Cancer Care Cost & Efficacy: Haumschild, PharmD, MS, MBA
- this excerpt highlights a pharmacist's crucial role in navigating the complex landscape of new therapies, cost, adn patient access.
- * Holistic Assessment: The pharmacist emphasizes evaluating new therapies not just on clinical efficacy and safety, but also on pharmacoeconomic impact - looking at the total cost of...
- * Balancing Cost & Innovation: The goal is to make cost-effective decisions without stifling innovation.
Key Takeaways from teh Pharmacist’s Viewpoint on Cost & Access to Therapy
this excerpt highlights a pharmacist’s crucial role in navigating the complex landscape of new therapies, cost, adn patient access. Here’s a breakdown of the key points, organized for clarity:
1. Evaluating New Therapies (P&T Committee Focus):
* Holistic Assessment: The pharmacist emphasizes evaluating new therapies not just on clinical efficacy and safety, but also on pharmacoeconomic impact – looking at the total cost of care, not just the initial drug price.
* Long-Term Value: Recognizing that higher upfront costs can be justified if they lead to reduced overall healthcare expenses (e.g., preventing disease progression, reducing hospitalizations).
* Quantifiable Evaluation: Belief that pharmacoeconomic impact can be quantified and should be a core part of the decision-making process.
2. Streamlining Treatment Protocols & reducing Friction:
* Balancing Cost & Innovation: The goal is to make cost-effective decisions without stifling innovation.
* EHR & payer Policy Integration: Treatment protocols need to be built into electronic medical records and aligned with payer policies to minimize delays and denials.
* Provider Support: Facilitating the process for providers to select the right therapy for the patient,considering both clinical needs and cost.
3. The Importance of Consistency & Line of Therapy:
* Side Effect & progression Planning: Pharmacists understand that inconsistent initial therapy choices can lead to higher costs and complexities in later lines of treatment.
* Appropriate Treatment Planning: Proactive planning is key to optimizing outcomes and controlling costs.
* Shared Decision-Making: Crucially, involving the patient in the decision-making process, ensuring they understand their out-of-pocket expenses.
4. Navigating the Financial Assistance Landscape (Pharmacist’s Role):
* Patient-Centric Approach: Prioritizing getting the patient on treatment,and recognizing financial barriers as a major obstacle.
* Comprehensive Assessment: Beyond clinical factors, understanding the patient’s:
* Treatment Goals: What matters most to them?
* Financial Situation: Insurance coverage, out-of-pocket costs, ability to cover travel/lodging, other financial burdens.
* Utilizing Available Resources:
* Manufacturer Programs: Co-pay assistance, drug replacement, patient support services.
* Foundations & Grants: Actively seeking and connecting patients with relevant funding opportunities.
* Proactive Screening: Implementing routine financial screening for all patients, not just when issues arise.
* Open dialog: Initiating conversations about affordability upfront, similar to discussing safety and efficacy.
* sustainable Affordability: Pharmacists can “care plan” for financial sustainability alongside clinical care planning.
In essence, the pharmacist is positioned as a vital advocate for patients, bridging the gap between innovative therapies, complex financial systems, and the need for accessible, affordable care. They are not just dispensing medication, but actively working to ensure patients can stay on treatment and achieve the best possible outcomes.