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California’s Chance to Help More Cancer Patients Get High-Value Care

In 2022, an estimated 189,000 Californians will hear the words “you have cancer.” We live in a golden age of innovation in cancer care, when new treatments like CAR T-cell therapies are improving health outcomes with data showing their cost-effectiveness to the health care system.

Still, as anyone who has had cancer or helped a loved one through the cancer care journey can attest, learning about and accessing optimal treatments can be all but impossible thanks to needless barriers patients encounter.

Studies have shown that systemic barriers to adequate cancer care result in worse outcomes for underserved minority groups, those lacking private insurance and those with a lower socioeconomic status. For instance, African American men and women have a 111% and 39% higher risk of dying from prostate cancer and breast cancer, respectively, compared with their white counterparts.

Working to find solutions for these disparities is important: Nationally, approximately 30% of African Americans and Hispanics reported the quality of care accessible in their area as a barrier to seeking treatment. These barriers are acutely felt here in California: less than half of California cancer patients receive care aligned with national guidelines. Patients on Medi-Cal, which covers roughly a third of Californians, experience less favorable five-year survival rates for several cancer types compared to patients on private insurance. Lest we forget, African Americans and Hispanics have the highest rates of Medi-Cal enrollment in California at 44.3% and 44.9%, respectively.

I am a clinical hematologist oncologist here at City of Hope, where we believe we have a moral imperative to democratize cancer care and increase access to the incredible innovations that are most likely to save a patient’s life. 

Joseph Alvarnas, M.D.
                                       Joseph Alvarnas, M.D.

City of Hope has partnered with a broad and diverse consortium of leading cancer organizations as part of the Cancer Care Is Different Coalition. We’re working to expand access to lifesaving, high-value care that helps reduce disparities.

We’re driven by the belief that for cancer, the best chance of a cure is the first chance at a cure: Cancer outcomes uniquely rely on the accuracy and speed of initial diagnosis, choice of therapy and access to appropriate clinical trials. And there are big changes on the horizon that give us hope that more Californians will be able to access the care that gives each the best chance to beat cancer.

The California State Senate and the California State Assembly both passed the California Cancer Care Equity Act (SB 987) this year, an important first step in implementing the promises of the 2021 California Cancer Patients Bill of Rights. This bill ensures people covered by Medi-Cal who receive a complex cancer diagnosis have the choice to seek care at specialty cancer centers where they can receive cutting-edge therapies and care often unavailable within community care settings.

One of the concerns raised about this legislation centers around adding costs to the state program. But we must consider the potential long-term value generated by embracing a model that incentivizes speed to innovation rather than encouraging suboptimal care—often too slowly. SB 987 would help more patients avoid secondary treatments, alleviate caregiver burden, open access to sponsored clinical trials and allow many patients a quicker return to productivity as a full participant of society.

A short-term increase in cost is likely to yield savings and reduce system inefficiencies in the long term, simultaneously helping to save the lives of Californians and increasing access to the kind of cancer diagnosis and care any of us would demand for a loved one fighting cancer.

SB 987 is now with Gov. Gavin Newsom for signature, and the cancer community urges him to enshrine this bill into California law and ensure patients can have greater access to optimal cancer care in our state. It’s an opportunity for California to show the rest of the nation what the first steps toward a model that works better for patients looks like.

For patients with cancer, access equals life. This legislation will help more of the Californians who hear “you have cancer” have the best shot at beating it. That’s worth fighting for.

Joseph Alvarnas, M.D., is a clinical hematologist oncologist and vice president for government affairs at City of Hope.