In 2023 the FDA approved 55 novel therapeutics, the second highest count in the past 30 years. This included 16 oncology approvals, including 4 novel bispecific antibodies, which contain multiple sites for 2 different antigens. New oncology clinical trial starts are at historically high levels. The next-generation biopharmaceuticals pipeline is robust and full of promise for patients with cancer, with many CAR T-cell, NK-cell, and gene therapies and cancer vaccines in development.

The use of cancer care pathways aims to improve patient outcomes by prioritizing provider prescribing to high-value evidence-based treatments and therefore reduce the use of expensive therapies that could be more toxic and/or marginally effective. With the rapid development of new treatments in oncology, especially in targeted therapies and immunotherapy, and the increase in cancer care options, it can be difficult for oncologists to keep up with the evolution of prognosis, available medications, and their potential side effects. The addition of care pathways may be a way to provide physicians with a comprehensive and clinically relevant decision support tool.

Biosimilars for oncology products and supportive agents have been on the market longer than any other class of biosimilars, with the first being a filgrastim biosimilar approved in 2015. There are now multiple biosimilars for filgrastim, pegfilgrastim, bevacizumab, trastuzumab, and rituximab. Payers have reported a significant decrease in cost per claim of oncology products that have biosimilars since 2019 with decreases in cost per claim between 33% and 39%. While oncology biosimilar uptake was initially slow, biosimilars for bevacizumab, trastuzumab, and rituximab now make up more than 73% of the market share through 2022.

One year after the end of the Center for Medicare and Medicaid Innovation’s multiyear Oncology Care Model (OCM), its successor program, the Enhancing Oncology Model (EOM), began on July 1, 2023. EOM is a voluntary 5-year model in which oncology practices assume risk and accountability for their Medicare patients’ health quality and total spend during 6-month episodes of care. Episodes begin with initiation of systemic chemotherapy for the 7 cancer types in which the Centers for Medicare and Medicaid Services (CMS) saw the greatest reductions in total episode payments under OCM: high-risk breast cancer; lung, prostate, and small intestine/colorectal cancer; lymphoma; chronic leukemia; and multiple myeloma.