As a large country, economic disparities persist as a public health issue in Brazil, with 70% of the population depending on the public health system. According to Dr. Theodora Karnakis, the aging population of patients with cancer is expected to result in a 61% increase of new cancer cases between 2020 and 2040. The type of care received depends heavily on where patients are located, due to the varying allocation of services. Dr. Karnakis emphasized equitable access to high-quality care, thorough cancer prevention efforts, and patient education as priorities in her country.

Guest:

Theodora Karnakis, PhD

Coordinator of Oncogeriatrics

Cancer Institute of the State of São Paulo-ICESP/FMUSP

Coordinator of Oncogeriatrics

Hospital SírioLibanês

São Paulo, Brazil

Quote:

"It's very interesting to recognize that in each part of the world, [our situations are different, yet the same]. It's difficult to imagine that our reality is the same in other countries...but at the same time, we learn a lot and find ideas to propose in our country."

Read more global perspectives from the international panelists who spoke at the October ACCC 41st National Oncology Conference in this ACCCBuzz blog.

Additional Resources: Quality Improvement Officers: Key Members of the Multidisciplinary Cancer Care Team – Oncology Issues Patient Navigation Services Promote Equitable Access to High-Quality Care Tailoring Education for the Oncology Patient – Oncology Issues ABC's of Health Disparities Reimbursement Changes Seek to Reduce Disparities in Access to Cancer Care

It is crucial that multidisciplinary cancer care teams stay informed about upcoming changes to Medicare Part D under the Inflation Reduction Act. To support this effort, the Association of Cancer Care Centers (ACCC) is committed to providing updated information on health care policy changes, ensuring that both providers and patients are aware of the financial benefits. In this episode, CANCER BUZZ speaks with Lindsay Greenleaf, JD, MBA, solution leader in federal and state policy at ADVI Health and Pam Traxel, senior vice president of alliance development and philanthropy at American Cancer Society, Cancer Action Network, to discuss the impact of these policy updates. Ms. Greenleaf sheds light on the $2,000 out-of-pocket cap that will take place for Part D patients in 2025 and how future pricing policy could have an effect on drug innovation. Ms. Traxel expands on benefits and challenges involved with providing updates to oncologists on the new Medicare Part D cap, with the goal of ensuring that all patients who could benefit are aware.

"I think the most important thing that oncologists and their practices can do is to make sure that they are providing information to patients about the fact that there is a change that will hopefully allow patients to better afford their cancer care." -Pam Traxel

"The second key piece of the Inflation Reduction Act related to Part D has to do with Part D benefit redesign, and that is what kicks in January 1, 2025, and that is a very notable, very positive change to the law where we finally have a $2,000 out-of-pocket cap that will be in place for Part D patients. This is a huge win for cancer patients, specifically due to the historically very high out-of-pocket costs for oral cancer drugs." -Lindsay Greenleaf

Lindsay Greenleaf, JD, MBA

Solution Leader, Federal & State Policy

ADVI Health, LLC

Austin, TX

Pam Traxel

Senior Vice President of Alliance Development and Philanthropy

American Cancer Society, Cancer Action Network

Silver Spring, MD

This podcast was developed in connection with the Oncology State Society Policy Program and made possible with support by Johnson & Johnson.

Resources:

ACCC Access, Payment & Reimbursement

CMS Medicare Part D Improvements

Immunotherapy and targeted therapies have transformed the way patients are treated and allow more patients than ever before to survive stage IV diagnoses. Other key advancements in oncology being prioritized in Puerto Rico today include early detection and prevention efforts. However, a lack of education, access, and health insurance coverage often prevents community members from timely cancer screenings. The same factors contribute to a lack of diversity in clinical trials, as noted by Dr. Marcia Cruz-Correa. Both these important issues require a community-based approach, through building advisory groups, working with local oncologists, and reaching community members where they are in a way they understand.

Guest:

Marcia Cruz-Correa, MD, PhD, AGAF, FASGEExecutive DirectorCentro Comprensivo de Cáncer de la Universidad de PuertoSan Juan, Puerto Rico

Quote:

"Less than 5% of patients in the US participate in clinical trials...and less than 5% of that [group] is diverse. That's a huge disadvantage...If you don't include the patients who will eventually be taking the drugs developed by pharmaceutical companies, how do you know it will work for them?"

Read more global perspectives from the international panelists who spoke at the October ACCC 41st National Oncology Conference in this ACCCBuzz blog.

Additional Resources:

Bridging the Gap: Early Detection of Cancer for the Medically Underserved – Oncology Issues

Effective Patient-Provider Communication for Colorectal Cancer Screening

Multi-Cancer Early Detection: Legislative Landscape— [PODCAST] EP 99

Examining Clinical Research for Patients with Acute Myeloid Leukemia

2023 NMQF Summit: Improving Diversity in Cancer Clinical Trials

In both high- and low-income countries, the most common struggles patients with cancer face are largely the same, including financial toxicity from treatment costs, difficulty with transportation to and from appointments, and the impact of treatment on their caregivers and families. Consistently, the greatest barrier to accessing health care in many nations is a lack of insurance coverage, often driving many patients to travel hours away to large centers to get basic oncology care. All health systems work with limited resources to some degree. The challenge faced across the globe is finding the best way to allocate those resources to help the patient population as much as possible. To that end, low-income countries often find ways to reach the same outcomes as high-income countries like the US, at a fraction of the cost, shared today's guest who has practiced medicine in both Mexico and the United States.

Guest:

Enrique Soto Pérez de Celis, MD, PhDAssociate Director for Global Oncology University of Colorado Cancer Center Aurora, Colorado

Quote:

"For multicultural countries like the US where people come from all over the world…[it's important to] make sure that we are providing care that has cultural humility, that includes the values of their culture and the things that matter to patients. That's what we should try to do: provide patients with care that is personalized to them, their values, their family, and their culture."

Read more global perspectives from the international panelists who spoke at the October ACCC 41st National Oncology Conference in this ACCCBuzz blog.

Additional Resources:

Addressing Social Determinants of Health through a Medical-Legal Partnership – Oncology Issues

Overcoming Health Disparities through Remote Patient Monitoring — [PODCAST] EP 97

Navigation: A Critical Component in a Comprehensive Approach to Dismantling Health Inequities – Oncology Issues

NOC Preview: Financial Advocacy Guidelines to Mitigate Financial Toxicity - [MINI PODCAST]

Providing Comprehensive Financial Advocacy Services in Rural America

UCSF Health's Seeking Care Patient Experience Team introduced web self-scheduling to improve fragmented workflows and streamline the process of seeking care from a cancer specialist. Patients now have the option to conveniently self-register and schedule appointments through 2 distinct models: direct scheduling of a new-patient appointment or use of a navigator-led intake appointment. This innovative self-scheduling approach improved the patient experience and contributed to cancer service line growth. Read more about this initiative in "The Evolution of Patient Empowerment: Self-Scheduling New Patient Consultations" in the Volume 39, Number 4 Oncology Issues.

"A lot of our stakeholders felt that patients would not be capable of accurately self-scheduling. [We found] that is not true. We were able to design simplified decision trees for patients to help them have high accuracy selecting the right practice and provider." —Laurel Bray-Hanin, MA

"Almost 50% of the patients who used our online self-scheduling did so outside of traditional business hours…in evenings and weekends. That's the time when they're able to deal with their medical care. And I think that's pretty striking because typically our call centers and staff who might respond to messages are not available during those hours."—Laurel Bray-Hanin, MA

Laurel Bray-Hanin, MA

Vice President and Chief Operating Officer of Cancer Services

UCSF Health

San Francisco, CA

Resources

Improving the Care of Patients Newly Diagnosed With Breast Cancer—Oncology Issues

Bedside Scheduling Improves Patient Access—Oncology Issues

Patient-Centered Scheduling

How Infusion Scheduling is Like a Game of Tetris—Oncology Issues

Breast Care ACCESS Program—Oncology Issues

CANCERBUZZ speaks with Dr. Naoto Ueno about his NOC session titled The Hawaiʻi Cancer Consortium: An Equitable Clinical Trials Initiative.

Guest:

Naoto T. Ueno, MD, PhD, FACP

Director

Interim Program Co-Leader, Cancer Biology Program, Translational and Clinical Research

University of Hawaiʻi Cancer Center

Resources:

ACCC 41st National Oncology Conference

CANCERBUZZ speaks with Melanie Grant about her NOC session titled Navigating Access and Equity: Providing the Answers That Matter.

Guest:

Melanie Grant, Esq.

Staff Attorney

Triage Cancer

Resources:

ACCC 41st National Oncology Conference

CANCERBUZZ speaks with guests at the 2024 NOC Gala event about what they are looking for at the conference.

Guests:

Una Hopkins, DNP, MSN, BSN, FNP-BC, NE-BC, FACCC, RN

ACCC President-Elect

Director for Research and Evidence Based Practice

Montefiore Medical Center

Bronx, NY

Nadine Barrett, PhD, MA, MS

ACCC President

Senior Associate Dean, Research Equity and Community Engagement

Wake Forest School of Medicine

Durham, North Carolina

Russell C. Langan, MD, FACS, FSSO

Director of Surgical Oncology

RWJBarnabas Health and the Rutgers Cancer Institute of New Jersey

Jersey City, New Jersey

Brittany McArn, OPN-CG, CPPN

ACCC Advisory Committee

Financial Navigation Manager, Outpatient Oncology Services

FirstHealth of the Carolinas, Inc.

Pinehurst, NC

Beau Palin

Co-Founder & COO

Colla Health

JiaJoyce Conway, DNP, CRNP, AOCNP

ACCC Board of Trustees

Nurse Practitioner

Cancer Care Associates of York

York, PA

Resources:

ACCC 41st National Oncology Conference

CANCERBUZZ speaks with Terry Keys about his NOC session titled Empowering Partnerships: Enhancing Cancer Research Through Patient Advocacy.

Guest:

Terry Keys

Patient Advocacy Manager

Staff Senator – President's Advisory Committee

University of Kentucky Markey Cancer Center

Lexington, KY

Resources:

ACCC 41st National Oncology Conference

CANCERBUZZ speaks with ACCC President Dr. Nadine Barrett about this year's NOC theme: Realizing Innovation. Listen to what's new in conversations and oncology education in 2024.

Guest:

Nadine Barrett, PhD, MA, MS

ACCC President

Senior Associate Dean, Research Equity and Community Engagement

Wake Forest School of Medicine

Durham, North Carolina

Resources:

ACCC 41st National Oncology Conference