Health-system specialty pharmacies (HSSPs) have a high rate of patient initiation of new oral oncology medication treatments, according to study findings presented at AMCP Nexus 2022.

“The growing number of new oncology medications brings new challenges when patients are initiating treatment,” the study abstract explained. “Cost, insurance requirements, and fulfillment logistics are a few of the hurdles that patients must overcome to initiate therapy.”

Primary medication nonadherence, or failing to obtain prescribed medication, has been reported to be as high as 30% in the patient population. The study sought to evaluate the rate, as well as reasons, for primary medication nonadherence among patients prescribed oncology medications in HSSP settings.

The retrospective cohort study included seven HSSP sites. Patients in the study had an oncology medication referral generated by the health system to the affiliated specialty pharmacy between May 1, 2020, and July 31, 2020.

Among a total 947 patients in the study, the median age was 65 years, and Medicare was the most common type of pharmacy coverage. Capecitabine (14%) was the most referred medication, and the most common diagnosis was prostate cancer (14%), researchers reported.

Out of 947 referrals, there were 69 cases of primary medication nonadherence, for a nonadherence rate of 7%. The most common reason for not filling a prescription was patient decision (17 of the 69 cases, or 25%), according to the study.

The HSSP filled 56% of referrals. After the initial referral, the median time to fill the prescription was 5 days.

For 37% of referrals, the final outcome was unknown. Possible explanations include referral to another fulfillment method or that the original referral was for a benefits investigation only.

“More research is needed to understand patient reasons for deciding not to start therapy,” researchers advised, “and to improve patient-centered cancer treatment planning decisions.”

Reference:
Crumb J, Patel R, Lo K, et al. Health-system specialty pharmacies ensure patients initiate new oncology treatments. J Manage Care Spec Pharm. 2022;28(10-a suppl):S1-S137. doi:10.18553/jmcp.2022.28.10-a.s1