL-LIFE IMPLICATIONS:Despite the short duration of the NCCCP pilot phase and the limited resources provided, the NCCCP pilot supported progress in sites' clinical trials programs as evidenced in their ability to open clinical trials and to accrue greater numbers of patients. Sites with less infrastructure and experience with clinical research can see large increases in enrollment in later phase trials with modest investment and mentoring. On the other hand, more operationally advanced sites may have maximized this capacity, but can see increases in underserved accrual and the initiation of earlier phase trials (Fig 2). National investments like the NCCCP have the potential to improve care for patients treated in community settings by bringing more clinical trials to community-based settings and involving greater numbers of patients among underserved communities. Materials and MethodsWe examined self-reported data from NCCCP sites during 2007 to 2010, supplemented with data from the National Cancer Institute Cancer Therapy Evaluation Program. ResultsTrial availability and accrual improved more quickly at NCCCP sites compared with national trends. Phase III trial availability increased 8% nationally versus 16% across NCCCP sites, and accrual increased 30% nationally versus 133% across NCCCP sites. Accrual of racial and ethnic minorities rose 82%, from 83 to 151 patients, and accrual of patients age $ 65 years rose by 221%, from 200 to 641 patients. Change in trial portfolio and accrual differed by sophistication of...

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Section: Introductionmentioning

confidence: 99%

Experience of the National Cancer Institute Community Cancer Centers Program on Community-Based Cancer Clinical Trials Activity

Hirsch

Locke

Abernethy

2016

JOP

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“…Approximately 60% of cancer care in the United States is given in community-based settings. 27,28 Recent studies show that the average out-of-pocket spending by patients with cancer is $1,730 to $4,727 per year depending on insurance status. 29 Funding cut backs have led to staff reductions in many of these cancer centers.…”

Section: Discussionmentioning

confidence: 99%

Utilization of Pharmaceutical Patient and Prescription Assistance Programs via a Pharmacy Department Patient Assistance Program for Indigent Cancer Patients

et al. 2016

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Background:With the advances in cancer treatments, mortality rates in the United States have been consistently falling but they are accompanied by substantial increases in the cost of cancer care. Patient and prescription assistance programs (PPAPs) are offered by pharmaceutical manufacturers to provide free medications to medically indigent patients. To assist the Cancer Care Center (CCC) at Nassau University Medical Center (NUMC) with drug costs for chemotherapies, the pharmacy department uses a patient assistance program (PAP) to obtain medications from the drug companies at no cost. Purpose: This study evaluates the impact of the PAP at a public hospital from which indigent cancer patients obtain assistance for chemotherapy. Methods: We followed all patients requiring assistance with chemotherapy who enrolled in the PAP from January 1, 2011 through December 31, 2012. Medications included both oral and parenteral chemotherapy drugs and antiemetics used in the outpatient clinic setting. Results: The program served 347 patients in 2011 and 579 patients in 2012. The total number of visits in the clinic over 24 months was 9,405. The total cost savings of the medications was $1,066,000 in 2011 and $1,715,538 in 2012. Conclusions: A pharmacy-based PAP to procure free medications from PPAPs for cancer patients has helped to defray the expense of providing care at NUMC, increased patients' compliance with chemo protocols, and allowed many patients to receive the treatment they otherwise would not be able to afford. The combination of PPAPs and PAP provides a safety net to ensure that indigent cancer patients receive needed prescription medications in the outpatient clinic setting.

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“…The primary goal of these centers is to provide medical services, and reduce the demand on tertiary hospitals. [3,4] Expanding the initiative of opening community oncology treatment centers depends on its beneficial outcomes, overall treatment quality and patient satisfaction as compared to community hospitals. The present work compares treatment process variables like availability, accessibility, "waiting time to treatment" in addition to treatment quality differences between tertiary hospitals and community oncology centers.…”

Section: Wwwwjprnet Vol 6 Issue 5 2017 39mentioning

confidence: 99%

Chemotherapy Treatment in the Community-Based Oncology Units Versus Tertiary Oncology Units: A Cross Sectional and Observatory Study

Bowirrat¹

2017

WJPR

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Improving Clinical Research and Cancer Care Delivery in Community Settings: Evaluating the NCI Community Cancer Centers Program

Cited by 10 publications

References 21 publications

Experience of the National Cancer Institute Community Cancer Centers Program on Community-Based Cancer Clinical Trials Activity

Experience of the National Cancer Institute Community Cancer Centers Program on Community-Based Cancer Clinical Trials Activity

Utilization of Pharmaceutical Patient and Prescription Assistance Programs via a Pharmacy Department Patient Assistance Program for Indigent Cancer Patients

Chemotherapy Treatment in the Community-Based Oncology Units Versus Tertiary Oncology Units: A Cross Sectional and Observatory Study

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