New oral oncology medications have significantly increased life expectancy for cancer patients.
Leukemia Survival Rates
Look back at where we were four decades ago. In a study by MD Anderson Cancer Center (published in Cancer, 2007) that looked at 123 leukemia patients between 1965 and 1974:
- Three years after diagnosis, survival rates were approximately 40%
- Six years after, survival rates were 20%
- Nine years after, survival rates were as low as 5%
Contrast that with where we are now. For patients treated with oral oncology drugs such as Gleevec® (imatinib mesylate), survival rates have increased to 84% nine years after being diagnosed.
Nonadherence Remains a Challenge
Even with these breakthrough improvements in efficacy, side effects like nausea and diarrhea continue to lower patients’ willingness to continue with the therapy. In 2011, nearly 37% of cancer patients on oral oncology agents were nonadherent.
Specialty pharmacy services can help address some of these challenges through a high-touch patient care model (CuraScript Oncology Care patients have adherence rates 12% higher than for those using retail pharmacies). However, for some medications with even more severe side effects, drop-off rates can be as high as 30% after only the first month.
Nonadherence and Waste
In addition to the negative health impact, this high rate of nonadherence has significant cost consequences, as plan sponsors and patients can pay up to $10,000 for a single 30-day supply of these medications.
U.S. drug spend for cancer medications rose nearly 16% last year, mainly due to increased drug prices. With these double-digit increases likely to continue for several years, it’s critical for the sustainability of our healthcare system that we only purchase the medication that will be used by the patient. At this price point, we simply can't afford to be wasteful.
New Program Increases Adherence While Decreasing Waste
In an effort to improve adherence and cut down on this waste, Express Scripts recently launched a pilot program, called OncoScripts.
The program cuts the typical 30-day prescription of oral oncology medication into an initial 14-day supply. A nurse, trained in clinical assessments, calls the patient on the eighth day to counsel the patient on managing side effects and to determine if the patient is tolerating therapy and remaining adherent.
If everything is going well at this eighth-day assessment, CuraScript ships the remainder of the drug to the patient. If, however, the patient is not tolerating therapy, CuraScript contacts the physician and the remainder of the drug is not shipped, saving both plan sponsor and patient as much as $5,000.
In the five months since the pilot was launched, adherence has improved by 11%. Less medication is wasted, and patients are put on a path toward better health outcomes.
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