Oncology Drug Management: Technology Solutions

Cardinal Health has expanded its services with an end-to-end solution for specialty oncology drug management covered under the medical and pharmacy benefits.

Health plans and physicians are looking for specialty pharmacies that offer solutions to promote the delivery of better outcomes and cost-effective care for oncology patients. Health plans realize that specialty drug spend growth will reach 40% of total plan drug spend by 2020.

CHALLENGES FOR EFFICIENT QUALITY OF CARE

The following challenges have historically made it difficult for health plans to manage their oncology drug spend in a way that improves the quality and costs of cancer care:

• Lack of physician alignment around evidence-based treatments
• Increased variances for oncology treatment
• Financial incentives in coverage rules resulting in more expensive regimens
• Limited quality programs for medical and pharmacy drug management
• Decrease in number of communitybased oncologists

We recognized that better solutions were needed to reduce drug waste, decrease costs to payers, and improve the quality of patient care. As a leader with innovative solutions in health care delivery, we have keenly focused on specialty oncology drug management covered under the medical and the pharmacy benefit by providing the following tools:

• Decision Support Solutions—PathWare Decision Transaction Solutions
• Clinical Pathways
• Specialty Pharmacy—Cardinal Health Specialty Pharmacy
• Payer protocol support services
• Physician compliance portals

POINT OF CARE SOLUTIONS

Cardinal Health Specialty Solutions recently launched a point of care decision support technology solution which integrates evidence-based treatment protocols, incorporates physician pay-for- performance models, automates step therapy algorithms, and facilitates claims adjudications and real-time order generation for a specialty pharmacy.

Our goal is for this integrated solution to generate 10% to 15% savings on payers’ overall oncology spend by:

• Creating collaborative reimbursement models
• Promoting active physician participation in guideline development
• Reducing treatment variability
• Reducing lines of therapy
• Promoting appropriate use of biologics
• Reducing emergency department and hospital visits
• Transition of therapy, support for endof- life decisions
• Appropriate transition to oral oncology drugs
• Enabling comprehensive management of patients on oral oncolytics
• Minimizing prior authorizations to evidence-based treatment protocols
• Streamlining the administration of medical claims

In order to drive cost savings, decision support technology solutions need to be easy to use and they need to drive functional benefits to payers and physicians alike. We have developed that balance in our integrated specialty solution.

PathWare Decision Transaction Solutions

Traditionally, oncology specialty therapies have been difficult to manage and the increased use of more specialized drugs have made them even more complex.

Innovative new approaches can help payers move beyond the traditional model of specialty pharmacy model of drug dispensing to a more progressive solution that helps contain healthcare costs for patients, physicians, and payers alike. SPT

About the Author

Recie Bomar, vice president, Specialty Pharmacy, Cardinal Health Specialty Solutions, has launched and operated pharmacy benefit management programs and prescription mail service organizations. Previously he was vice president of PrecisionRx Specialty Pharmacy—a WellPoint Company.