In a presentation at the inaugural Clinical Pathways Congress, Michael Kolodziej, MD, national medical director, Managed Care Strategy, Flatiron Health, argued that clinical pathways as we know them will cease to exist as a result of the rise of immunotherapies for the treatment of cancer.
Clinical pathways guide physicians through the treatment options for a given disease, most often by weighing the evidence for efficacy, toxicity, and cost for each treatment. However, “immunotherapies make pathways irrelevant,” Dr Kolodziej said, because these highly effective therapies must be on the pathway regardless of their toxicity and cost. “Efficacy always rules the day in pathways content,” he said.
Instead, he argued that clinical pathways will continue to evolve from simply helping physicians to choose appropriate therapy to being used to optimize processes for the delivery of care. For example, Dr Kolodziej said, therapies for cancer must increasingly become personalized. “Personalized therapy is not just precision therapy,” he clarified, suggesting that each patient’s treatment must be based not only on their genetics but also on other patient factors such as age, comorbidities, and preferences.
“Care reform cannot happen without the intellectual rigor of pathways,” he concluded.
