In the battle to tame the soaring cost of cancer care, projected to skyrocket past $245 billion by 2030, a new strategy emerges from the frontlines: pharmacist-led initiatives. A recent study from The US Oncology Network, representing nearly half of the Enhancing Oncology Model (EOM) providers across the nation, underscores the substantial impact pharmacists can have on cost reduction efforts in the oncology arena.
The EOM, a voluntary, risk-based payment model launched by the Centers for Medicare and Medicaid Services (CMS), aims to enhance care quality while simultaneously curbing the total cost of care (TCOC). In this ecosystem, drug costs average a staggering 63% of a patient’s TCOC, spotlighting the immense potential for medication-focused interventions.
The study deployed clinical review pharmacists (CRPs) to comb through oncology treatment orders remotely, hunting for cost-saving opportunities. The CRPs advised on multiple initiatives, including monoclonal antibody dose rounding, pembrolizumab (Keytruda) dose banding, biosimilar therapeutic interchange to preferred products, and prioritized use of zoledronic acid. The CRPs revised eligible treatments according to practice protocols or after consulting with oncologists.
Over an 18-month span from July 2023 to December 2024, seven CRPs across five EOM-participating practices evaluated more than 5600 patients. They identified a remarkable 1271 interventions, with a noteworthy 1180 accepted. This effort translated into a near $9 million reduction in TCOC. Beyond these six primary initiatives, CRPs unlocked an additional $1.2 million in medication savings through other drug selection optimizations.
Pembrolizumab dose banding and the preferred use of zoledronic acid emerged as the prime contributors to these savings. This evidence robustly underscores the value of pharmacist-driven interventions in not only lowering costs but also in bolstering the success of value-based care models within oncology practices.
This approach exemplifies a broader trend in healthcare towards value-based care and precision medicine. By leveraging their unique expertise in clinical resources and developing medication protocols, pharmacists are becoming instrumental in streamlining processes and optimizing treatment outcomes. Their role is evolving from dispensing medications to providing value-based, patient-centered care.
Looking ahead, the integration of network pharmacology in oncology could further enhance this cost reduction effort. Recent studies have demonstrated potential in optimizing treatment outcomes and resource utilization. By leveraging network pharmacology principles, healthcare providers can make more informed decisions in medication management, potentially leading to even greater cost savings and improved patient care in oncology settings.
In an era where the cost of cancer care continues to spiral upwards, largely due to expensive cancer drugs, these pharmacist-led initiatives represent a beacon of hope. They highlight the pivotal role that pharmacists can play in not only improving patient outcomes but also in achieving significant total cost of care savings that ultimately benefit patients, practices, and CMS.
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