%0 Journal Article
%T Oncology Clinical Pathways: A Form of Governance?
%A Peter Paul Yu
%J General Information | Journal of Oncology Practice
%D 2018
%R https://doi.org/10.1200/JOP.17.00084
%X The 2016 ASCO Policy Statement on Clinical Pathways in Oncology delineated attributes of oncology clinical pathways (OCPs) that support transparency, timeliness, evidence-based recommendations, and the best practices of academic and community oncologists.1 In particular, the design of OCPs should support the choice of a clinical trial when available, and oncologists should not be subjected to compliance with multiple OCPs when one would meet the criteria for high quality. The focus is on the governance and process by which OCPs are constructed and not on the specifics of each OCP. In this issue of Journal of Oncology Practice, Daly et al2 report on OCP products currently available in the United States. Only four such products were identified by the authors, and fears regarding the proliferation of OCPs that would result in variability and confusion have not yet materialized. Two OCPs can trace their origins to academic medical centers. The first is Via Oncology, which originated at the University of Pittsburgh Medical Center, and its disease committees had a strong commitment to input from community oncology. The second is Value Pathways, which is powered by the National Comprehensive Cancer Network (NCCN), and it combines the NCCN academic medical center network with the community oncology¨Cbased US Oncology Network of McKesson Specialty Health, which provides oncology drug distribution among its business lines. Third is the Anthem/AIM Cancer Care Quality Program, which is owned by a payer, and fourth is New Century Health, which is owned by Water Street, a health management company. Two state legislatures have bills under consideration that regulate the use of OCPs by health plans and insurers. Both California state oncology societies, Association of Northern California Oncologists and Medical Oncology Association of Southern California, cosponsored AB 1107.3 This bill provides an opportunity for input on OCPs from oncologists and oncology societies, requires timely updates as new evidence develops, transparency regarding the evidence base and rationale used and identification of the individuals or institutions involved in designing the pathways. Importantly, an OCP is broadly defined as a cancer treatment plan used by physicians and surgeons that includes procedures, tasks, interventions, and treatment regimens, and it is not limited to chemotherapy. The California Health Benefits Review Program (CHBRP), created by the University of California under statutory authority, is required to assess the medical, economic, and public health impact of
%U http://ascopubs.org/doi/full/10.1200/JOP.17.00084