I recently gave a lecture at a well-known graduate school of business, and I was struck by how much it was like a lecture I had given more than 10 years ago, when I was employed by a large national payor. On my last slide, entitled, “Déjà vu all over again: 90s to 00s,” the final line read: “This will be your lecture in 10 years—as we will still be dealing with this, you can borrow my slides.”
Indeed, the pressures and tensions currently at work in our nation's health care system are much like those experienced in the early 1990s. Our nation's expenditures on health care could reach $3.6 trillion in 2014 and could then account for 20% of the nation's gross domestic product. Large employers are again expressing substantial concern about the impact of providing health benefits at a high cost to their companies, in an era of global economy in which foreign competitors are not burdened with such costs. Cost concerns within the Medicare and Medicaid programs dominate public policy debate.
Nowhere in medicine is the concern about rising expenditures greater than in oncology. Large national private payors tell NCCN that oncology costs represent 12% of a typical payor's overall medical expense budget. Furthermore, these costs for cancer care are growing annually at a rate of 14%, almost double the average growth of a plan's medical costs. One major national insurer has informed me that, in cancer care, the costs of drugs and biologics now exceed all...
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William T. McGivney, PhD, is the Chief Executive Officer of the National Comprehensive Cancer Network (NCCN) and a recognized expert in coverage policy and drug and device regulatory policy. Before joining the NCCN in 1997, Dr. McGivney directed the Division of Health Care Technology at the American Medical Association and worked for Aetna Health Plans as Vice President for Clinical and Coverage Policy. Awarded the FDA Commissioner's Medal of Appreciation in 1989, Dr. McGivney has served on numerous national boards and committees. He earned his PhD at the University of North Carolina at Chapel Hill and completed a postdoctoral fellowship in the Department of Psychiatry at the Harvard Medical School.