New Collaboration Augments Cancer Care

Jun 20, 2012
The Express Scripts - NCCN collaboration provides oncologists real-time access to the latest research on which cancer medications are clinically appropriate.
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  • Cancer

During this year’s American Society of Clinical Oncology (ASCO) annual meeting, a clear call was made for more effective and coordinated cancer care.

Express Scripts plays its part by offering providers innovative tools and resources to support their clinical decision making. We have recently strengthened these tools through a new license agreement with the National Comprehensive Cancer Network® (NCCN®) for use of the NCCN Drugs & Biologics Compendium (NCCN Compendium®), a resource to help guide the appropriate use of specialty medications and biologics in patients with cancer.

The NCCN Compendium is based directly on the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®), which are the most frequently updated clinical practice guidelines available in any area of medicine. They are the recognized standard for clinical policy in oncology.

The Express Scripts-NCCN collaboration is significant. It gives us the ability to provide oncologists real-time access to the latest evidenced-based research on determining which cancer medications are clinically appropriate and effective for a specific patient’s condition. As a result, cancer patients may receive more effective care faster.

Express Scripts will integrate data from the NCCN Compendium into our ExpressPAth™ platform platform, a web-based portal that allows physicians and their office staff to request, renew or check on the status of pharmacy and medical prior authorizations. ExpressPAth reduces administrative burdens and gives providers easy access to NCCN Compendium data, streamlining and accelerating the most comprehensive care to cancer patients.

The NCCN Compendium is the latest addition to the Express Scripts offering of clinical programs and utilization management tools designed to control the cost of specialty medications and improve care for patients. It is critical for oncologists to have access to the most up-to-date, evidence-based criteria so they can navigate the complex landscape of options for cancer care. Given that almost half of the medications in the drug development pipeline are cancer drugs, the landscape will only grow more complicated, and our NCCN collaboration will become even more important.

Oversight across the Medical and Pharmacy Benefits

Spending on cancer therapies will grow more than 20% annually for the next few years. Since the majority of cancer medications are administered in doctors’ offices, outpatient hospital settings and infusion centers, roughly 77% of specialty cancer drug costs are covered under the medical benefit rather than the pharmacy benefit. By integrating the NCCN Compendium into ExpressPAth, we are able to help improve medication cost and safety across the entire medical-pharmacy spectrum.

And that’s good news for everyone involved – patients, oncologists and payers.

About NCCN

The National Comprehensive Cancer Network (NCCN), a not-for-profit alliance of 21 of the world’s leading cancer centers, is dedicated to improving the quality and effectiveness of care provided to patients with cancer. Through the leadership and expertise of clinical professionals at NCCN Member Institutions, NCCN develops resources that present valuable information to the numerous stakeholders in the health care delivery system. As the arbiter of high-quality cancer care, NCCN promotes the importance of continuous quality improvement and recognizes the significance of creating clinical practice guidelines appropriate for use by patients, clinicians, and other health care decision-makers. The primary goal of all NCCN initiatives is to improve the quality, effectiveness, and efficiency of oncology practice so patients can live better lives.

The NCCN Guidelines - the recognized standard for clinical policy in oncology - are the most comprehensive and most frequently updated clinical practice guidelines available in any area of medicine. Covering 97% of all patients with cancer and updated on a continual basis, the NCCN Guidelines are developed through an explicit review of the evidence integrated with expert medical judgment and recommendations by multidisciplinary panels from NCCN Member Institutions. There are 44 individual panels, comprising nearly 900 clinicians and oncology researchers from the 21 NCCN Member Institutions and their affiliates. Specific treatment recommendations are implemented through performance measurement.

Based directly on the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines), the NCCN Compendium contains authoritative, scientifically derived information designed to support decision-making about the appropriate use of drugs and biologics in patients with cancer. The NCCN Compendium is now recognized by the Centers for Medicare and Medicaid Services (CMS) as an authoritative reference for oncology coverage policy. Managed care medical directors, pharmacy benefits directors, and other health care professionals also reference the NCCN Compendium when making decisions that impact patient access to appropriate therapy. The uses identified are based upon evaluation of evidence from scientific literature integrated with expert judgment in an evidence-based process. Indicated uses are categorized in a systematic approach that describes the type of evidence available for and the degree of consensus underlying each recommendation. All recommendations (at all category levels) in the NCCN Compendium constitute appropriate, medically-necessary care. The NCCN Compendium lists both FDA-approved uses and appropriate uses beyond the FDA-approved label.

For more information, visit NCCN.org.

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