Christine Pfaff on Ensuring Patient Access to Affordable Treatments

There needs to be close collaboration between providers and payers to help patients access their treatments in a timely manner, said Christine Pfaff, RPh, senior regional director of operations, American Oncology Network (AON).

She also discussed her skepticism around CMS’ list of drugs for price negotiation and whether it will work as intended.

Transcript

As a pharmacist at the Zangmeister Cancer Center, can you speak to the importance of facilitating relationships with payers to ensure patients have access to their treatment regimens?

Currently, I don't practice pharmacy as much as I'd like to, but I do work very closely with our pharmacy staff at the Zangmeister and corporately at AON. And it's really important to work with payers. We need to make sure that they understand what we're offering to the patients in our community, making sure that we can get patients their treatments quickly.

So, one of the hot topics in oncology care—and in any specialty—is prior authorization and making sure that we have timely access to treatment. You know, those are things we try to work with our payers on. Can we get any kind of special approval turnaround time so that we can get our patients treated quickly?

Additionally, I think it's important to understand we're trying to do the right thing for patients as physicians and providers, and some of the prior authorization processes make us justify clinically why we want to give something and how we're going to give it. I think that it'd be nice if there was more collaboration between the payers and the physicians to help patients overall, because I've never had a situation where a physician is trying to give a patient something inappropriate. It'd be nice if we could work with payers to kind of understand both sides of the situation and, in the end, help our patients.

Currently, there is just 1 oncology drug on CMS' list of drugs up for price negotiations under the Inflation Reduction Act (IRA). Should additional oncology drugs be added in subsequent rounds, and what should be priorities to avoid potential drug reimbursement negotiation barriers?

Now, this is a hot topic, right? The IRA and adding the drugs to the list. I was speaking with one of the physicians in our practice the other day, and about which products are going to be on there. And this is a tough question, because I think what we all want to see is fairly priced medication for patients. We want to make sure our patients can afford medication.

On the flip side of that there has to be innovation to get there. And so, the pharma company is going to spend money on research and development, and they need to be reimbursed for that. Finding that fairness between how do we get a drug to market, what does that cost, and then what is the patient or the system willing to pay for it, I think is tough.

I guess I'm on the fence on how this is going to work with the government involved in price negotiations. I don't have a strong opinion on how effective it will be. I guess I'm skeptical, if you can maybe tell by the tone in my voice.

In the end, if we can get to that goal of transparent cost for patients in the end, and for health plans and providers, I think I think that would be a win. I just am, I guess, skeptical of whether we'll get there.