Peter Bach

Bach earned a bachelor's degree in English and American Literature from Harvard University (1986), a MD from the University of Minnesota (1992) and a Masters of Arts in Public Policy (1997) from the University of Chicago. He obtained his internal medicine training at Johns Hopkins Hospital, and completed a fellowship in Pulmonary and Critical Care Medicine at the University of Chicago and Johns Hopkins Hospital.{{citation needed|date=June 2023}}

In 2021 Bach joined DELFI Diagnostics, a liquid biopsy cancer screening company, as its chief medical officer in 2021.{{Cite web |last=Herper |first=Matthew |date=2021-06-23 |title=Peter Bach, industry critic, joins company aiming to make blood tests to detect cancer |url=https://www.statnews.com/2021/06/23/peter-bach-industry-critic-joins-company-aiming-to-make-blood-tests-to-detect-cancer/ |access-date=2023-12-29 |website=STAT |language=en-US}}

Beginning in 2009, Bach and his team published and reported on multiple technical attributes of the US pharmaceutical market that raised awareness and ultimately led to changes in how Medicare paid for drugs for its beneficiaries. The work in cluded, in 2009, the first comprehensive description of how Medicare paid for cancer drugs documenting inflationary policies published in the New England Journal of Medicine.{{cite journal |last1=Bach |first1=Peter |title=Limits on Medicare's Ability to Control Rising Spending on Cancer Drugs |journal=New England Journal of Medicine |date=February 5, 2009 |volume=360 |issue=6 |pages=626–633 |doi=10.1056/NEJMhpr0807774 |pmid=19176475 |url=https://www.nejm.org/doi/abs/10.1056/NEJMhpr0807774}}

[https://www.nytimes.com/2012/10/15/opinion/a-hospital-says-no-to-an-11000-a-month-cancer-drug.html?adxnnl=1&adxnnlx=1354305797-JyaH/EvyHN7Z2djiZwDpqQ&_r=0] Leading, in 2012, an opinion article describing why the hospital where he worked (Memorial Sloan-Kettering Cancer Center) was rejecting a drug [Zaltrap] due to its high price in 2012 - a move led the company to lower the drug's price, and to widespread coverage including a cover story in New York Magazine and a segment on "60 Minutes". Releasing the DrugAbacus, billed as an interactive tool that users can apply to model prices for cancer drugs based on a number of factors, including clinical efficacy, safety and toxicity, the value placed on a year of life, and the value of innovation in 2016. The tool demonstrated that there was no formula that could be used to 'solve' or explain current pricing for drugs.

In 2016, Bach led a team that described how pharmaceutical companies were packaging drugs in oversized single use vials, thus earning billions in excesss revenue on drug that was never used in the treatment of patients.{{cite journal |last1=Bach |first1=Peter |title=Overspending driven by oversized single dose vials of cancer drugs |journal=BMJ |date=2016 |volume=352 |issue=i788 |pages=i788 |doi=10.1136/bmj.i788 |pmid=26932932 |pmc=6894487 |url=https://www.bmj.com/content/352/bmj.i788}} The study led to an investigation by the HHS OIG, then to a pilot modification of billing codes for physician administered drugs then made permanent, a National Academy of Medicine report analyzing solutions to the problem, and a provision (Section 90004) of the Infrastructure Investment and Jobs Act (IIJA) that clawed back excess revenues earned from the practice. Avalere estimated that 2023 clawback alone for discarded drugs would equal $210Million.{{cite web |title=Drug Waste of Single-Use Vial Drugs |date=17 December 2018 |url=https://oig.hhs.gov/reports-and-publications/workplan/summary/wp-summary-0000146.asp}}{{cite web |title=Implications of Discarded Weight-Based Drugs |url=https://www.nationalacademies.org/our-work/implications-of-discarded-weight-based-drugs}}{{cite web |url=https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=55932}}{{cite web |url=https://www.govinfo.gov/content/pkg/PLAW-117publ58/pdf/PLAW-117publ58.pdf}}{{cite web |url=https://avalere.com/insights/medicare-waste-refunds-could-cost-manufacturers-over-210m-annually |title=Medicare Waste Refunds Could Cost Manufacturers over $210M Annually |date=13 October 2022 }}

Bach and his colleague Mark Trusheim described an alternative payment approach for highly effective Hepatitis C treatments where states would pay a flat fee 'subscription' to the drug company in exchange for unlimited supply of treatment, a design focused on providing predictable revenue to the company and adequate supply to eliminate the disease. The approach was successfully implemented in Louisiana by Secretary Rebekah Gee, and has been proposed for national implementation.{{cite news |last1=Louisiana Department of Health. |title="Louisiana launches hepatitis C innovative payment model with Asegua Therapeutics, aiming to eliminate the disease". |date=June 26, 2019}}{{cite journal |last1=Trusheim |first1=Mark R. |title=Alternative State-Level Financing for Hepatitis C Treatment—The "Netflix Model" |journal=JAMA |date=2018 |volume=320 |issue=19|pages=1977–1978 |doi=10.1001/jama.2018.15782 |pmid=30383176 }}{{cite news |last1=Collins |first1=Francis |title=We Are Squandering One of the Most Important Medical Advances of the 21st Century |work=New York Times |date=2023-11-28}}

Bach has also worked on areas related to racial disparities within the provision of cancer care. Along with research collaborators, he has published evidence that black Medicare beneficiaries with lung cancer do not receive as high quality care as white patients.{{cite journal |name-list-style=vanc|pmid=10519898 |year=1999 |last1=Bach |first1=PB |last2=Cramer |first2=LD |last3=Warren |first3=JL |last4=Begg |first4=CB |title=Racial differences in the treatment of early-stage lung cancer |volume=341 |issue=16 |pages=1198–205 |doi=10.1056/NEJM199910143411606 |journal=The New England Journal of Medicine|doi-access=free }}{{cite journal |name-list-style=vanc|pmid=15295050 |year=2004 |last1=Bach |first1=PB |last2=Pham |first2=HH |last3=Schrag |first3=D |last4=Tate |first4=RC |last5=Hargraves |first5=JL |title=Primary care physicians who treat blacks and whites |volume=351 |issue=6 |pages=575–84 |doi=10.1056/NEJMsa040609 |journal=The New England Journal of Medicine|doi-access=free }}{{cite journal |name-list-style=vanc|pmid=11966385 |year=2002 |last1=Bach |first1=PB |last2=Schrag |first2=D |last3=Brawley |first3=OW |last4=Galaznik |first4=A |last5=Yakren |first5=S |last6=Begg |first6=CB |title=Survival of blacks and whites after a cancer diagnosis |volume=287 |issue=16 |pages=2106–13 |journal=JAMA |doi=10.1001/jama.287.16.2106}} A paper in 2007 demonstrated that care in Medicare is highly fragmented, with the average beneficiary seeing multiple primary care physicians and specialists.{{cite journal |name-list-style=vanc|pmid=17360991 |year=2007 |last1=Pham |first1=HH |last2=Schrag |first2=D |last3=O'Malley |first3=AS |last4=Wu |first4=B |last5=Bach |first5=PB |title=Care patterns in Medicare and their implications for pay for performance |volume=356 |issue=11 |pages=1130–9 |doi=10.1056/NEJMsa063979 |journal=The New England Journal of Medicine|citeseerx=10.1.1.622.7686 }} He has worked on developing lung cancer screening guidelines also developed a lung cancer risk prediction model.{{cite journal |name-list-style=vanc|pmid=12644540 |year=2003 |last1=Bach |first1=PB |last2=Kattan |first2=MW |last3=Thornquist |first3=MD |last4=Kris |first4=MG |last5=Tate |first5=RC |last6=Barnett |first6=MJ |last7=Hsieh |first7=LJ |last8=Begg |first8=CB |title=Variations in lung cancer risk among smokers |volume=95 |issue=6 |pages=470–8 |journal=Journal of the National Cancer Institute |doi=10.1093/jnci/95.6.470|doi-access=free }}{{cite journal |name-list-style=vanc|pmid=22610500 |year=2012 |last1=Bach |first1=PB |last2=Mirkin |first2=JN |last3=Oliver |first3=TK |last4=Azzoli |first4=CG |last5=Berry |first5=DA |last6=Brawley |first6=OW |last7=Byers |first7=T |last8=Colditz |first8=GA |last9=Gould |first9=MK |last10=Jett |first10=James R. |last11=Sabichi |first11=Anita L. |last12=Smith-Bindman |first12=Rebecca |last13=Wood |first13=Douglas E. |last14=Qaseem |first14=Amir |last15=Detterbeck |first15=Frank C. |title=Benefits and harms of CT screening for lung cancer: A systematic review |volume=307 |issue=22 |pages=2418–29 |doi=10.1001/jama.2012.5521 |journal=JAMA|display-authors=8 |pmc=3709596 }}{{cite journal |name-list-style=vanc|pmid=12527567 |year=2003 |last1=Bach |first1=PB |last2=Niewoehner |first2=DE |last3=Black |first3=WC |author4=American College of Chest Physicians |title=Screening for lung cancer: The guidelines |volume=123 |issue=1 Suppl |pages=83S–88S |journal=Chest |doi=10.1378/chest.123.1_suppl.83s}}{{cite journal |name-list-style=vanc|pmid=17873161 |year=2007 |last1=Bach |first1=PB |last2=Silvestri |first2=GA |last3=Hanger |first3=M |last4=Jett |first4=JR |author5=American College of Chest Physicians |title=Screening for lung cancer: ACCP evidence-based clinical practice guidelines (2nd edition) |volume=132 |issue=3 Suppl |pages=69S–77S |doi=10.1378/chest.07-1349 |journal=Chest}} He has proposed a number of strategies by which Medicare could link payment level to the value of healthcare delivered.{{cite journal |name-list-style=vanc|pmid=21383369 |year=2011 |last1=Bach |first1=PB |last2=Mirkin |first2=JN |last3=Luke |first3=JJ |title=Episode-based payment for cancer care: A proposed pilot for Medicare |volume=30 |issue=3 |pages=500–9 |doi=10.1377/hlthaff.2010.0752 |journal=Health Affairs |doi-access=free }}{{cite journal |name-list-style=vanc|pmid=20921478 |year=2010 |last1=Pearson |first1=SD |last2=Bach |first2=PB |title=How Medicare could use comparative effectiveness research in deciding on new coverage and reimbursement |volume=29 |issue=10 |pages=1796–804 |doi=10.1377/hlthaff.2010.0623 |journal=Health Affairs |doi-access=free }}

His lay press contributions have included op-eds on topics such as medical school tuition funding,Peter B. Bach, [https://www.nytimes.com/2011/05/29/opinion/29bach.html "Why Medical School Should Be Free"], The New York Times, 5/28/2011 (accessed 11/9/2012) setting physician reimbursement based on market forces,Peter B. Bach, [https://www.nytimes.com/2009/06/04/opinion/04bach.html "Medicare, Start the Bidding"], The New York Times, 6/3/2009. (accessed 11/9/2012) and why cancer screening recommendations are often not followed.Peter B. Bach, [https://www.nytimes.com/2012/06/05/health/views/essay-urging-doctors-to-do-less-may-fall-on-deaf-ears.html "The Trouble With 'Doctor Knows Best'"], The New York Times, 6/4/2012. (accessed 11/9/2012)

Bach chronicled his wife Ruth’s treatment for early breast cancer in a series of articles of blog posts for the New York Times,{{cite news |last1=Balch |first1=Peter |title=Posts published by Peter B. Bach, M.D.|url= https://well.blogs.nytimes.com/author/peter-b-bach-md/|access-date=9 May 2021 |work=New York Times|date=4 April 2011 }} and then wrote about her death in 2012 from the disease in a piece for New York Magazine.{{cite news|last1=Bach|first1=Peter|title=The Day I Started Lying to Ruth|url=http://nymag.com/news/features/cancer-peter-bach-2014-5/|work=New York Magazine|date=May 6, 2014}} Bach discussed the article on Leonard Lopate's former show on WNYC.{{cite news|title=A Cancer Doctor on Losing His Wife to Cancer|url=http://www.wnyc.org/story/cancer-doctor-losing-his-wife-cancer/|work=Leonard Lopate Show on WNYC|date=May 7, 2014}} Bach married the writer Bianca Turetsky in 2021.{{cite news |last1=Reyes |first1=Nina |title=A Cancer Doctor and YA Novelist Find the Right Words for Each Other |work=The New York Times |url=https://www.nytimes.com/2021/10/08/style/bianca-turetsky-peter-bach-wedding.html |date=Oct 8, 2021}}

• The Centers for Medicare and Medicaid Services (Senior Advisor to the Administrator: 2005-2006)[http://www.cancernetwork.com/display/article/10165/108908 CMS Seeks Methods to Appropriately Reimburse High-Quality Cancer Care] Oncology NEWS International, Vol. 15 No. 2, 2/1/2006. (accessed 11/9/2012)
• National Cancer Policy Forum of the Institute of Medicine (Member: 2005-current)[http://www.iom.edu/Activities/Disease/NCPF.aspx National Cancer Policy Forum] {{webarchive|url=https://web.archive.org/web/20100308065809/http://www.iom.edu/Activities/Disease/NCPF.aspx |date=2010-03-08 }} Institute of Medicine updated 9/20/2012. (accessed 11/9/2012)
• Working group on HIT for the President’s Council of Advisors on Science and Technology (PCAST) (2009-2011)[https://obamawhitehouse.archives.gov/sites/default/files/microsites/ostp/pcast-health-it-report.pdf Report to the President: Realizing the Full Potential of Health Information Technology to Improve Healthcare for Americans] PCAST, pg. 7, December, 2010. (accessed 11/9/2012)
• Institute of Medicine Committee on Geographic Variation in Healthcare Spending (Member: 2010-current)[http://www.iom.edu/Activities/HealthServices/GeographicVariation.aspx Geographic Variation in Health Care Spending and Promotion of High-Value Care] {{webarchive|url=https://web.archive.org/web/20100928111103/http://www.iom.edu/Activities/HealthServices/GeographicVariation.aspx |date=2010-09-28 }} Institute of Medicine updated 8/16/2012. (accessed 11/9/2012)
• The World Economic Forum's Global Agenda Council on Health Technology (2012-current)[http://www.weforum.org/global-agenda-councils/peter-bach Peter Bach] World Economic Forum (accessed 11/9/2012)

{{Reflist}}

• [http://www.mskcc.org/research/epidemiology-biostatistics/health-outcomes/staff/peter-bach Profile at Memorial Sloan-Kettering Cancer Center Department of Epidemiology and Biostatistics]
• [https://web.archive.org/web/20121026154805/http://www.thirteen.org/openmind/health/do-we-waste-money-on-terminal-patients/2571/ Open Mind TV Show, PBS, 4/12/21. Interview with Richard Heffner, "Do We "Waste" Money on Terminal Patients?"]
• [https://web.archive.org/web/20121010071549/http://www.thirteen.org/openmind/health/do-we-waste-money-on-terminal-patients-part-ii/2573/ Open Mind TV Show, PBS, 4/12/28. Interview with Richard Heffner, "Do We "Waste" Money on Terminal Patients?" (part 2)]

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Category:1964 births

Category:Living people

Category:American medical researchers

Category:Cancer researchers

Category:Harvard College alumni

Category:University of Chicago Harris School of Public Policy alumni

Category:University of Minnesota Medical School alumni

Category:Members of the National Academy of Medicine