Managing high-cost oncology therapies requires extensive cross-functional coordination, with pharmacists playing a central role.
In an interview with Pharmacy Times, Anthony Boyd, PharmD, BCPS, senior director of pharmacy, oncology, and infusion services at Cleveland Clinic, described the complex operational infrastructure required to successfully manage high-cost, specialty oncology therapies within a health system setting, emphasizing the central coordinating role of pharmacy. Boyd explained that implementing these therapies extends well beyond drug selection and administration, requiring close collaboration among executive leadership, clinicians, managed care teams, and pharmacy stakeholders to ensure timely, safe, and financially viable patient care.
Boyd noted that multiple C-suite leaders—including chief pharmacy, medical, and financial officers—are often involved in oversight and decision-making, reflecting both the clinical complexity and financial impact of these treatments. Physicians and advanced practice providers manage direct patient care, while pharmacy teams work closely with managed care and prior authorization specialists to navigate payer requirements. Within pharmacy itself, responsibilities span clinical pharmacists, procurement and supply chain teams, electronic health record build specialists, and infusion and cell therapy operations, underscoring the need for clearly defined ownership across each step of the process.
A key theme of the discussion was the importance of closed-loop communication. Boyd highlighted vulnerabilities that can arise during handoffs, particularly when clinical status changes, manufacturer delays occur, or treatment timelines shift unexpectedly. To address these challenges, his organization developed standardized internal workflows and operating procedures to map responsibilities, clarify communication pathways, and ensure continuity from referral through administration and financial reconciliation.
Boyd also described the value of structured, multidisciplinary touchpoints, including weekly meetings that bring together pharmacy, clinical, administrative, and payer teams to review patient cases in real time. This proactive approach helps identify issues early, reduce reliance on fragmented email communication, and maintain alignment across stakeholders. As demand for these therapies continues to grow, Boyd emphasized that dedicating specialized pharmacy teams to ordering and coordination has been critical to improving efficiency and sustainability, positioning pharmacists as essential leaders in complex oncology care delivery.
