Development and Implementation of an Oral Oncology Drug Repository Program

Stanz, Lauren; Ulbrich, Tim; Yucebay, Filiz; Kennerly-Shah, Julie

doi:10.1200/op.20.00513

Cited by 9 publications

(6 citation statements)

References 17 publications

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“…A media campaign targeted at oncology patients raised awareness of the program. After a review of OACDs consistently in demand for payment assistance and with an expected suitable donation-based supply, OSUCCC piloted a repository program for capecitabine and temozolomide, 28 which is still ongoing and expanding to offer other OACDs.…”

Section: Resultsmentioning

confidence: 99%

Oncologic drug repository programs in the United States: a review and comparison

Heater,

Kircher,

Weldon

et al. 2024

Health Affairs Scholar

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As cancer affects forty percent of all Americans during their lifetime, the financial burden of cancer care represents a significant contribution towards the overall cost of healthcare in the United States. Cancer drug repository programs offer a unique solution for patients who have limited financial ability to access medications while reducing medical waste. We reviewed all state legislation in the United States regarding cancer drug repository programs. Five states have OACD-specific drug repository programs, while 28 states have generalized drug repository programs. Iowa’s state-wide, mail-order OACD repository program is the preeminent example of an effective and efficient program which should be replicated across the country. Many states have passed legislation allowing for drug repository programs but have struggled to translate such legislation into active programs due to lack of funding and management. We offer recommendations across policy, manufacturing, institutional, healthcare professional and patient domains in order provide optimal patient care.

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Section: Resultsmentioning

confidence: 99%

Oncologic drug repository programs in the United States: a review and comparison

Heater,

Kircher,

Weldon

et al. 2024

Health Affairs Scholar

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“…Some states have repository programs for high-priced specialty therapeutics; however, they remain seldom used given significant regulatory barriers. 74,75 State policies can mandate that financial assistance programs improve transparency of eligibility criteria and standardize application processes. The US House of Representatives is currently considering legislation (H.R 830) that would mandate that financial assistance programs count toward patients’ total OOP maximums.…”

Section: Discussionmentioning

confidence: 99%

Section: Disparities In Assistancementioning

confidence: 99%

Pharmacy Assistance Programs for Oral Anticancer Drugs: A Narrative Review

Ragavan,

Swartz,

Clark

et al. 2024

JCO Oncol Pract

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Oral anticancer medications (OAMs) are high priced with a significant cost-sharing burden to patients, which can lead to catastrophic financial, psychosocial, and clinical repercussions. Cost-conscious prescribing and inclusion of low-cost alternatives can help mitigate this burden, but cost transparency at the point of prescribing remains a major barrier to doing so. Pharmacy assistance programs, including co-payment cards and patient assistance programs administered by manufacturers and foundation-based grants, remain an essential resource for patients facing prohibitive co-payments for OAMs. However, access to these programs is fraught with complexities, including lack of trained financial navigators, limited transparency on eligibility criteria, onerous documentation burdens, and limits in available funding. Despite these drawbacks and the potential for such programs to incentivize manufacturers to keep list prices high, assistance programs have been demonstrated to improve financial well-being for patients with cancer. The increasing development of integrated specialty pharmacies with dedicated, trained pharmacy staff can help improve and standardize access to such programs, but these services are disproportionately available to patients seen at tertiary care centers. Multistakeholder interventions are needed to mitigate the burden of cost sharing for OAMs, including increased clinician knowledge of financial resources and novel assistance mechanisms, investment of institutions in trained financial navigation services and centralized platforms to identify assistance programs, and policies to cap out-of-pocket spending and improve transparency of rates charged by pharmacy benefit managers to a health plan.

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“…Traditionally, such medications are discarded; however, several drug repositories are now established, primarily in the USA, such as the Wexner Medical Center Oral Oncology Drug Repository Program [85], and have been endorsed by ASCO guidelines [86]. These allow patients to donate leftover medications, with the intent of these being used for un-or underinsured patients, and one European scheme found a 68% waste reduction, with net savings of $1591 in selected cohorts [87].…”

Section: Reducing Wastage Of Oral Treatmentsmentioning

confidence: 99%

Optimising oncology drug expenditure in Ireland

Kieran,

Hennessy,

Coakley

et al. 2024

Ir J Med Sci

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A combination of improvements in patient survival, increasing treatment duration, and the development of more expensive agents has led to a doubling of per-capita spending on cancer medicines in Ireland (2008–2018). Despite this, access to new drugs is poor in comparison to other EU countries. We examine methods to optimise oncology drug spending to facilitate access to newer anticancer agents. Key targets for spending optimisation (biosimilar use, clinical trials and expanded access programs, waste reduction, avoidance of futile treatment, and altered drug scheduling) were identified through an exploratory analysis. A structured literature search was performed, with a focus on articles relevant to the Irish Healthcare system, supplemented by reports from statutory bodies. At the present time, EMA-approved agents are available once approved by the NCPE. Optimising drug costs occurs through guideline-based practice and biosimilar integration, the latter provides €80 million in cost savings annually. Access to novel therapies can occur via over 50 clinical trials and 28 currently available expanded access programmes. Additional strategies include reversion to weight-based immunotherapy dosing, potentially saving €400,000 per year in our centre alone, vial sharing, and optimisation of treatment schedules. A variety of techniques are being employed by oncologists to optimise costs and increase access to innovation for patients. Use of biosimilars, drug wastage, and prescribing at end of life should be audited as key performance indicators, which may lead to reflective practice on treatment planning. Such measures could further optimise oncology drug expenditure nationally facilitating approval of new agents.

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Development and Implementation of an Oral Oncology Drug Repository Program

Cited by 9 publications

References 17 publications

Oncologic drug repository programs in the United States: a review and comparison

Oncologic drug repository programs in the United States: a review and comparison

Pharmacy Assistance Programs for Oral Anticancer Drugs: A Narrative Review

Optimising oncology drug expenditure in Ireland

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