The Path Ahead

J Clin Pathways. 2021;7(10):8.

It’s hard to believe we are in December 2021 already.  Where has this year gone? When December rolls around, it’s natural to take a look back while also gearing up for the start of a new year. In spite of being another difficult, COVID-tainted year with multiple spikes, 2021 brought a lot of positive behind the scenes changes to the Journal of Clinical Pathways (JCP). I’m particularly proud of the tremendous response rate to our Clinical Pathways survey over the summer. Your responses gave us a lot to work with as we plan for 2022, and this includes a live in-person Oncology Clinical Pathway Congress meeting in October.

Speaking of positive changes, we are featuring a new column in this issue.  A recent addition to the JCP Advisory Board, Joshua M Liao, MD, MSc, will be bringing us insights from a health system. Dr. Liao is the Associate Chair for Health Systems in the UW Department of Medicine.

His column, titled Health System Insights, brings a new perspective to the journal, gained from his work with the Value & Systems Science Lab and the Health Systems Collective in the Department of Medicine at University of Washington School of Medicine, both in Seattle, Washington. This month, Dr. Liao takes an in-depth look at the concept of population health and its impact upon improving overall outcomes. We will be running more columns from Dr. Liao in 2022, and hope you enjoy this new voice in the journal.

Helmy Guirgis, MD, PhD, returns this month discussing the costs associated with the extended use of immune checkpoint inhibitors (ICI) for treating first line advanced/metastatic non-small cell lung cancer (a/m-NSLC). Many patients choose to continue therapy beyond two years after a sustained response; however, reports on costs and the impact of extended use of the ICI are rare. Dr. Guirgis notes that the high cost of ICIs negatively impact access, and that while cost differences between the different ICI are non-significant, what is significant is the unsustainable high cost of prolongued therapy.  Dr. Guirgis suggests that use of an ICI beyond the indicated 2 years calls for guidance on therapy duration and the need for cost considerations.  

As we close out 2021, I and the entire staff of JCP wishes you and your family a happy and healthy holiday season. Use this opportunity to reflect on your many blessing of the past year,  and may you have many more in 2022.