Low rates of primary medication nonadherence in patients prescribed oral oncology agents across health system specialty pharmacies

Abstract

BACKGROUND: New oral oncology medications bring novel challenges when patients are initiating treatment. Rates of primary medication nonadherence (PMN), the rate at which a medication is prescribed but not obtained, of up to 30% have been reported for oral oncology medications. More research is needed to identify causes and develop strategies for health system specialty pharmacies (HSSPs) to improve cancer treatment initiation rates. OBJECTIVE:To evaluate the rate and reasons for PMN to specialty oral oncology medications in an HSSP setting. METHODS:We performed a multisite retrospective cohort study across 7 HSSP sites. Patients were included if they had an orally self-administered oncology medication referral generated by the health system of the affiliated specialty pharmacy between May 1, 2020, and July 31, 2020. Data collected at each site using pharmacy Plain language summaryThis study found that most patients (89%) who received cancer medication to take at home from a health system specialty pharmacy start treatment. The most common reason for not starting was because of the patient's own decision not to start. Implications for managed care pharmacyRates of primary medication nonadherence as high as 30% have been reported in previous studies of patients starting oral oncolytics. With the increasing number of cancer treatments moving toward patientadministered oral therapies, it is important to understand reasons behind primary medication nonadherence and how the health system specialty pharmacy model is uniquely positioned to positively impact these rates. This study proves that patients are most likely to initiate treatment when managed by health system specialty pharmacies.