Clinical Pathways: A Cost-effective System for Determining mCRC Treatment

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Before the guidance system was implemented, panitumumab was selected as a treatment in only 6.5% of cases.
Before the guidance system was implemented, panitumumab was selected as a treatment in only 6.5% of cases.

Clinical pathways may help in choosing the most effective, least toxic, and most cost-effective treatment for patients with metastatic colorectal cancer (mCRC). These results may generalize to other types of cancer, according to the authors of an article published in the Journal of Oncology Practice.1

Clinical pathways, which are used in medical areas outside of oncology, provide evidence-based guidance for physicians to prescribe cost-effective treatments in various settings. For this study, the authors implemented a clinical pathways system — Via Pathways — to evaluate whether this evidence-based guidance system would improve treatment outcomes and costs for patients with mCRC.

The University of Pittsburgh Medical Center's Cancer Center and Indiana University Health implemented the Via Pathways system in 2003 and 2013, respectively. The pathways system determined that cetuximab and panitumumab have roughly equivalent efficacy and toxicity in mCRC; a cost analysis, however, favored the use of panitumumab.

Before the guidance system was implemented, panitumumab was selected as a treatment in only 6.5% of cases. This figure rose to 81.9% after the guidance system was implemented in both hospital systems.

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Annual savings totaled over $700,000 for both hospitals together.

The authors concluded that clinical pathways are effective for guiding treatment-decisions for patients with mCRC, and that this tool may be useful in other areas of oncology.

Reference

  1. Ellis PG, O'Neil BH, Earle MF, et al. Clinical pathways: management of quality and cost in oncology networks in the metastatic colorectal cancer setting. J Oncol Pract. 2017 Apr 5. doi: 10.1200/JOP.2016.019232 [Epub ahead of print]

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