A clinical pathways navigation program for patients with non-small cell lung cancer significantly reduced cost of care while preserving clinical outcomes, according to a study that will be presented at the 2017 American Society of Clinical Oncology (ASCO) Quality Care Symposium.1
With the goal of decreasing costs and reducing medical complexity, the lung cancer group at Dana-Farber Cancer Institute (DFCI) in Boston, MA, created a customized clinical pathways program to prospectively support and guide medical decision-making for patients with stage IV non-small cell lung cancer (NSCLC). The team partnered with Via Oncology to develop a web-based platform for real-time pathway navigation and post-treatment data aggregation, which went live in January 2014.
To evaluate the impact of the DFCI Pathways for NSCLC program on cost and outcomes, investigators in the thoracic oncology program analyzed data from 160 patients with stage IV NSCLC diagnosed in 2012 who did not participate in the program and 210 patients diagnosed in 2014 who did.
Patients between groups were similarly matched with respect to smoking status and presence of targetable changes in EGFR and ALK; however, the pretreatment group had more women (61% vs 50%).
After adjusting for multiple variables, results showed that the average total 12-month cost of care was $67,050 for patients diagnosed in 2012 and $52,037 for patients who participated in the pathway navigation program, corresponding to a savings of $15,013 after implementation of the program.
The study further demonstrated that implementation of the clinical pathways program did not compromise clinical outcomes, with no significant difference in median overall survival between 2 groups (P = .08).
The findings suggest that a clinical pathways navigation program can significantly decrease health care costs without negatively impacting clinical outcomes for patients with advanced lung cancer.
1. Zhang Y, Fraile B, Dalby CK, et al. Cost and survival analysis before and after implementation of Dana-Farber Clinical Pathways for Patients with Stage IV Non-Small Cell Lung Cancer. J Clin Oncol. 2017; 35 (suppl 8S; abstract 3).