Future of Care in CLL: Provider, Managed Care Perspectives

Adam Kittai, MD, hematology specialist and assistant professor of medicine, Ohio State University; Farrukh Awan, MD, professor of internal medicine, UT Southwestern Medical Center; and Jeffrey Dunn, PharmD, MBA, chief clinical officer, Cooperative Benefits Group, respond to recent advancements in chronic lymphocytic leukemia care and look ahead at what the future may hold.

This podcast is a highlight from part 2 of a roundtable discussion focused on chronic lymphocytic leukemia, titled, "Payer, Clinical Considerations for Treating Patients With Zanubrutinib."

The first part of the roundtable can be viewed here.

Read the transcript:

Dr Adam Kittai: It's a really exciting time in CLL and B-Cell lymphoid malignancies. Our drugs are just getting better in terms of both efficacy and safety. And I think that for our patients specifically, we've had remarkable advances over the last 10 years, and I'm excited to see what's to come.

Dr Farrukh Awan: I agree. I think these are exciting times. We have so many new, exciting treatments, and we are now arguing about cost and efficacy and toxicity. Ten years ago, we didn't have this luxury. I think it's a great outcome for patients.

We are now a little spoiled because of all we have for managing the disease, that we are now arguing about how we can select one agent over the other based on the different side effect profiles and the cost of care, both to the health system and the patient. I think these are exciting times to be in, and hopefully we can continue to work on these drugs and develop more which are better for our patients, and hopefully our patients can live a normal life.

I think this is exactly the time where you start debating this whole concept of curing cancer. What is a cure, and what does it actually mean? How much should a cure cost? Is a cure even important? These are very important health care discussions, and I think we've been fortunate that we are now in a position to talk about these issues since we are doing such a good job for the vast majority of our patients.

Dr Jeffrey Dunn: It's awesome that we have better agents and we're making clinical advancements. It would be nice if we did a better job at de-siloing health care: sharing risk, aligning incentives, all of those buzzwords. I think the shared risk is more between payers and pharma, but aligning incentives, we all want to do the right thing for our patients and for our members.

My fear is if we continue to ignore cost and don't manage this, patients who need these drugs won't be able to take them.