Oncology therapy (More on Desktop Resource, March 2007)

March 1, 2007

Oncology therapy has the potential to become the single leading category promoting drug spending growth, however, the class of drugs is rife with challenges for plans and employers.

Oncology therapy has the potential to become the single leading category promoting drug spending growth, however, the class of drugs is rife with challenges for plans and employers.

The oncology category will be particularly challenging, because it is not only projected to be the top single category driving drug spend growth, but also a challenge clinically to manage patients within this category, according to Ryan Haynes, RPh, director of clinical services at HealthTrans, Greenwood Village, Colo.

"To further complicate the situation, it is often difficult to apply traditional cost management tools-for example, prior authorization, step therapy-to oncology, because timely patient care is critical and with new oncology drugs becoming available there can be uncertainty as to their place in therapy, not to mention the potential political ramifications surrounding new and appropriate therapies in this category," he says. "Managed care executives will continue to be challenged with attempting to balance appropriate, evidence based care with financial considerations involved with new drug therapy."

"Moving these drugs over to dispersion by specialty pharmacies has not been a scenario that payers are eager for. Moving the adjunctive agents, such as those for anemia, white blood cell growth or nausea, to the pharmacy benefit will increase as payers appreciate the savings the pharmacy benefit allows them to receive."