Cancer patients and Quality of life : the 3 next steps to reach optimal care management

1. Value-based care – for the patient’s benefit

When it comes to care pathways, we can observe a movement towards patient centricity in the recent years. This translates optimally into a focus on outcome and one of its key measures, patient’s quality of life.

The concept of value-based care is of special interest and importance in cancer care as cancer treatments are often very costly and inefficiencies in care can further increase these costs. The focus of value-based healthcare is the reimbursement of costs of a healthcare outcome driven by optimized personalized approaches, standardized treatment schemes, multidisciplinary collaboration and the accessibility to- and knowledge in handling data.

An example could be expensive CAR-T cell therapies such as Kymriah and Yescarta: some countries have introduced rebates (Germany) or staged payments (Italy and Spain), which are linked to individual patient outcomes.

This stands opposite to volume-based care that favors volume-based reimbursement and incentivizes physicians (often) to provide volume not quality to patients when it comes to care. In my opinion, value-based cancer care plays an important role in the future and one step towards this is the optimization of patient- or treatment pathways.

2. Optimizing the cancer treatment pathway increases patients’ quality of life

Not only drugs and the treatments themselves influence quality of life, rather the whole patient pathway has an impact on this multidimensional concept. Treating patients in an optimal manner is very often a key challenge for hospitals or physicians in private practices. The problems or pain points being various such as a lack of disease awareness of physicians and patients, lack of treatment structures and SOPs or a lack of engagement of treating stakeholders. Also, it can happen that hospitals are overwhelmed by innovative and complex treatments as structures and knowledge do not exist and consequently patients’ needs are not optimally served anymore.

All barriers for optimal care can negatively impact patients’ quality of care. For a therapy to be successful, physicians and patients need to be aware and well educated and structures provided. Care optimally is done in a multidisciplinary mode and modern cancer care accesses data as a tool to streamline care and enable efficient care management. Pathway optimization shall target these and other unmet needs by sharing best practices, providing personalized counselling including auditing, or by establishing networks of specialists and care structures.

Learn more about patient care pathways >

3. Digital tools and digital therapeutics can support patients’ QoL

Pathway optimizations come together with digital tools with an interesting range of applications.

On the one hand, digital tools will allow the patient to self-monitor themselves, a pre-requisite to track symptoms and realize early signs of aggravation of e.g., symptoms. This can be done using apps, wearables, or other types of technologies. This leads to the 2^nd layer of connectivity, which is to connect patients with physicians. Allowing to transmit daily news, symptom tracking etc. gives the physician the chance to swiftly react, modify treatments and be often able to avoid a severe aggravation of symptoms. Again, the physician – by doing so- can help the patient immediately by feeling better, can help the hospital in avoiding unnecessary hospitalization and also help the patient in the longer run in gaining better QoL including longer survival.

Digital tools can also be used for awareness raising, knowledge sharing and shared decision making. The latter 3 elements are essential for an environment of trust, will increase adherence and QoL and fall in the category of digital therapeutics.

Besides, patients will have more and more responsibility than nowadays and work conjointly with the industry, for example to re-define how clinical trials are designed and executed. Compassionate care and novel technologies such as digital tools will make treatment smoother and more plannable, and enable patient-centric treatment. Digital tools also allow for simple access and analysis of data, which often involves artificial intelligence and is subject of another review.

The Covid-19 pandemic has substantially changed how cancer patients care is organized and executed. On the one hand, positive effects can be seen and have impacted on care pathways; for example, more often remote care is applied, which for cancer patients can have many positive impacts such as reduced travel load or hospitalization, or lower risk of Covid infections. Digital tools in the communication have been introduced in cancer care and these tools already change care pathways and further optimizations together with value-based care approaches will play an important role in the future of cancer care. On the other hand, Covid-19 has impacted negatively on side quality of life of many patients, and concerns later diagnosis, postponed treatment starts and decreased survival and QoL. It will be important to see how the needs of cancer patients is targeted in the post-Covid era. We will keep you posted around these important topics on QoL!

About the author,

Volker, Great Explorer Oncology in Alcimed’s Healthcare team in Germany