Oncology Unscripted With John Marshall: Episode 7: Too Complex, Too Costly: Are CROs Draining Clinical Trials?

[00:00:05]

John Marshall, MD:

Hey, everybody, John Marshall back for oncology unscripted. If you've been silly enough to further away your time with me, we're now on the 7th episode, believe it or not. Goodness gracious, the sponsors of this are crazy to let me keep going. 

But we do have some really cool stuff to talk about today, and I hope you'll listen in as I review not only sort of what's going on in our world, a little bit of gossip, a little bit of business, we're going to talk about the latest science, but as you remember, this is the third in three parts about the middle men, the middle people in oncology. And so, we've done pharmacy benefit managers. We've done the EMR. Now, the next one is Clinical Research Organization, CROs. So, stick around for some discussion about the impact of CROs on us, on clinical research, and maybe, are they helpful or not? You'll have to decide after you listen in. 

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Vermont Sues PBMs

But let's start with a little bit of gossip. So, if you remember, we talked about PBMs before, and just so happened that the state of Vermont, their attorney general has sued the pharmacy benefit managers for illegally driving up drug costs. You thought that was just me saying that? No, the Attorney General of Vermont also thinks that. 

[00:01:29]

ACS CEO Steps Down

Sort of on a business note too, Karen Knutson, who's a really very prominent member of our cancer community, was or still is briefly the CEO for the American Cancer Society and the American Cancer Society Action Network. She has decided to step down, she's going to do a lot more work in that space. So, we will be seeing a new ACS leader. I always want to think about the ACS. It is the largest private nonprofit funder of cancer research in the United States. And, so, we do want to make sure and hold them accountable for their product beyond their journals and the like and what comes out of their science, but I think they've had a great impact over time. So, congratulations to Karen and we look forward to the transitions ahead.

[00:02:16]

NCI Puts Millions into AI Efforts in Breast Cancer

Sort of a crazy thing we came across is that, you know, there's a lot more AI in health care today. But the NCI just dropped 3. 7 million in an effort for AI to predict breast cancer risk and also sort of to try and wrap in health disparities to try and level that up a bit. But there's another one looking at AI outperforming conventional methods for prostate cancer. management. So, we're increasingly seeing AI being used, just like every time you drop something in your Google browser, AI being used to try and help us be better at what we do.

[00:02:59]

Honoring Dr. Jeff Weber

I do want to give us a bit of an update. There's a really important obit that I'm sure you saw a guy named Jeff Weber. Jeff Weber was 72 and he died. He actually. died of pancreas cancer, but we will know him forever as one of those people who's made a major impact in the world of cancer. His work in melanoma, his work in immunotherapy, frankly, his work as a mentor and making sure that for generations to come, we are going to see that kind of high quality clinical translational researcher, educator, the whole bit. We lost a big one when Jeff Weber died of one of my diseases, sadly, pancreatic cancer. I wish he was working on this one, because maybe he would've solved that one. I feel like we let him down, but here's to him and all that he has done and all the lives that he has touched.

[00:03:48]

McKesson Wins Bid for Florida Cancer Specialists

Just one little bit of business news. You may remember a few episodes back, we talked about sort of the interface about the You know, our industry and how groups are buying other groups, etc. Well, I mentioned Florida cancer specialists was being looked at by a bunch of different parties. Well, we now know McKesson, I guess, won the bidding for a low 2. 5 billion. McKesson bought Florida Cancer Specialists. And then if you think about everything from patient care all the way up the business chain is owned and organized by one group. And so, I do think we need to watch this space carefully because are things going to improve? Are they going to get more expensive? Are they going to get more efficient? We really need to see how this kind of structure works, because we know more and more of that is going to happen. In fact, I've heard some people predict that not too long from now, the entire United States might be covered by just 10 different health systems that there'll be mergers and acquisitions up and down the chain. so that will be just about 10 of us nationwide. We'll see if that comes too fast. But there's the 1st pass at it with Florida cancer specialist and McKesson working together. 

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