Oncology: The Brass Ring?

Welcome to our third annual special Oncology edition of Specialty Pharmacy Times! While new targeted oral medications are convenient and effective, they are also expensive and toxic, so the need for creating the greatest effectiveness from therapy is warranted. That's where specialty pharmacy comes in.

Welcome to our third annual special Oncology edition of Specialty Pharmacy Times. According to the recently published EMD Serono Report, the majority of oral oncology products in the United States are dispensed by specialty pharmacies. Why? Studies have shown that the cost of treating cancer is one of the leading drivers of increased health care costs. While new targeted oral medications are convenient and effective, they are also expensive and toxic, thus the need for creating the greatest effectiveness from therapy is warranted.

Specialty pharmacy offers the patient a “one-stop-shop” of services for their oral oncology products. Once the prescription is ready to be filled, specialty pharmacies offer a level of medication therapy management (MTM) service that general service pharmacies do not currently provide on a regular basis. For example, in most cases when a patient obtains their medication through a typical walk-in pharmacy, the physician has no contemporaneous notice of when—or whether, for that matter—the patient has filled the prescription.

In the specialty pharmacy pathway, the doctor and the specialty pharmacy work in tandem because the case manager knows exactly when the patient receives the pills and educates the patient at the outset about the course of therapy, side effects, and dosing schedule. In addition, the case manager is able to emphasize the importance of following the dosing schedule correctly.

MTM and follow-up programs instituted by many oncology specialty pharmacies are tailored to specific treatment protocols. Therefore, case managers know to be on the lookout for specific toxicities and other issues that clinical trials and other patient experience have made apparent. When the prescription is ready to be refilled, the specialty pharmacy delivers the new bottle of pills straight to the patient’s home.

Patient nonadherence has been a widespread health care issue. Many oncologists will tell you that patient nonadherence and their concern for the patients sticking with their treatment regimen might determine their use of an IV therapy versus oral. Their partnership with specialty pharmacy can be a difference maker.

Specialty pharmacies are experts at obtaining reimbursement for high-cost products, and most specialty pharmacies offer those patients assistance in locating a patient assistance program, offering them robust patient reimbursement support programs. Specialty pharmacies’ ability to educate patients about their oncology care and improve their adherence therapy is effective, leading to improved adherence behavior, as well as substantial reductions in overall medical costs.

Our time has come in specialty pharmacy—and employers and insurers should consider investment in specialty pharmacy programs with an integrated approach to clinical management for cancer patients to improve outcomes and reduce costs.

About the Author

Mr. Steiber is a principal of D2 Pharma Consulting LLC (d2rx.com) and is responsible for commercial operations, trade-supply chain strategy development including 3PL selection, regulatory oversight, and “operationalizing”organizations. Mr. Steiber has served in several senior positions in pharmacy, distribution, and industry over the course of his 40-year career. He is a licensed pharmacist in Texas, Washington, California, and Pennsylvania and is affiliated with several professional associations and publications. He is also a frequent speaker on behalf of many professional organizations. Mr. Steiber graduated from Washington State University College of Pharmacy. He has participated in a variety of postgraduate programs in law and business development/marketing at Harvard University and Northwestern University. Mr. Steiber currently resides in Highland Village, Texas.