From The Catalyst (blog) – A Conversation with Marcia Kean, Chairman, Feinstein Kean Healthcare

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This entry is reposted with permission from PhRMA’s blog, The Catalyst.

ASCO’s Annual Meeting this week highlighted some of the exciting advances that are emerging in the fight against cancer. PhRMA has joined with many other organizations in supporting a conference next week, “Turning the Tide Against Cancer Through Sustained Medical Innovation,” which is focused on the critical issue of how we sustain this progress in an era of increasing cost-cutting pressure. Conference participants will examine how we measure the value of new treatments and how we can promote high quality, patient-centered care.

The conference is being convened by the American Association of Cancer Research, the Personalized Medicine Coalition, and Feinstein Kean Healthcare. We sat down with each of the conference co-hosts about the event and progress in cancer care.

Conversation with Marcia Kean, Chairman, Feinstein Kean Healthcare


Q:  In the course of 30+ interviews of national thought leaders that you conducted to develop a Discussion Paper for the Turn the Tide conference, what themes emerged most strongly? 

Marcia Kean:  I was very surprised at how much consensus there was from such a disparate group of stakeholders from academe, patient advocacy, industry, providers and payers.  There was strong agreement, for example, that as daunting as cancer is, innovation is going to be the best way to overcome both the clinical and economic burden of cancer in coming years, and that above all, innovation has to be protected.

Five major themes recurred.  The first was around the need for an ongoing, community-wide commitment to overcome the issues we face as a society in oncology.  I don’t mean that everyone had the same perspective about those issues – remember, this was a very diverse set of individuals – but rather, there was agreement that we have the opportunity at this moment to do things differently to accelerate research and improve care, and that in order to reward innovation, it’s important for stakeholders to identify overlapping interests rather than remaining rigid in their safe and separate silos.  Creating a joint, defined vision of what constitutes value will help to outline a pathway for development.

Second, while everyone recognizes that we’ve made progress toward patient-centered cancer care, much more needs to be done. We need a better system for measuring value that puts patients’ needs and preferences first, and keeps up with the rapidly evolving scientific and clinical environment. As personalized medicine becomes more central, of course, this kind of dynamic measurement will only become more difficult.

Third, there’s huge excitement about the potentially positive impact of digital technologies to accomplish the dramatic productivity gains in cancer research and care that they’ve done for other fields.  Developing effective tools for shared decision-making and clinical decision support is seen as a major opportunity in that regard.

Fourth, there’s a desire to move to “next-generation” tools for assessing value through Health Technology Assessment, as well as a fervent desire to develop next-generation Comparative Effectiveness Research that aligns with personalized medicine and gives a fuller picture of real-world value. We heard that current approaches aren’t centered enough on patient value, and don’t do an adequate of job keeping pace with how the use and value of tests and treatments evolves over time – they are just too static in a highly dynamic world.

Finally, there’s a strong drumbeat about the shift to models of “continuous learning” that give a more dynamic, patient-centered picture of value, so that every clinical encounter informs our overall knowledge base and research advances are moved rapidly into clinical use.  That virtuous circle is seen as the light on the horizon for all of us.

Q:  Your firm has been very active in efforts to implement health information technology and develop a learning health care system. How will these concepts accelerate progress in cancer care?

Marcia Kean:  In some ways, the field of biomedicine has been the last to benefit from the digital revolution.  For many cultural – and technical – reasons, we just haven’t been able to move data rapidly from lab bench to doctor’s office to hospital to patient, and so on.  But there is a growing cadre of researchers and clinicians and patients who are demanding the kind of ‘data liquidity’ in science and health care that they see in every other sector of their lives, and they are gaining traction.  Once we have seamless data exchange, based on the use of standards in Health Information Technology and bioinformatics tools, we’ll have a solid foundation for a learning health care system. In that picture, everyone wins:  innovators can accelerate and improve research; patients and doctors can get the information they need to make wise decisions; and the efficiency of the process can drive down costs.

However, we need to remember that even a digitally-enabled system doesn’t happen in a vacuum — it has to unfold in a community where every sector is interconnected and working towards a common, patient-centered vision, because all these challenges and solutions are inter-related in a very complex and dynamic ecosystem.

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