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Specialty Pharmacy Trends Report: Oncology
According to the Centers for Disease Control and Prevention, globally, about 14 million people each year are diagnosed with cancer, while 8 million people die from the disease. Excluding skin cancers, the most commonly diagnosed cancers among men and women are prostate and breast cancer, respectively. According to the American Cancer Society, 1 in 7 men in the United States will be diagnosed with prostate cancer within their lifetime, while 1 in 8 women will be diagnosed with breast cancer.
According to the National Institutes of Health, medical expenditures for cancer in 2020 are projected to reach $158 billion, an increase of 27% compared to 2010 oncology costs. Oncology treatments vary by cancer type and stage. Treatments include chemotherapy, radiation therapy, and target therapies. Chemotherapy and target therapies are often administered as injections or through an intravenous infusion.
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When the survey participants were asked if they are involved in reporting adherence and/or compliance on the use of oncology medications obtained through specialty pharmacy, 27.78% said “a
moderate amount,” 24.07% said “occasionally,” 22.22% said “a great deal,” and 20.37% said “never” (Figure 1).
When asked what percentage of specialty pharmaceuticals for the treatment of oncology require
in-office administration of the drug, 37.04% of the survey participants said 51% to 75%, 25.93% said 26% to 50%, and 20.37% said 0% to 25% (Figure 2).
The survey respondents were divided when asked if they felt there are enough patient assistance
programs to help support the cost of expensive oncology treatments beyond insurance programs. A majority of participants said “no” (46.3%), 33.33% said “yes,” and 20.37% said they were unsure (Figure 3).
Both the American Society of Clinical Oncology guidelines and the National Comprehensive Cancer
Network guidelines are referenced by 48.15% of survey participants with regard to treatment approaches for oncology agents (Figure 4).
The survey participants were divided when asked if they utilize cancer treatment pathways in their
institution; 35.19% said “yes” and 35.19% said “no” (Figure 5).
A majority of the survey respondents (55.56%) said that they are managing oncology more than
they did previously and are implementing value- based and evidence-based care principles; whereas, 24.07% said they were unsure and 20.37% said “no” (Figure 6).
Specialty pharmacy is a burgeoning field that continues to be of importance for managed care professionals. With the rates of chronic, high-cost conditions increasing, payers are eager to find ways to diffuse costs, while also providing patients with the best care possible. First Report Managed Care partnered with the National Association of Specialty Pharmacy to put together this Specialty Pharmacy Trends Report.
The information for this trends report was generated through a comprehensive survey developed via the collaborative efforts of an Advisory Panel of key thought leaders and the First Report Managed
Care editorial staff. This survey was then sent to a diverse pool of specialty pharmacy professionals. This is part 3 of a 3-part series we bring to you on the climate of specialty pharmacy as it relates to the managed markets. We hope that you find the information presented to be practical, informative, and compelling. We hope the survey results serve as a resource you can use in making future management decisions.
Survey Participant Demographics
Key thought leaders in the field of specialty pharmacy have provided the information collected in this Specialty Pharmacy Trends Report series. The following are the demographic responses, providing a snapshot of the survey participants and the organizations for which they are affiliated.
The Northeast is home to most of the survey participants (33.93%), while 28.57% of participants are in the Midwest, 10.71% in the Southeast, 10.71% in the Pacific, 10.7% in National regions, 3.57% in the Mountain region, and 1.79% said “not applicable.”
The majority of the survey respondents (60.71%) have a PharmD degree, while 39.29% have a BS in
Pharmacy, 17.86% have an MBA, 10.71% have an MS, and 5.36% have a PhD. A significant majority of survey participants (53.57%) have an RPh certification, while 17.86% have a BCPS, and 12.5% have a CSP.
When asked how long they have been in the specialty pharmacy field, 35.71% of survey participants said 0 to 5 years, while 28.57% said 11 to 20 years, and 26.79% said 6 to 10 years.
Mail-order specialty pharmacy is the primary facility of work for 23.21% of the survey participants. An additional 16.07% said their primary facility of work is an academic institution (not a university hospital), another 16.07% said a managed care organization, 14.29% said a retail specialty pharmacy,
and 10.71% said a consulting firm.
When asked what type of specialty pharmacy they are involved with, 26.79% of the survey respondents said independently owned (nonretail) and another 26.79% said pharmacy benefits manager. Another 16.07% of the survey respondents are involved with a health plan-owned specialty pharmacy and 14.29% are retail pharmacy owned.
Most of the survey respondents (39.29%) reported that they have 1% to 25% of patient interaction time on a monthly basis, while 28.57% said their role does not currently involve patient interaction.
When the survey participants were asked to select the top 5 therapeutic categories with which they are most involved, and with the option to select up to 5 areas, the results were the following:
• Oncology (69.64%)
• Rheumatoid arthritis (67.86%)
• Hepatitis C (64.29%)
• Multiple sclerosis (50%)
• Diabetes (37.5%)
• Crohn’s disease (35.71%)
• Psoriasis/Psoriatic arthritis (35.71%)
• HIV/AIDS (25%)
• Hemophilia (23.21%)
• Immunoglobulins (12.5%)
• Cystic fibrosis (8.93%)
• Hereditary angioedema (5.36%)
• Gout (3.57%)
• Infertility (1.79%)
