Defining Value in Oncology Pharmacy: Insights on Care and Costs

The theme of our inaugural regional Institute for Value-Based Medicine® event in Boston was, “Elevating Value in Cancer Care,” and one of the 4 panel discussions focused on the important contributions of pharmacists and the practice of pharmacy to the oncology space. Corey McEwen, PharmD, MS, Massachusetts General Hospital (MGH), was a panel participant on “Pharmacy Decision-Making in Value-Based Oncology Care.”

Here he discusses the importance of understanding how your organization defines value and how it hopes to achieve the end goal of providing that to patients, while considering the role of payers in the space and how they influence care choices. McEwen is director of oncology pharmacy services at MGH, one of the largest academic-based research centers in the country, with responsibilities that include leadership and oversight of all clinical trial pharmacy services that support ongoing research efforts at MGH, its cancer center, infusion centers, and several community sites in the greater Boston area.

This transcript has been lightly edited.

Transcript

Can you address the importance of defining value in pharmacy care within oncology?

I think the biggest thing for me, and the point that I want to get across, is that the big focus of this entire panel discussion [was] value-based care and oncology. And I think my biggest point is, value is not necessarily an objective criteria. I think the most important thing that I found is trying to understand how your organization defines value. I think there are core consistencies across every health care organization, in terms of what they focus on for value, but I think there's intricacies and nuances to each organization. What I found very helpful is trying to understand how my organization defines value and how they hope to achieve value.

I think another thing that always comes up in really anything when you're talking about care in the oncology space is payers and how we're dealing with payer-directed care. That has a big impact on, I think, the value of care that we're providing, and it creates an incredibly complex process for us to navigate and trying to get the discussion out there about that.

How does pharmacy decision-making help to optimize treatment outcomes and reduce financial toxicity for patients?

This may be a biased opinion. I think we, as pharmacists, are probably the most equipped and have the most unique perspective in health care, both from the clinical expertise as well as the understanding and knowledge of the financial and reimbursement components that go along with care in the oncology setting. We, in pharmacy, ultimately have the responsibility of our drug budget, which for any organization is probably one of the, if not the highest cost centers and expenses in any health care organization.

I think our role as pharmacists and leaders in pharmacy is to help educate our peers and help guide that decision-making process. So when we're looking at a particular drug enough or we’re bringing it on formulary, I think the biggest thing that we started to do, in the transition I've seen, is really looking more of the total cost of care, and not looking at just the acquisition cost of the drug, but trying to evaluate more broadly speaking, how is the total cost of care going to be impacted by these drugs?