Clinical Pathways for 2018 and Beyond

As another year draws to a close, I look back on the work produced by Journal of Clinical Pathways (JCP) with pride. But it is still important to keep our focus on what’s next. I have no doubt that 2018 will bring about new and exciting developments in the field of clinical pathways. In the meantime, we have another excellent issue to close out 2017.

December brings two of the year’s most eagerly anticipated conferences. The San Antonio Breast Cancer Symposium celebrates its 40th year in 2017. This year’s meeting (page 22) included presentations on re-excision rates among women with surgically treated tumors; the impact of trastuzumab sequencing on overall survival and relapse-free survival; and the cost-effectiveness of digital breast tomosynthesis—also known as “3D mammography”—when compared with traditional mammography.

The 59th American Society of Hematology Annual Meeting & Exposition (page 26) unveiled many new advancements in the areas of malignant and nonmalignant hematology. Our editors attended the meeting; beyond our conference coverage in this issue, be sure to check out our website for on-the-ground dispatches.

This issue also features three terrific columns. In Clinical Pathways GPS, Richard G Stefanacci, DO, MGH, MBA, AGSF, CMD, considers how health care reforms—coinciding with the nomination of Alex Azar II, JD, to replace Tom Price, MD, as Secretary of Health and Human Services—will impact value-based care in 2018 and beyond (page 43). This month’s Pharma Insights column (page 47) provides an extensive look at how the market for biosimilar adoption in the United States will be influenced by treatment and prescription patterns in Europe. The European Union has approved biosimilars for more than a decade, and their advances surely have a lot to teach us as we move into this uncharted territory. And JCP Editorial Advisory Board member Aymen Elfiky, MD, MSc, MBA, discusses how cognitive clinician biases can hamper the impact of clinical pathways in his Pathways in Focus column (page 51).

Our feature this month is a research report on the costs of care associated with chemotherapy in advanced bladder cancer (page 63). Bladder cancer is a disease of the elderly, but little research has focused on the cost-effectiveness of chemotherapy in this population. Ashish M Kamat, MD, MBBS, FACS, and colleagues determined through their analysis that older patients receiving first- or second-line chemotherapy for advanced cancer experience high cost burdens, a significant portion of which must be paid out of pocket. Because neither patient population investigated in this study experienced a median survival greater than 1 year, many questions remain unanswered.

The editorial staff of JCP wishes you a very happy New Year. See you in 2018!