The oncology pharmaceutical market is rapidly growing and changing.
The oncology pharmaceutical market is rapidly growing and changing. In the midst of these changes, specialty pharmacy stakeholders are being challenged, and have a responsibility, to take on a greater role than ever before in guiding how oncology care is delivered.
Over the past 5 years, the FDA has approved 61 cancer drugs. Advances in research and development have resulted in new chemotherapy drugs and new indications for existing therapies. Treatments are being developed that attack cancer cells in different and more effective ways, harnessing cutting-edge science and genetic manipulation. Targeted treatments and immunotherapy, including chimeric antigen receptor T-cell agents, provide a way to treat a tumor based on its specific genetic makeup rather than its location in the body. Targeted therapy zeroes in on the changes that make cancer cells different from healthy cells, whereas immunotherapy uses the immune system to help find and attack cancer cells.
These advancements are good news for patients who are achieving better outcomes, often with treatment regimens that have fewer adverse effects (AEs) than previous chemotherapies. The oncology pipeline continues to be strong, with more than 1100 drugs and vaccines in various stages of development.
The Rising Cost of Cancer
The mortality rate from cancer has declined steadily over the past 2 decades, yet the disease continues to have a tremendous impact on patients and the health care industry. There are more than 100 types of cancer. For women, the most common types are breast (30%), lung (13%), colon (7%), and uterine (7%); for men, prostate (19%), lung (14%), colon (9%), and bladder (7%). The breadth of types, as well as subtypes based on genetic variation, contribute to the complexity of treating cancer. This also means that we have the opportunity to be more precise with medications.
Newer treatments come with higher costs, however, and oncology, medical, and pharmaceutical spend continues to rise. The Express Scripts 2018 Drug Trend Report shows that oncology has the highest drug trend among other therapy classes, at 18%.1
The Critical Role of Oncology Specialty Pharmacy
With innovative new therapies on the market and hundreds more in development, many patients with cancer are surviving and thriving, living with the disease as a chronic condition. Simultaneously, the number of oncologists is projected to decrease over the next decade, as will the time they have to spend with patients. In addition, oncologists are reporting increased administrative burden and patient volumes, with a greater percentage of oncologists than ever before (63%) reporting an increase in personal workload.2
Specialty pharmacy has always been more than a mode of getting a drug to a patient. Now, however, our role as specialty pharmacy care providers in the overall care continuum is increasingly critical. This role will only grow as physicians have less time and resources to support patient needs related to their drug therapy.
Specialty care that meets the needs of the ever-changing oncology market should include these goals:
Four in 10 oncologists specialize in specific tumor types, so it makes sense that a specialty pharmacist has that same level of expertise. At Accredo, our oncology pharmacists are 100% dedicated to cancer care. They receive specialized training and focus on specific types of cancer, which allows for a deeper level of clinical knowledge. Our pharmacists understand the market landscape and treatment paradigms for particular tumor types based on area of study and patient experience.
The importance of this focused expertise is especially critical for childhood cancers. Physicians treating children with cancer face a lack of approved drugs specifically for the pediatric population. Typically, less than 4% of oncology funding goes to the research and development of therapies for children. Safety concerns are a factor in this shortage of pediatric research. Pharmaceutical manufacturers must have the safety of a product established in adults before testing in children. That leaves physicians and pharmacists to face the challenge of exercising professional judgment regarding pediatric administration. These decisions require a strong clinical perspective that comes from being familiar with oncology drugs and experience with pediatric patients.
Severe malnutrition and weight loss play a role in at least 1 in 5 cancer deaths. Proper nutrition is a critical element of patient care that can support recovery from chemotherapy or radiation therapy, prevent unnecessary hospitalization, and improve quality of life. Accredo offers TherapEase Cuisine, a patented, web-based oncology nutrition service available to all of oncology patients. For critical or complex cases, patients may engage with our oncology dietician.
As discussed earlier, oncologists are spending more time on administrative duties. The less time they spend on these tasks, the more time they can spend with patients. A specialty pharmacy with a well-designed physician’s portal allows for oncologists to quickly access referral status and prior authorization support.
Specialty pharmacy must continue to find innovative solutions for this patient population and for the financial health of our industry. Providing a focused level of care to oncology patients from pharmacists, nurses, and support teams who are specially trained to support the specific requirements associated with the unique characteristics of oncology medications is critical to achieving the best outcomes—clinically, emotionally, and financially.
1. 2018 Drug Trend Report. St. Louis, MO: Express Scripts; 2018. lab.express-scripts.com/lab/drug-trend-report/2018-drug-trend-report. Accessed March 3, 2019.
2. The 2018 Genentech Oncology Trend Report. 10th ed. South San Francisco, CA: Genentech; 2018. genentech-forum.com/content/dam/gene/managedcare/forum/pdfs/Oncology-Trends/2018_Genentech_Oncology_Trend_Report.pdf. Accessed March 3, 2019