A recent survey shed light on the perceptions of health care workers regarding the cost and safety of oral oncolytic agents, as well as highlighted perceptions of impact on patient care.
Results of the survey were published in the Journal of the Advanced Practitioner in Oncology (May 2020;11[4]:354-365).
A significant percentage of newly approved cancer medications are oral agents. These therapies have advantages including patient convenience, prolonged drug exposure, and noninvasive administration. However, many patients are not fully adherent to therapy due to cost premiums that are unaffordable.
Madeline Tompkinson, PharmD, University of Arizona College of Pharmacy, and colleagues designed a study to further evaluate and understand the perceptions of health care workers regarding the cost and safety of oral oncolytic agents. The descriptive, non-experimental, cross-sectional study surveyed 503 health care professionals in hematology or oncology patient care settings across the US. A total of 35 questions were included on the survey to measure quality improvement areas when using oral oncolytic agents.
Among the survey respondents were pharmacists (54%), pharmacy administrators (15%), and nurses (10%), researchers noted.
Results showed that adherence to oral oncolytics was not included in outcome measurements at 31.5% of respondents’ facilities. Treatment abandonment due to cost was reported by 46.6% of respondents, and the most common agents abandoned due to cost were capecitabine, abiraterone, and palbociclib.
Researchers also found that 6.1% of respondents utilized drug interactions to increase drug half-life in an attempt to reduce cost.
Additionally, prior authorization delays were found to occur in one-to-two patients per week, which led to a 4- to 6-day wait to initiate therapy. Twenty-four percent of respondents spent more than 30 hours per week resolving these issues.
“Health care professional responses indicate a high incidence of abandonment of therapy, delay in therapy initiation, and significant resources allocated to resolving issues in assuring patient access to oral oncolytic therapy,” authors of the study concluded, noting a need to further evaluate cost issues in therapy and develop approaches to minimize impact on patient care.
“Further objectives should include increasing adherence and improving overall survival for oral oncology patients,” they added.—Zachary Bessette
