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Research Letter
February 2018

Financial Conflicts of Interest Among Oncology Clinical Pathway Vendors

Author Affiliations
  • 1Memorial Sloan Kettering Cancer Center, New York, New York
  • 2The Center for Cancer and Blood Disorders, Ft Worth, Texas
JAMA Oncol. 2018;4(2):255-257. doi:10.1001/jamaoncol.2017.4473

Oncologist use of clinical pathways (OCP) has reached 58%. Clinicians and payers have aggressively adopted OCPs as a means of delivering high value care because pathways promise to weigh the efficacy and toxicity of a regimen and, if no significant difference is found, make a therapy determination based on cost. This method facilitates changes in prescribing behavior. One study that measured the effect of a substitution of panitumumab for cetuximab across metastatic colorectal cancer pathways at 2 large health care networks found that selections for cetuximab plummeted from 93.5% to 18.1%.1 The determination of “on-pathway” is frequently subjective depending on a committee’s evaluation of the available data. The American Society of Clinical Oncology advocates for the disclosure of conflicts of interest for OCP committee members and those that contribute to development. We sought to quantify those financial conflicts of interest.