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Pharmacy Practice in Focus: Oncology
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The industry has been ushered into a new age of medicine.
Over the past year, pharmacists have overcome many of the challenges imposed on our profession during COVID-19. Although the virus still dominates the headlines, pharmacists have found innovative strategies to navigate through the pandemic and provide even better care for our patients.
During the pandemic, pharmacies have become the primary site of COVID-19 vaccinations—pharmacists are accessible, clinically educated experts who are willing to lead. Furthermore, with the explosion of new therapies for cancer, the role of the oncology pharmacist continues to expand.
Just as the pharmacy profession has continued to evolve, so does our publication. With the Pharmacy Times® platform acting as a mainstay of our profession since 1987, we decided to strengthen our tie to its history with a new name: Pharmacy Times Oncology Edition™.
Let us explore some trends that we should anticipate for oncology pharmacy in 2022.
New Oncology Drug Approvals
Despite the challenges brought on by the pandemic, the pharmaceutical industry continues to churn out oncology therapies at a frenetic pace. With more than 21 new drugs approved to treat cancer in 2021, the industry broke its record of 20 cancer drug approvals, which was set in 2020.1 This is an amazing feat, considering the research and development challenges posed on the industry during the pandemic. Nonetheless, the industry has found a way to work quickly and effectively in this new virtual landscape.
We are also seeing an even greater acceleration on the precision medicine front. Precision medicine provides oncology pharmacists with the ability to select a medication and dose based on patient-specific genomic factors. Through genome sequencing, generic information is gathered so that scientists can secure specific abnormalities and design products with therapies targeting tumors.
Personalized therapies will also be a dominant player in the new molecular-entity approvals oncology stable, as this category continues to mature and innovate at an accelerated pace. Precision medicine is not only effective, but its ability to target cancer cells also allows patients to experience fewer adverse effects and complications from their therapy.
Because much of the drug approval process is the continued proliferation of clinical trials, investigators from these trials have had to work to adjust to a new practice environment to continue their efforts. Candidate recruitment has had to shift to be more virtual in nature, and thanks to these pandemic-based adaptations, the number of trials has risen. This increase in trials will likely continue this year in alignment with the increase in drug candidates. Further, not only do more trials mean a greater likelihood of clinical breakthroughs, but participating patients will have more access to new treatment options as well.
New Technologies
The use of artificial intelligence in the development of new drugs will also be a hot trend for 2022. With recent software innovations, it has become easier to interpret millions of pages of scientific literature and data, which can help investigators and pharmaceutical companies quicken the pace of drug development.
To succeed in their role, oncology pharmacists are trained to develop a disciplined approach to documentation of data. Although it remains a core element of the job, data management is also one of the more challenging areas of our work. In 2022, we will continue to see more efficiency in clinical data management systems and greater accessibility of those data as key points of development.
Furthermore, there is growth toward the use of a single platform that integrates all health information technology systems. Beyond the clinical benefit, this would reduce the costs associated with managing different information systems. Additionally, associated efficiency increases will better facilitate the use of health care data, which can be leveraged as a tool for research and development, as well as help create better treatment plans for patients with cancer.
Gone are the days of pharmacists being tied to computer terminals to complete tasks. Mobile health technology on smartphones, tablets, and wearable technology has now made it possible for clinicians to gather relevant data more quickly and easily than ever before. With these advances, patients are better able to communicate with their oncology teams, educate themselves on their own care, and provide self-driven data inputs that can enhance their teams’ ability to provide that care.
When combined with telehealth, digital tools offer clear health benefits, with evidence mounting that these tools may be able to reduce health care costs. In 2022, it seems likely that we can expect more innovation in software and hardware, such as smartwatches and phones, that will support wireless data-capturing systems; additionally, with the expansion of 5G, there is the potential for continuous and transparent data capture on the horizon. Patients can be monitored closely from the comfort of home as opposed to being constrained to a traditional clinical setting.
Telehealth
With the push toward telemedicine, both the provider community and payers urged patients with cancer to seek care through virtual platforms. Although all practice settings have developed options for a wide range of telehealth services, patients with cancer had to adapt to virtual alternatives in multiple facets of their care. With payers watching these trends, there will be a shift in 2022 toward reimbursement that enhances patients’ access to this virtual care. With telehealth continuing to play a vital role in the care of immunocompromised patients during the pandemic, this move on the payer side is a welcome change for patients.
An Increased Role for Oncology Pharmacists
In 2022, the role of the oncology pharmacist will continue to grow. Because the pharmacist pool has shrunk due to the pandemic, oncology pharmacists are filling in those gaps and expanding the scope of their practices.
Additionally, there has been a shortage of well-trained oncologists and nurses due to the pandemic’s strain on our health care system; again, oncology pharmacists stepped up. As the drug expert on the cancer care team, the oncology pharmacist has become an integral component of the work done.
With these changes, it is likely that oncology pharmacists’ responsibilities will grow to further incorporate the education of patients and caregivers on medications, as well as support the goal of improving medication adherence. Additionally, the role of oncology pharmacists in 2022 will likely be more engaged with developing treatment guidelines, leading pharmacy and therapeutics committees, establishing standards, enforcing policies, and applying clinical pathways in all areas of practice, including hospital, institutional, specialty, and ambulatory.
Specialty Oncology Pharmacy
New oral oncology drug approvals will be an important part of 2022, and specialty oncology pharmacists are the predominant dispensers of these products. Oncology specialty pharmacies continue to develop unique programs and services to support patient-based drug utilization plans, optimal oncology therapy selection, and maximized cost-management outcomes.
We will also see more demands from health plans and prescription benefit managers to increase the use of evidence-based drug management strategies, including comparative-evidence research and testing quality and biomarkers, to drive appropriate cancer therapy selection. Pharmacy benefit managers and plan sponsors are demanding that programs provide insight into medical and pharmacy benefits.
However, there is a reason approximately 80% of the specialty pharmacy revenue is generated by 5 payer-owned specialty pharmacies. In 2022, payers will continue to impose their will and leverage in the oral oncology space and, where possible, other dosage forms, creating even more market share.
Overall, trends in the oncology pharmacy space in 2022 are ushering the industry into a new age of medicine. Although oncology pharmacists may be pressed forward by the force of this change, we will certainly not sit idly by as we are propelled toward the future of our industry—it’s not in our nature.
Dan Steiber, RPh, operates Genesis Pharma Consultants, a practice responsible for commercial operations and trade–supply chain strategy development. Steiber has served in senior positions in pharmacy, distribution, and industry during his 40-year career and is a licensed pharmacist in Texas, Washington, California, and Pennsylvania.
REFERENCE
1. New drugs at FDA: CDER’s new molecular entities and new therapeutic biological products. FDA. Updated on January 6, 2022. Accessed January 14, 2022. https://www.fda.gov/drugs/development-approval-process-drugs/new-drugs-fda-cders-new-molecular-entities-and-new-therapeutic-biological-products