NCI and the Centers for Medicare & Medicaid Services (CMS) have announced that they are collaborating to improve the process for bringing new lifesaving cancer treatments to patients. Implicit in this collaboration will be increased information that clinicians and patients can use to guide decisions on directing new technologies to improve the quality and outcome of life with cancer.

"We have collaborated with CMS in the past," said NCI Director Dr. Andrew C. von Eschenbach, "but we expect this unique and important partnership to produce results that will make a significant impact on the way we deliver evidence-based care to cancer patients.

To this end, NCI and CMS are developing a joint Memorandum of Understanding with five areas of collaboration:

• Identification of high-priority clinical questions on the optimal use of new technologies and the creation of postapproval processes to study them
• Definition of a consultation process between NCI and CMS experts for evaluating new diagnostics and technologies for payment and coverage decision making
• Development of more efficient methods for collecting clinical evidence on technologies and strategies and ways of making them more available to patients, clinicians, and researchers, including the addition of CMS claims data on the NCI bioinformatics grid, caBIG
• Development of a joint process for the prospective identification and evaluation of emerging technologies so that reimbursement policies will fully anticipate them and expedite their adoption in the marketplace
• Identification of opportunities for sharing data and resources to address issues such as disparity in cancer care, unwarranted variations in treatment, and palliative and end-of-life care.

"We need to work together to serve society's long-term need for new knowledge, new technologies, and, above all, effective health care that is affordable for all," said CMS Administrator Dr. Mark B. McClellan.

The two agencies will develop a strategic approach for prioritizing clinical questions identified by clinicians and patients as lacking the information necessary for guiding their decision making between competing or new therapies. Since these therapies must first be approved by the FDA, the NCI-CMS partnership will also build upon successful NCI-FDA collaborations to better align all three agencies' efforts.

Recognizing that changes in the understanding of the biology of cancer are leading to a shift in diagnostic and therapeutic approaches, NCI and CMS will work together to ensure that the reimbursement infrastructure can adapt to potentially critical changes. Their alignment will ensure earlier access to safe and effective new technologies for patients.