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There is a growing recognition among payers and providers that social determinants of health—the social and socioeconomic factors that influence a patient’s care, such as income and access to transportation—are strongly linked to health outcomes. This recognition has been reinforced by a shift toward value-based payments, which incentivizes improved health outcomes rather than service delivery alone. Although it is evident that mitigating adverse social determinants can have a positive impact on patient outcomes and curb spending, results from a recent study reveal that Accountable Care Organizations (ACOs) face substantial challenges in integrating social services with patient care (Murray GF, et al. Health Aff (Millwood). 2020;39:199-206).
Patients with metastatic urothelial cancer receive first-line treatment with platinum-based chemotherapy and second-line treatment with a checkpoint inhibitor. There is currently no approved third-line therapy for this malignancy. The investigational antibody-drug conjugate enfortumab vedotin may be a good choice for third-line therapy, based on the results of a phase 2 clinical trial presented at the 2019 American Society of Clinical Oncology (ASCO) Annual Meeting.
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