Financial impact from in-office dispensing of oral chemotherapy

Howard, Anna; Kerr, Julia R.; McLain, Monica; Modlin, Jessie

doi:10.1177/1078155218799853

Cited by 9 publications

(4 citation statements)

References 6 publications

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“…In a clinic-based oral chemotherapy program serving a group of 5 outpatient cancer centers, in-office dispensing of oral chemotherapy resulted in a total cost avoidance annually of $1,730,416 when compared to the time period before in-office dispensing. 9 Similarly, a retrospective cohort study examining medical and pharmacy claims of Medicare Advantage beneficiaries over a year found the use of a medically integrated pharmacy in a health system was associated with lower risk-adjusted healthcare costs per member per month than patients who used the same provider outside of a health system or those who used different providers outside of a health system ($7,060 vs $7,683 and $8,155, respectively). 10 Finally, a study evaluating the impact of out-of-pocket cost of oral oncolytics on treatment found that as the out-of-pocket cost increased, so did the rate of prescription abandonment and the delay of treatment initiation, highlighting an important role for IDNs and medically integrated pharmacies to identify financial barriers early in care and communicate with patients and providers to obtain access to care efficiently.…”

Section: Discussionmentioning

confidence: 99%

Impact of health system specialty pharmacies on total cost of care in cancer treatment, a multisite review

Wink,

Schroader,

Giglio

et al. 2023

J Oncol Pharm Pract

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Introduction Integrated delivery networks can use medically integrated dispensing of oral oncolytics on site through health system specialty pharmacies. There is little published research examining cost savings. Our objective was to demonstrate the financial value of health system specialty pharmacies among patients receiving oral oncolytics dispensed through fully, partially, and non-integrated dispensing strategies. Methods This was a retrospective cohort study of adult patients from Symphony Health's Integrated Dataverse® repository who filled a prescription for an agent of interest from 7/1/16–6/30/20 that was written within 25 US health systems. Outcomes included costs, healthcare resource utilization, and duration of therapy. Results In total, 36,816 patients were included; 986 patients (2.7%) integrated, 1,822 (4.9%) partially integrated, and 34,008 (92.4%) non-integrated. Mean 6-month medical charge and oncolytic prescription costs were lower for the integrated group ($36,831; $55,786) than the partially integrated ($46,304, p = 0.053; $63,295, p = 0.071) and non-integrated groups ($54,261, p < 0.001; $65,005, p = 0.004). In most healthcare resource utilization categories, the integrated group had the lowest patient percentage utilizing medical care. Duration of therapy was lower on average by ∼3 months in the integrated vs non-integrated group, which may represent closer monitoring of patient medical records and need for fills vs autoship practices. Conclusions Patients receiving oral oncolytics through medically integrated dispensing at health system specialty pharmacies may have lower medical and pharmacy costs and decreased healthcare resource utilization. This study adds to the growing body of literature supporting integrated delivery networks and integrated dispensing. Further research is needed to demonstrate the value of medically integrated dispensing through health system specialty pharmacies in the delivery of treatment to patients with cancer and other high-cost diseases.

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Section: Discussionmentioning

confidence: 99%

Impact of health system specialty pharmacies on total cost of care in cancer treatment, a multisite review

Wink,

Schroader,

Giglio

et al. 2023

J Oncol Pharm Pract

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“…Conversely, medically integrated dispensing has demonstrated increased patient and provider satisfaction, clinical benefit to patients, and financial benefit to third-party payers. [7][8][9][10][11][12][13] Over the past 5 years, NCODA members reported a significantly greater amount of cost avoidance in the MID population compared with the mail-order population. Although these data are limited by the fact that practices could choose what to input or omit in the tracker tool, the financial difference between the two models should not be ignored.…”

Section: Discussionmentioning

confidence: 99%

“… 6 Data from a single medically integrated site showed an annual estimated net cost avoidance of $1,730,416 USD, and an annual estimated net waste of $119,794 USD for patients who were required to fill through a mail-order pharmacies. 7 Through the use of NCODA's CAWT tool, this research sought to identify the top oral oncolytics contributing to cost avoidance and waste across the United States, and to quantify the total cost avoidance and waste documented within NCODA's membership over the past 5 years.…”

Section: Introductionmentioning

confidence: 99%

Financial Impact of Medically Integrated Pharmacy Interventions on Oral Oncolytic Prescriptions

Darling

Starkey

Nubla

et al. 2022

JCO Oncology Practice

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PURPOSE: As the utilization of oral cancer medications rises, it is vital that cancer centers track costs associated with these expensive medications. This research seeks to report the cost interventions associated with medically integrated pharmacies (MIPs) and mail-order pharmacies. METHODS: Data collection occurred from October 2016 through May 2021. Volunteers input data from their oncology practice into NCODA's Cost Avoidance and Waste Tracker tool, an innovative easy-to use tool that allows practices to document any cost saving interventions or waste occurrences. RESULTS: The Cost Avoidance and Waste Tracker tool was used by nearly 50 MIPs across the country. Specifically, 26 practices submitted cost avoidance data, and 37 practices tracked waste associated with oral oncolytic therapy. Among the 26 practices, 677 cost avoidance events led to a total cost avoidance of $7,057,053.73 US dollars (USD). The net cost avoidance for the MIP's was $6,510,971.28 USD compared with $546,082.45 USD for the external mail-order pharmacies. Among the 37 practices that reported waste, 768 events were reported, leading to a total drug waste of $11,275,642.16 USD. Of that, $8,935,612.15 USD was attributed waste from external mail-order pharmacies, whereas $2,429,592.01 USD worth of drug waste was reported from MIPs. CONCLUSION: Medically integrated dispensing of oral oncolytic therapies allows for increased pharmacy oversight, leading to increased cost avoidance and reduced waste for patients and third-party payers. Although these data are difficult to compare because of the complexity of workflows at different dispensing sites, the real-world financial differences between medically integrated dispensing and mail-order pharmacies appear to be significant.

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“…Other methods aimed at oncology-drug cost avoidance are using in-office dispensing and the National Community Oncology Dispensing Association waste tracker. 20,21 These innovations, in conjunction with repository programs, have the potential to substantially reduce oncology costs associated with unused drugs.…”

Section: Discussionmentioning

confidence: 99%

Development and Implementation of an Oral Oncology Drug Repository Program

Stanz

Ulbrich

Yucebay

et al. 2021

JCO Oncology Practice

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PURPOSE: Because of high costs associated with oral oncology drugs, patients are often unable to afford their medications. Developing and implementing an oral oncology drug repository program can provide cost savings and waste reduction opportunities to oncology patients and health care systems. METHODS: Strategies to implement an oral oncology drug repository program include the following: (1) define patient eligibility requirements for the collected drug, (2) ensure patients have long-term availability to preferred treatment, (3) identify optimal oral oncology drugs to use, (4) provide safe drug collection with protocol, (5) calculate the amount of resources needed to provide services, (6) obtain adequate space to operate safely and efficiently, (7) establish safe disposal of the drug deemed inappropriate for use, and (8) spread awareness to prospective patient participants. RESULTS: To date, The Ohio State University Wexner Medical Center oral oncology drug repository program has received 11 drug collections and has redispensed drugs several times. With additional resources, the plan is to expand the repository program’s scope to include other drugs and reach more patients. CONCLUSION: Developing and implementing an oral oncology drug repository program for patients was logistically feasible due to strategic planning with many early successes. As national attention continues to be placed on reducing oral oncology drug costs, additional research is needed regarding strategies to best incorporate pharmacy services into innovative patient care opportunities.

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Financial impact from in-office dispensing of oral chemotherapy

Cited by 9 publications

References 6 publications

Impact of health system specialty pharmacies on total cost of care in cancer treatment, a multisite review

Impact of health system specialty pharmacies on total cost of care in cancer treatment, a multisite review

Financial Impact of Medically Integrated Pharmacy Interventions on Oral Oncolytic Prescriptions

Development and Implementation of an Oral Oncology Drug Repository Program

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