Cancer care is evolving faster than ever. Emerging drugs and technologies offer new treatment options to oncologists and their patients. Some are promising, others less so. Knowing which ones offer real benefit is critical to optimizing outcomes and managing costs. The focus on drug reimbursement is one important and necessary way of addressing costs. But this approach does little to address the vast treatment variation seen in oncology. The real clinical opportunity is in using the right treatment at the right time.
 
Level I Pathways: The Next Step
Level I Pathways are the next step in managing the quality of care for cancer patients. Moving beyond broad label indications and public domain guidelines, Level I Pathways refine the options to those with proven clinical effectiveness and the least possible toxicity. When Level I evidence* points to a superior treatment regimen, in terms of efficacy and safety, that is the one that is used. If there is no clear evidence of clinical superiority, then costs are factored into the Pathway.

Moving Solid Scientific Evidence into Clinical Practice
Cancer care is increasingly complex. Level I Pathways are developed and updated by a multidisciplinary Pathways Task Force, which engages a network of more than 1,000 practicing community oncologists to participate in the development of these guidelines for patient care. Their work is an ongoing, exhaustive review of documented clinical evidence from an array of sources including published, peer-reviewed outcomes data

Proven Value of Level I Pathways
In two separate studies, the value of Level I Pathways has been proven to lower costs while maintaining equivalent health outcomes.

A joint study between Aetna and The US Oncology Network, published in the January 2010 peer-reviewed Journal of Oncology Practice, evaluated the cost-effectiveness of Level I Pathways for patients with non-small cell lung cancer in the community setting. The study found that certain outpatient costs were 35% lower for those patients treated according to Level I Pathways while maintaining equivalent health outcomes. In a similar study published in a special joint issue between the peer-reviewed Journal of Oncology Practice and the American Journal of Managed Care in May 2011, The US Oncology Network and Milliman found that evidence-based care for patients with colon cancer results in significant cost savings with equivalent health outcomes. The study showed a total cost savings of more than 30%, $53,000 for the treatment of adjuvant colon cancer and $60,000 for the treatment of metastatic colon cancer.
 
Hoverman, Pathways, Outcomes, and Costs in Colon Cancer: Retrospective Evaluations in Two Distinct Databases, JOP 7:3S; Neubauer, Cost-Effectiveness of Evidence-based Treatment Guidelines for the Treatment of NSCLC in the Community Setting, JOP, 6:1