Specialty Pharmacy Improves Cancer Outcomes

Dec 19, 2013
Patients taking some oral oncology drugs are nearly 50% more likely to be adherent when receiving their medications from a specialty pharmacy like Accredo.
  • Cancer

When it comes to cancer, higher adherence rates to oral oncology agents can help improve health outcomes and lower treatment costs. However, cancer treatment is complex, and staying compliant to the prescribed medication regimen – adherence – can often be a major challenge.

New research published in The American Journal of Pharmacy Benefits demonstrates that patients taking certain oral oncology medications are nearly 50% more likely to achieve optimum adherence rates when receiving their medications from a specialty pharmacy such as Accredo. Accredo’s specially trained pharmacists can help provide disease-specific counseling to patients that can increase adherence and lower overall treatment costs by more than $17,000 per patient per year.

The Issue

Chronic myeloid leukemia (CML) is a slow-growing cancer of the white blood cells in bone marrow and blood. If left untreated, after about four years, most patients see a disease progression with the cancer becoming more aggressive. After this point, CML is generally fatal.

Recent advancements, such as the introduction of oral oncology agents that a patient can self-administer, have helped simplify treatment. But these new treatments often have significant adherence barriers, including side effects and the cost of treatment. Gleevec® – or imatinib in its generic form – is a commonly prescribed first-line oral oncology agent for the treatment of CML.

Oral oncology agents such as imatinib can help slow down the progression of CML and improve quality of life for many patients – if patients are adherent to their treatment.

Recommended optimum adherence to imatinib is 90% or above. However, actual average adherence is generally reported to be about 80%, with only 54% of patients achieving adherence rates of 90% or higher.

Adherence Challenges

While safe and effective for most patients, oral oncology medications have adherence barriers that must be addressed.

Oncology medications – including oral agents – tend to have more disruptive and potentially serious side effects, such as immune-suppression, gastrointestinal distress and hand-and-foot syndrome, as compared to traditional oral medications. Patients self-administering oral therapies such as imatinib at home also do not have a clinician providing direct oversight at the time of the treatment. This means that the prescriber has to ensure that patients have adequate education about how to safely and effectively take their medication.

In addition, the cost of oral oncology medications such as imatinib – up to $92,000 per patient per year – poses another challenge to adherence.


Our research found that patients who used Accredo, the Express Scripts specialty pharmacy, were 46% more likely to achieve optimum adherence to imatinib compared to patients who used other dispensing channels. Specialist pharmacists with disease-specific expertise in oncology encourage communication between patients and pharmacists, identify potential safety concerns, help prevent unwarranted drug expenditures and ensure appropriate use of medications, all of which boost adherence and improve health outcomes.


  • The study examined pharmacy claims data from 2010 to 2012.
  • Commercially insured patients starting a new course of imatinib therapy were followed for 365 days after treatment initiation.
  • Analysis was done controlling for differences in factors such as demographics, out-of-pocket spend, average days’ supply per prescription and use of a prescription days’ supply optimization program.

The study cohort consisted of 704 patients.

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