Melody Chang, RPh, BCOP, MBA, on scaling community oncology pharmacy

American Oncology Network (AON) has administered more than 4,000 bispecific antibody therapies across its network, with roughly 1,000 more expected in the next three months, and recently completed its first outpatient CAR-T therapy, according to Melody Chang, RPh, BCOP, MBA, vice president of pharmacy operations at AON. One of the nation's largest community oncology networks, AON comprises 46 physician practices, more than 350 providers, and over 140 locations across 21 states.

Chang, who oversees AON’s national pharmacy strategy, said the network’s biggest initiative since 2024 has been building the infrastructure to give bispecific antibodies in the outpatient setting, therapies many organizations still default to hospitalizing patients for because of the risk of cytokine release syndrome (CRS), immune effector cell-associated neurotoxicity syndrome (ICANS) and the intensive monitoring step-up dosing requires. "Rather than ask whether this therapy belongs in the outpatient setting, we ask a different question: What systems do we need to build to safely make outpatient treatment possible?" Chang said.

That effort produced standardized protocols across the network, patient-selection criteria that weigh caregiver availability, transportation, social support alongside disease status, toxicity-management pathways covering nursing and physician education, emergency department communication and after-hours triage. AON also built escalation and observation workflows with local hospitals for patients who need a higher level of care. Chang said the same infrastructure is now the operational foundation for AON's outpatient CAR-T program.

Supporting that model is a network of regional clinical pharmacists who work remotely but function as embedded consultants, reviewing complex cases, advising on CRS and ICANS management, and helping standardize care across AON’s 46 practices. "I often describe them as the virtual extension of every oncology care team," Chang said.

AON has also developed a bracelet for patients on bispecific therapy, with plans to extend it to CAR-T patients. The bracelet carries a QR code linking to CRS and ICANS grading, prevention and treatment information that patients, caregivers or emergency department physicians can access if side effects develop.

In this interview with Managed Healthcare Executive, Chang discusses how AON balances clinical, operational and financial priorities through its biosimilar and drug-shortage strategies. Chang is set to speak at the 2026 Health System Executive Summit held on October 16, 2026, in San Francisco.