By the end of 2020, the incidence of gastric cancer (cancer of the stomach) is expected to rise about 13 percent — reaching 250,400 cases in seven countries — the United States, Japan, France, Germany, Italy, Spain, and the United Kingdom. That’s the forecast provided by Datamonitor, a business information and analysis company.

For the United States, the company predicts about 27,000 incident cases in 2010, accounting for 12 percent of all cases in the seven countries. That number is expected to rise to 18 percent by 2020.

Among patients with known tumor characteristics, 90.3 percent of stomach cancers were adenocarcinomas; gastrointestinal stromal tumors accounted for 3.4 percent. Approximately 62 percent of stomach cancers were diagnosed at the regional or distant stage, with women having greater percentages of localized stage cancer than men (24.8 percent and 21.7 percent, respectively). Approximately 50 percent of stomach cancers were poorly differentiated.

According to the Centers for Disease Control and Prevention, stomach cancer rates in 2004 were highest among men in the Northeast (11.7 percent) and lowest in the Midwest and South (9.0 percent). Rates among women were highest in the Northeast (5.6 percent) and lowest in the Midwest (3.9 percent). Connecticut, Hawaii, New Jersey, and New York had some of the highest rates of stomach cancer among men (10.2–18.4 percent) and women (5.1–6.7 percent).

New cases of gastric cancer, 2010–2020

Source: Datamonitor, 2010

Managed Care’s Top Ten Articles of 2016

There’s a lot more going on in health care than mergers (Aetna-Humana, Anthem-Cigna) creating huge players. Hundreds of insurers operate in 50 different states. Self-insured employers, ACA public exchanges, Medicare Advantage, and Medicaid managed care plans crowd an increasingly complex market.

Major health care players are determined to make health information exchanges (HIEs) work. The push toward value-based payment alone almost guarantees that HIEs will be tweaked, poked, prodded, and overhauled until they deliver on their promise. The goal: straight talk from and among tech systems.

They bring a different mindset. They’re willing to work in teams and focus on the sort of evidence-based medicine that can guide health care’s transformation into a system based on value. One question: How well will this new generation of data-driven MDs deal with patients?

The surge of new MS treatments have been for the relapsing-remitting form of the disease. There’s hope for sufferers of a different form of MS. By homing in on CD20-positive B cells, ocrelizumab is able to knock them out and other aberrant B cells circulating in the bloodstream.

A flood of tests have insurers ramping up prior authorization and utilization review. Information overload is a problem. As doctors struggle to keep up, health plans need to get ahead of the development of the technology in order to successfully manage genetic testing appropriately.

Having the data is one thing. Knowing how to use it is another. Applying its computational power to the data, a company called RowdMap puts providers into high-, medium-, and low-value buckets compared with peers in their markets, using specific benchmarks to show why outliers differ from the norm.
Competition among manufacturers, industry consolidation, and capitalization on me-too drugs are cranking up generic and branded drug prices. This increase has compelled PBMs, health plan sponsors, and retail pharmacies to find novel ways to turn a profit, often at the expense of the consumer.
The development of recombinant DNA and other technologies has added a new dimension to care. These medications have revolutionized the treatment of rheumatoid arthritis and many of the other 80 or so autoimmune diseases. But they can be budget busters and have a tricky side effect profile.

Shelley Slade
Vogel, Slade & Goldstein

Hub programs have emerged as a profitable new line of business in the sales and distribution side of the pharmaceutical industry that has got more than its fair share of wheeling and dealing. But they spell trouble if they spark collusion, threaten patients, or waste federal dollars.

More companies are self-insuring—and it’s not just large employers that are striking out on their own. The percentage of employers who fully self-insure increased by 44% in 1999 to 63% in 2015. Self-insurance may give employers more control over benefit packages, and stop-loss protects them against uncapped liability.