Evaluation of Options and Outcomes in a "Me Too" Market

In the past 5 years, the FDA has approved 52 new agents for oncology use, and 24 of those agents have novel mechanisms, explained Stacey W. McCullough, PharmD, senior vice president of Pharmacy at Tennessee Oncology, PLLC, during her presentation at The American Journal of Managed Care’s 4th Annual Patient-Centered Oncology Care Meeting. With these emerging options in oncology care, there are 3 things to consider when choosing the appropriate option for the patient, she said.

McCullough explained that clinical efficacy, safety and side effects, and cost should be taken into account when considering options for patients, though these characteristics may be difficult to compare because they each have their own unique profiles. Generally, she said, clinical trial results can’t truly be compared to another clinical trial.

These therapies can make a large dent in the amount of money that is spent on care, both on the payer side and the patient side. For example, in chronic myelogenous leukemia (CML), treatment could cost a patient of about $10,000 per month. Over 12 months, the patient is looking at $120,000 in costs of care, and while CML may not be as prevalent a disease state as some of the other cancer types, it still has an impact on overall costs, McCullough explained. Approximately, 6000 people are diagnosed with CML every year; if each of these individuals is paying $120,000 a year, the cost of care can rapidly increase.

Alongside costs of care, McCullough added that adherence hasn’t seen much focus in this new era of changing therapies and oncology strategies.

“In the convenience patients have with being able to take medications home with them, they’re also taxed with the responsibility of managing their own care,” she said. “How do we define optimal adherence?”

Adherence, she suggested, could be improved by a number of ways. Education is important—incorporating the medications into a person’s everyday life is helpful in getting the patient to remember to take them. Side effect management and the length of therapy also come into play in a patient’s adherence, though most notably affordability has been to known to be one of the largest contributors to hinder adherence.

“We live in a world where in meetings like this, the jargon and the medical language that we’re accustomed to needs to be broken down for these patients that have a diagnosis that they’re now in charge of driving the outcome for,” said McCullough.