Coordinate Cancer Care; Improve Outcomes

Jan 21, 2013
At the American Society of Clinical Oncology (ASCO) annual meeting, experts will discuss the latest in cancer research, treatments and patient care.
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  • Cancer

Cancer experts from around the world are gathering in Chicago for the American Society of Clinical Oncology (ASCO) annual meeting to share and discuss the latest in cancer research, treatments and patient care.

ASCO is quite possibly the most anticipated medical meeting of the year. Cancer is the second leading cause of death in the United States, with 1,500 cancer-related deaths each day. The American Cancer Society anticipates more than 1.6 million new cancer cases will be diagnosed this year. It is also one of the most costly diseases to treat: according to the Express Scripts Drug Trend Report, utilization and spending on cancer medication grew 15% in 2011, and is projected to grow more than 20% annually over the next few years. With numbers like these, it’s no wonder that medical, patient and payor communities – as well as Wall Street – closely follow the news from ASCO.

We will hear a lot about breakthrough treatments and their associated costs, but what’s important about this year’s meeting is the focus on how we approach cancer care. Collaborating to Conquer Cancer, the theme of this year’s meeting, will stimulate conversations about improving the care continuum for cancer patients – a team approach that includes doctors, pharmacists, nurses, dietitians and caregivers. As cancer has become a chronic condition for many, much like heart disease or diabetes, the multidisciplinary team is increasingly fundamental.

Adding to the need for coordinated cancer care is the use of oral cancer agents. In fact, more than half of the cancer drugs newly approved in 2011 are administered orally. Oral cancer medications can help improve quality of life and make cancer therapy more manageable. But they also pose potential challenges that are more commonly associated with chronic conditions, such as nonadherence and the possibility of interactions with other medications.  Consider this:

  • There is a 37% nonadherence rate to oral cancer agents, compared to 31% for high blood pressure and heart disease or 29% for high cholesterol. Aside from poor outcomes resulting from nonadherence, when you consider the expense of some of these agents – many cost more than $70,000 per year – nonadherence also leads to significant financial waste.
  • There are hundreds of medications that may interact with oral cancer agents, potentially decreasing the efficacy or increasing the toxicity of the cancer medication. In fact, oncologists may be unaware that a primary care physician prescribed a potentially interacting medication – and this happens between 34% and 51% of the time.

At Express Scripts, we have been implementing a collaborative care approach through our Oncology Therapeutic Resource Center, where specialty-trained clinicians leverage wired pharmacy data and information technology to help coordinate care to improve outcomes and drive down both cost and waste. Our specialists focus primarily on oncology patients, and therefore can quickly identify gaps in care, potentially harmful drug-drug interactions, and barriers to adherence. Rounding out our coordinated care capabilities are nutrition support, waste management programs, and infusion services.

Oncology is the largest area of new drug development, with more than 900 drugs in late phase II and phase III clinical trials representing 45% of the pharmacy pipeline. Additionally, 39% of the cancer medications under investigation “may” be self-administered (oral, self injectables, topical), creating a promising future for cancer treatment. However, if these new treatments are going to impact outcomes and improve quality of life, they need to be managed wisely. Coordinated care can truly be the next big breakthrough in cancer treatment.

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Lab Staff
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