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  • Writer's pictureBen Freeberg

Oncology Ventures Thesis: Cancer Survivorship

Let’s take a look at what Oncology Survivorship Care looks like today:

After six long months of chemotherapy infusions, radiation, surgeries and countless scans and doctors appointments, you are finally done with your cancer treatment. You ring the chemotherapy bell and are ready to get back to your life before cancer.

But, it’s not that easy.

Chemotherapy weakened your body, your surgeries probably didn’t go perfectly, so you now have nerve damage, and you have a strong, inherent fear of the cancer coming back.

At this emotionally charged point of your treatment journey when you are still sick, in constant pain and need behavioral health support, you don’t have anyone to turn to.

It is unfortunately difficult for you to find time with your oncologist, because they are treating the next patient. And, you can’t go back to your primary care doctor (“PCP”), because they have been out of the loop for the past six months and are not well equipped to handle your issues. Outside of your clinicians, only 3% of cancer patients feel that their friends and family truly understand what they are going through.

So, you end up in and out of the emergency room (“ER”) because of neuropathy, get placed on an 8-week waitlist (which could be up to 6 months) for a therapist, find it difficult to go back to work, and have to be the quarterback of your own care, booking appointments with a host of different specialty providers, most of whom aren’t the right fit.

At a time when you should be given every opportunity to get your life back on track, you are instead lost, confused, scared and frustrated.

This journey is all too common for the 17M cancer survivors in the U.S. today.

Why is Survivorship Care prime for disruption?

The group of 17M cancer survivors in the U.S. is projected to increase to 22M by 2030. This growth in survivorship is associated with a considerable economic impact on society.

A 2020 study by researchers at the National Cancer Institute and the American Cancer Society found that medical costs associated with survivorship totaled $183B in 2015, and are projected to increase 34% to $246B by 2030.The annual excess economic burden of cancer survivorship among those recently diagnosed is $16k per cancer survivor.

Further, there is an increased likelihood of survivors to suffer from a range of non-cancerous physical and mental health conditions due to treatment. For example, compared to the general population, survivors have an average “excess heart age” of 8.5 years for men and 6.5 years for women.

And it is leading to a significant strain on our cancer-care ecosystem. This pressure impacts survivors, caregivers, health plans, employers and notably, the oncology workforce. In the coming years, we will see a 40% increase in demand for oncology services, with only a 25% increase in supply of oncologists.

PCPs may not have adequate time or training to manage the complexity of cancer survivors' care; for reference, 75% of PCPs are unfamiliar with basic survivorship guidelines for breast cancer, a common cancer that has established guidelines.

These forces lead to cancer patients feeling lost and stressed, which manifests itself in the use of emergency services instead of light-weight, ongoing side effect management, poor adherence to medication, and overutilization of oncologists for low-value services. That's costly to survivors, systems, and payers.

Lastly, there are two regulatory tailwinds that will help this market continue to grow:

1. Comprehensive Cancer Survivorship Act. Although this bill has not yet passed, it is far along and has bipartisan support. Notably, the bill includes the following:

  • Coverage of cancer care planning and coordination services: Establishes a Medicare service and payment for cancer care planning and coordination services to help improve care coordination and cancer survivors’ transition to primary care

  • Survivorship navigation: Requires a review of navigation programs and submission of a report assessing how navigation programs can best be developed across the continuum of cancer care

  • With the new EOM, it is going to be mandatory for participating oncology practices to document a survivorship plan, including a summary of treatment and information on recommended follow-up activities and surveillance, as well as risk reduction and health promotion activities

How is VivorCare changing the cancer survivorship journey for patients who so desperately need support?

VivorCare is building a fully-integrated cancer survivorship platform, designed to more effectively transition cancer survivors out of acute cancer care and into the long-term care management phase. By doing so, VivorCare is set to improve cancer care outcomes and reduce costs for key healthcare stakeholders.

Vivor’s digitally-enabled survivorship platform is supported by a care team of survivorship Nurse Practitioners (“NPs”), therapists and peer coaches.

Transitional care broadly has proven effective across various facets of our healthcare system, and we believe transitional care applies extremely well to the cancer care setting.

VivorCare can be the go-to transitional care platform for cancer care that catches patients at a stressful, engaged part of their treatment journey.

VivorCare is built by and for survivors. As they continue to scale, we see an opportunity to assist with different aspects of the cancer survivorship journey, including side-effect management, screening adherence and specialty e-consults.

How can VivorCare build an industry-leading platform?

As VivorCare builds toward these fundamental shifts of cancer survivorship care, VivorCare has the advantage of their platform and care services being reimbursable so they can start collecting revenue early on in their journey.

From there, given that the clinically-defined acute survivorship has a set time period and traditional set of appointments, scans and tests that follow patients during that time period, VivorCare can start to negotiate bundled rates with health plan partners as they prove outcomes.

And, as mentioned above with the launch of EOM and its focus on survivorship care planning, VivorCare can become the industry standard provider for survivorship care planning.

Down the road, VivorCare can be first in line to help patients manage a potential second incidence of cancer, which a large health plan found to occur at a rate of 10%+.

VivorCare can develop an industry-leading repository of survivorship data - including real world evidence and patient-reported outcomes - and leverage tools like AI and machine learning to improve survivorship care. Interoperability will be a core component of growth, allowing VivorCare to pull and input data into the electronic health record to clinically document care plans for survivorship.

Lastly, VivorCare could align with biotech and pharmaceutical companies around areas like minimal residual disease testing, novel therapeutics survivorship, and personalized medicine.

Oncology Ventures is thrilled to partner with Hil, Justin and the VivorCare team as they seek to improve survivorship care for the 17M+ cancer survivors in the U.S.

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