Specialty Pharmacy Solutions Responds to COA Oral Oncolytic Study
Back in February, I reported key findings in a study commissioned by COA and performed by Avalere to examine roadblocks to oral Oncolytic usage. Included in their recommendations for practices that wish to prescribe them rather than infuse them the traditional way were the following suggestions as short term solutions to access issues:
(1) Oncologists should dispense oral oncolytics from in-office pharmacies,
(2) Health plans either should include a medical oncologist on their pharmacy and therapeutics committees or should consult with one,
(3) A patient’s oncology care team should include a dedicated financial counselor, and
(4) Oncologists should take advantage of health information technology, including electronic medical records.
Avalere’s long-term suggestions included, “…the creation of a universal patient-assistance program and an oncology-specific benefit, as well as shifting oral oncolytics from the pharmacy benefit to the medical benefit.”
In response to those above-mentioned solutions, Bill Sullivan, principal consultant for Specialty Pharmacy Solutions LLC, offers his comments, as reported by Angela Maas, Managing Editor for AISHealth.com (http://www.aishealth.com/Bnow/hbd042110.html). He first takes issue with in-office pharmacy dispensing, noting that only larger practices have the wherewithal to cover the operating costs. Patrick Cobb, M.D., president of COA, agrees that smaller practices cannot afford such a setup, plus some states don’t allow them, anyway. Sullivan also defends leaving oral oncolytics within the pharmacy benefit rather than medical due to the “…added specificity and data tracking enabled through the NDC adjudication process [that is part of pharmacy benefits] would be significantly preferred to the antiquated J-code billing system [what medical benefits use], which most agree is ill-suited for care management purposes.”
While insurance coverage issues are yet to be worked out, Sullivan insists specialty pharmacies have, “…more than enough capacity to support the growing oral oncolytics market.”