For years, some observers have called the trend in cancer therapy “unsustainable” as cancer cases rise, and the number—and cost—of drug therapies rise even faster. In a just-released white paper, Avella Specialty Pharmacy doesn’t address these trends directly, but does offer that specialty pharmacies like itself can moderate rising healthcare costs. The paper’s argument, based largely on existing studies, positions specialty pharmacies as a key member of the care team: payer, physician and patient.
On a per-member, per-month basis, cancer care has risen from 9.4% of overall cost for commercial plans in 2004, to 10.7% (most analyses expect this proportion to jump higher in the next few years). Oncology drug sales have nearly doubled form $28 billion in 2008 to $50 billion in 2016, and are on pace to reach $75 billion in 2024, according to cited DataMonitor Healthcare statistics. And in 2016, while there were 21 oncology drugs approved by FDA, 12 were oral oncolytics—and therein lies the patient-support problem, since oral products are typically consumed at home by the patient (and are often dispensed from specialty pharmacies). Adherence for such therapies is sub-optimal; it dropped, in one study, from 91% during a clinical trial, to 56% when the drug was commercialized.
Two prime reasons for non-adherence are drug cost and unmanaged side effects. To address these, Avella touts its role in helping patients obtain financial assistance (claiming $54 million in such support during 2016), and patient support through education and such tools as starter kits containing OTC products to address side effects. It also provides treatment data back to healthcare providers and payers, and looks toward integrating its data resources with the electronic medical record (EMR) systems at health facilities for a higher level of care coordination.
The free white paper is available at Avella’s website.