Waste and Missed Opportunities Drive Up Cost

Feb 19, 2014
Wasteful spending and the missed opportunities of biosimilars are two reasons cancer costs are on an unsustainable trajectory.
  • Cancer

As the price of cancer treatment rises and payers shoulder more of the cost of care, it is vitally important to reduce wasteful spending. Without waste reduction, pharmacy benefits are unsustainable.

Drivers of Pharmacy Waste

According to the results of a collaborative, multiyear study from Eviti, Inc., 28.7% of cancer treatments prescribed to patients did not meet evidence-based standards or could not be medically justified, needlessly increasing costs by an average of $25,579 per case and putting patients at risk without delivering additional clinical benefit.

Furthermore, according to the Express Scripts 2012 Drug Trend Report, 37% of oncology patients do not properly take the regimen they are prescribed. Nonadherence becomes an enormous driver of waste for drugs that can cost tens of thousands of dollars a month; cancer is the third-largest specialty therapy class for claims under our company’s pharmacy benefit.

Potential of Biosimilars

Another reason costs continue to rise is that U.S. regulators have not approved generic versions of biologic medications, which comprise the bulk of recently launched and soon-to-be launched cancer therapeutics. Even if fewer than a dozen biosimilars reached the market, the savings could be tremendous: In the U.S. alone, the country would realize $250 billion in cost savings between 2014 and 2024. As with small molecule, oral medications, biosimilars would be permitted only after a period of patent protection that would allow drugmakers to recoup the cost of innovation.

We support legislation to bring biosimilars to market, and we also offer solutions to help manage today’s costs and challenges. For example, our Oncology Therapeutic Resource CenterSM offers end-to-end patient care, including counseling and adherence support from specially trained, highly experienced oncology nurses and pharmacists.

We also help physicians better manage how they prescribe cancer medications. Our oncology decision support tools give physicians immediate access to evidence-based suggestions to enable optimal treatment decisions.

Waste today, coupled with the missed opportunities of biosimilars tomorrow, are two reasons cancer costs are on an unsustainable trajectory. We're focused on doing our part to bend the cost curve down while ensuring quality cancer care.

Click here to read more about why cancer drugs are so costly, as recently published in Clinical Advances in Hematology & Oncology:

Author Bio

Lab Staff
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