Learning from the ongoing coronavirus disease 2019 (COVID-19) pandemic, the American Society of Clinical Oncology (ASCO) released recommendations to modify policies created before the pandemic to improve patient access to cancer care and research.
The recommendations were the product of the Research Task Force and the Cancer Care Delivery Task Force, which together made up ASCO’s Steering Group on Cancer Care Delivery and Research in a Post-Pandemic Environment.
With many practices under financial strain, ASCO recommended continuing to suspend the sequester and halting the initiation of new payment models, including 2-sided risk within the Oncology Care Model, Oncology Care First Model, and Radiation Oncology Model.
“It is not appropriate to test a mandatory new payment model in circumstances where practices are already struggling to adapt and provide safe care for their patients,” ASCO reasoned.
Given the role telemedicine has played during the pandemic, ASCO recommended optimizing the use of this technology. For example, all providers should have additional training and education on telemedicine. Also, research should be done to identify best practices and standards for telemedicine and to elucidate the impact of telemedicine on vulnerable populations, cost for patients, and referral patterns.
Although home infusions were proposed as a way to maintain continuous care when stay-at-home orders were issued, ASCO does not support “routine use” of home infusion for anticancer therapies because of concerns for “increased waste and the loss of valuable patient toxicity assessment during an infusion visit in the clinic.”
Recommendations for improving patient access to research include continuing to allow patients to provide consent remotely or virtually with e-signatures, administering treatment for a study at a local site, and allowing local sites to conduct patient assessments, laboratory testing, and imaging.
ASCO also recommended reducing administrative and regulatory requirements for research and incorporating pragmatic designs into clinical trials, which may produce more generalizable results and reduce the cost of conducting a trial. Also, clinical trials should consider adaptive designs, which can improve efficiency by letting patients participate in more than one trial arm and using common control groups.
“ASCO will work at all levels to advance these changes and to implement those that can be directly addressed by ASCO.”
Pennell NA, Melissa Dillmon MD, Levit LA, et al. American Society of Clinical Oncology road to recovery report: Learning from the COVID-19 experience to improve clinical research and cancer care. J Clin Oncol. Published online December 8, 2020. doi:10.1200/JCO.20.02953