FOR IMMEDIATE RELEASE

Press Contact: Suzanne Pruitt

678.285.0307 |Suzanne@marshmeadowsmarketing.com

AXESS ONCOLOGY PROJECTS UNINTENDED CONSEQUENCES OF

CONTINUED CONSOLIDATION IN US PHYSICIAN MARKETPLACE
The Sunshine Act, coupled with oncology practice consolidation, are reducing
interactions between oncologists and pharmaceutical companies, hampering the
sharing of vital information needed in the battle against cancer
ATLANTA (October 27, 2014) Private medical practices owned by physicians will continue to consolidate at a
brisk pace over the next twelve months, according to analysis produced by Axess Oncology, Inc., a provider of
timely, actionable market research and business intelligence that predicts and assesses movement in the oncology
market. Axess data predict that pharmaceutical manufacturers will be challenged across 2014 and into 2015 in
their efforts to educate physicians about essential treatment options available in the fight against cancer.
In the last two years, the consolidation of independent, physician-owned oncology practices into both large, regional oncology groups and hospital-owned oncology services has accelerated, posing new challenges and unintended consequences for oncologists, pharmaceutical companies, and ultimately, cancer patients requiring stateof-the-art drugs and treatment protocols. In a recent survey of over 250 oncologists who consult to Axess Oncology through the Axess Oncology Physician Network, 11% of practicing medical oncologists who currently practice in a physician owned, physician managed practice intend to change their practice model in 2014 and consolidate into a larger group-based setting. Movement from Physician owned, physician managed private practice
setting was projected to change, as follows:
Total number of community oncology (physician owned/physician
managed model) respondents surveyed

N=253

Percentage of community oncologists expressing known intent to

change practice model in 2014

11%

Intend to join a larger Physician Owned/Physician-Managed Private

Practice

3.3% of community oncologists

Intend to convert to a Physician Owed/Hospital Managed Private

Practice Model

3.6% of community oncologists

Entering into a Physician Owned/Corporately Managed

Private Practice arrangement (e.g. US Oncology, Vantage Oncology)

1.2% of community oncologists

Move from Private Practice Setting into

Academic Medical Center/University

2.4 % of community oncologists

Move from Private Practice Setting into a

Destination or "Boutique" Cancer Hospital
(e.g. Cancer Treatment Centers of America)

0.5% of community oncologists

The driving forces behind this continuing advance in practice consolidation are well-known: regulatory pressures
and reductions in both Medicare and private sector insurance carrier payments for oncology services; expansion of
the federal (340 B) Drug Pricing program intended to reduce costs for hospitals treating a disproportionate share
of indigent patients.
Less well known - and possibly more troubling - are the unintended consequences of these reimbursement and
regulatory changes. For example, Section 6002 of the Affordable Care Act, (popularly referred to as the Sunshine
Act) was designed to promote transparency in the financial dealings between pharmaceutical companies and
physicians. It requires manufacturers of drugs, devices, biologicals, or medical supplies covered under title XVIII of
the Social Security Act, or state Medicaid regulations, to report annually to federal regulators payments or other
transfers of value to physicians and teaching hospitals.
In response to economic and regulatory pressures, physicians are consolidating into both larger medical practices
and hospital based medical practices that often impose new, restrictive policies against communication with
pharmaceutical manufacturers. At the same time, the Federal Sunshine Act component of the Affordable Care Act
has introduced challenges to traditional education tools used by pharmaceutical manufactures in their efforts to
educate physicians, said Dr. Stanley Winokur, Senior Medical Director of Axess Oncology, Inc. Both conditions are
reducing the educational exchanges between manufacturers and physicians that both parties rely on to deliver the
most effective interventions to patients in the fight against cancer.
Ambiguity in the wording of the Sunshine Act surrounding the calculation of transfer of value, differences across
manufacturer policies as to what conditions will trigger reporting and institutional requirements to limit engagements between physicians and industry representatives have caused many physicians to retreat from communications with manufacturer representatives. I avoid all Sunshine Act related events, altogether reports Sushil
Bharwaj, MD, an oncologist who practices cancer care medicine in affiliation with Good Samaritan Regional Medical Center in Suffern, New York. If I were to attend a presentation from a pharmaceutical company sponsored
speaker even if I do not participate in the dinner that might be provided along with the talk I dont know what
the company will report. That means I have to go on a website to see what they are reporting about me and maybe argue to be taken off their list --- its just too complicated. Id rather get my information from another source.
Unintended Consequences: Long-established paths of communication between drug and device manufacturers
and cancer physicians are fraying due to the combined impact of regulatory guidelines restrictions against manufacturer representative communications to physicians imposed by hospitals and large medical practices. Increasingly, evidence suggests that the ongoing consolidation movement combined with more restrictive hospital compliance guidelines have begun to disrupt the vital exchange of information needed to speed the development and
dissemination of critical new research, information and best practices.
Further data from the survey commissioned by Axess Oncology reveals that pharmaceutical manufacturers are
encountering significant difficulty in delivering vital information to medical oncologists in the U.S. market. According to the Axess Oncology Physician Network :

16.2% (41 of 253 respondents) of surveyed medical oncologists reported that restrictions against pharmaceutical industry access to their medical practice were already in place prior to September, 2013.

26.1% (66 of 253 respondents) of practicing medical oncologists have imposed new restrictions against
pharmaceutical Industry representative access to their oncology practice since the launch of the Federal
Sunshine Act in September, 2013.

Thus, 42.3% percent (107 of 253 respondents) report significant restrictions to pharmaceutical industry
representative access to their physician practice.
17.8% percent (45 of 253 ) say they will further reduce or fully eliminate participation in pharmaceutical
industry-sponsored forums as a direct result of the launch of the Sunshine Act.

It is becoming more and more difficult to speak with reps commented Dr. Bhardwaj. It is more difficult to
communicate with pharma reps when you work in a hospital-based practice. They [hospitals] have strict regulations surrounding compliance. There are lots of restrictions that prevent reps from getting to see us. So I must
work within those regulations. And I avoid Sunshine Act related events, so it is hard to see new reps you did not
already have a close relationship before, from your private practice.
In response to market changes, manufacturers are scrambling to establish new modes of communication and find
new access points to doctors. To determine the best approach, many manufacturers are relying on the capabilities
of Axess Oncology. Dr. Winokur, describes the Axess Oncology approach: Our Network is being called upon with
increasing frequency to help manufacturers define the most appropriate entry points for educational messaging,
to define what gaps exist in current physician understanding and to define the regional variation in factors that
impact physician decision making. Our goal is to facilitate communication between manufacturers and physicians
and to make sure that manufacturers are positioned to deliver the information that has the greatest positive impact on patient care when the two parties come together.
ABOUT AXESS ONCOLOGY
Headquartered in Atlanta, GA, Axess Oncology is a provider of analytics, market research, business intelligence and
training to clients with vested interest in the oncology and hematology marketplace. Further, Axess is an information exchange that produces venues for exchange of knowledge, opinion and insight among constituents in the
oncology/hematology market space, including: patients, physicians and other healthcare providers, patient advocates, medical product manufacturers, marketing entities and investors. Axess leverages a unique business model
and exceptional relationships with both physicians and medical product manufacturers/marketers to create opportunities for constituents to exchange critical information in a manner that protects protected health information
and which facilitates compliance with State and Federal regulations.
For more information, visit www.axessoncology.com | 855.292.9377
ABOUT AXESS ONCOLOGY PHYSICIAN NETWORK
The Axess Oncology Physician Network is a proprietary network of more than 400 consulting physicians who are
board certified in oncology, hematology, or both. Carefully crafted to reflect the proportional representation of
oncologists by state, as well as the proportional representation of practice setting among physicians in the US,
physicians are invited to join the Network in consideration of a range of features, including years in practice, clinical research experience, medical specialty, number of patient cases managed per year and more. Consultants are
bound to Axess Oncology through a formal consulting agreement. Neither Axess Oncology nor Axess Network
physicians are compensated in regard to utilization of any medical product or service.
For more information, visit www.axessoncology.com | 855.292.9377

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