Evaluation of a Medication Acquisition Program for Patient Access to Off-Label Treatment
A recent analysis by Vicki Doctor, BSN, RN, Cancer Treatment Centers of America, Boca Raton, FL (part of City of Hope), and colleagues examined the success rate of their institution’s medication acquisition program (MAP). They presented their findings in an abstract at the 2023 ASCO Annual Meeting in Chicago, IL.
The MAP helped patients with cancer obtain off-label, scientifically appropriate targeted therapy and immunotherapy when patients faced access barriers such as inability to afford their copay while on government insurance, a denial or exclusion from insurance, and unavailability of clinical trials. For their institutional review board–approved retrospective analysis of the MAP, the researchers defined clinical benefit to patients as a treatment duration ≥4 months.
The study included 1,041 referrals to the MAP between October 1, 2015, and December, 31, 2021, of patients who were receiving an off-label treatment or were being denied access for an on-label indication. Of those initial referrals, 769 patients went on to start treatment and were included in the analysis, and all patients accessed these therapies through patient assistance programs or appeals to payers.
For the 769 patients who started treatment, 120 (16%) were on therapy for 4 to 6 months, 64 (8%) for 7 to 10 months, and 78 (10%) for ≥11 months; thus, the MAP showed clinical benefit for 262 (34%) patients total. However, a majority of patients were on therapy for ≤3 months (507 [66%]) and did not meet the clinical benefit threshold in the analysis. In addition, 342 of the 769 patients experienced disease progression; of those, 231 (68%) were able to receive another treatment for their cancer.
The MAP, which only had one dedicated oncology nurse, maintained a 99% successful medication access rate for patients who initiated treatment. “Our medication acquisition program has provided our patients access to targeted treatments that would have otherwise not been available,” the authors wrote. The program also allowed their institution “to offer innovative options to patients who have exhausted SOC [standard of care] options.”
Source:
Doctor V, Schink JC, Moran A, Gandra N, Markman M. Medication acquisition program: Successful access to innovative treatment options. Presented at the 2023 ASCO Annual Meeting; June 2-6, 2023; Chicago, IL, and virtual; Abstract e1852.
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