Cancer treatment today is just as likely to involve self-administered pills at home, as it is to mean sitting in an infusion clinic for chemotherapy. Oral oncolytics bring benefits to both patients and their health care providers, but challenges also remain. Many of these challenges are best addressed with proactive communication among the treatment team, including the specialty pharmacy that fills the prescription.
For the patient embarking on oral oncolytic treatment, a specialty pharmacy offers important services that support treatment success. Firstly, there’s the navigation of the insurance authorization process and financial assistance that BioPlus offers to our patients. This crucial step in the process is why I always say: “healing begins when you heal the wallet.” It’s only when patients are comfortable with their insurance and the affordability of the medication that they’re ready to learn about their medicine and the treatment process. In addition, the specialty pharmacy provides a safety net for patients, ensuring that other medications they are taking (perhaps even from other doctors) do not interact or cause adverse effects with their cancer treatment. The specialty pharmacy is where essential counseling and education about adverse effects and ways to self-manage these problems, as well as ongoing monitoring for toxicities and (when necessary) adjustments to dosages, happens for the patient.
Most states have now passed laws requiring health plans to charge patients the same amount, regardless if their cancer treatment comes in intravenous or pill form. These parity laws aim to protect the pocketbooks of cancer patients. Now that these laws have been on the books for a few years, researchers took a closer look at how patients have benefited. They were surprised to find that, despite parity laws, cancer patients facing high-cost medications have their out-of-pocket costs continuing to rise.
Thus, the financial piece of the puzzle remains a significant hurdle for many patients facing oral oncolytic treatment, with some research showing that one in every ten cancer patients discontinues oral oncolytics due to financial barriers. It is true that there are high out-of-pocket costs associated with these treatments. Fortunately, patient assistance programs exist, which BioPlus is well-versed in connecting patients to the appropriate resources, which in turn helps overcome this barrier to patient adherence.
The other leading cause of non-adherence with oral oncolytics is adverse effects. The access to knowledgeable oncology nurses and pharmacists with special training in this area at BioPlus is another way that we help our patients work through this challenge and be more likely to stay on therapy.
Weintraub A. Laws to control cancer drug costs don’t help patients with highest expenses. Forbes Nov 9, 2017.
Fact sheet: Patient access to oral oncolytics. Community Oncology Alliance http://www.communityoncology.org/pdfs/fact-sheet-oral-oncolytics.pdf
Implementing oral oncolytics. White paper: Association of Community Cancer Centers, 2016.