Oral Antineoplastic Agents: Assessing the Delay in Care

Abstract

The study was undertaken to determine the length of time between when a prescription for an oral antineoplastic agent is written by the provider and when the medication is received by the patient and to identify risk factors that significantly increase time to medication receipt. First-time fill prescriptions for oral antineoplastic agents were identified. The date the prescription was written and received by the patient was determined. A retrospective review was completed to gather additional information, including prescribed medication, indication, insurance coverage, patient assistance program use, dispensing pharmacy, and prior authorization requirements. The data was analyzed through multivariate statistical analysis and used to identify risk factors that may significantly increase the time to medication receipt. A total of 58 patients were included in the study. A median of 8 days elapsed between when the medication was prescribed and when it was received by the patient. Medication prescribed, absence of a Risk Evaluation Mitigation Strategies (REMS) program, and insurance type are factors that increased time to medication receipt. An understanding of the median time involved, as well as factors affecting the time to delivery of prescriptions, will help healthcare providers better plan and prepare for the use of oral antineoplastic agents.

Barriers to receipt of novel oral oncolytics: A single-institution quality improvement investigation

“…Our results were corroborated by a smaller study of 58 patients that also investigated treatment delays in novel oral anticancer drugs. 24 The design of the study conducted by Anders et al differed from ours in that they included older, traditional chemotherapies (i.e., temozolomide, capecitabine) and other oncolytics that we excluded due to limited distribution (lenalidomide and pomalidomide). The Anders et al patient population was also slightly younger than ours (median 60 years vs. 65 years, respectively).…”

Association Between Copayment Assistance, Insurance Type, Prior Authorization, and Time to Receipt of Oral Anticancer Drugs

“…This study also showed that Medicare beneficiaries and uninsured patients waited longer for their medications and were more likely to need copayment assistance. By contrast, a retrospective study of 58 patients by Anders et al 8 in 2015 found that PA requirement and cost-assistance programs did not affect TTR. Compared with these studies, our work assesses a larger, prospective cohort, and includes all first-time OACD prescriptions per patient within the study period.…”

“…3-5 Several recent studies showed that at least a third of patients need financial assistance to afford their OACDs. 4-8 One recent study showed that between 2010 and 2019 oral oncolytic prices for Medicare beneficiaries have increased beyond inflation, resulting in higher OOP spending for patients with Medicare. 9 A retrospective study looking at insurance claims for over 38,000 patients with Medicare and commercial insurance showed that higher OOP costs were associated with higher rates of oral prescription abandonment and delayed initiation across cancer types.…”

“…[3][4][5] Several recent studies showed that at least a third of patients need financial assistance to afford their OACDs. [4][5][6][7][8] One recent study showed that between 2010 and 2019 oral oncolytic prices for Medicare beneficiaries have increased beyond inflation, resulting in higher OOP spending for patients with Medicare. 9 A retrospective study looking at insurance claims for ACCOMPANYING CONTENT Appendix…”