Human Capital Costs of Obtaining Oral Anticancer Medications

May 31, 2016

Oral anticancer medications (OAMs) are commonly prescribed for various cancers. But initiating OAMs can involve extensive effort from clinic staff, including obtaining prior authorization and copayment assistance and coordinating with specialty pharmacies. A session that will take place on Monday, June 6th will discuss “Human Capital Costs of Obtaining Oral Anticancer Medications.”

For their study, researchers conducted a retrospective review to characterize potential delays in treatment. Prostate and kidney cancer patients who were prescribed on-label OAMs at an academic center between August 1, 2014 and August 31, 2015 were included. The following was extracted from nursing notes and patient charts: demographics, date of OAM prescription (Rx), date of first dose, number and reason for staff phone calls required to obtain OAM, copay amount, and whether financial assistance was requested.

Presenters found that in 116 patients (55% kidney cancer, 45% prostate cancer) with 149 unique Rx (median age 65 [27-88], 85% male, 89% white) 78% had Rx drug coverage. In patients with information available (56 unique Rx), quoted average/median copay/month was $1,224/$175 ($0-9453) but dropped to $42/$3 per month ($0-$1056) after copayment assistance program utilization.

They found that the initiation of on-label OAMs was a labor intensive process, and on average it took 2 weeks to obtain a drug. The significant OAM dependent differences found may be related to specific drug plans, assistance programs, or unmeasured variables and needs to be further validated in a larger sample. Out-of-pocket costs were variable and required considerable staff effort to mitigate via financial assistance. The process of initiating OAMs can be a barrier to care and should be a focus of quality improvement initiatives.

This presentation will take place June 6 between 9:45 a.m. to 12:45 p.m.