Optimizing Oncology Drug Use While Mitigating Shortages

Chelsee Jensen, PharmD, BCPS, senior pharmacy specialist at Mayo Clinic, highlights several strategies to reduce health care costs while maintaining quality. She suggests prioritizing generic and biosimilar medications when appropriate, carefully evaluating 505(b)(2) generics, and optimizing care pathways to utilize less expensive options first.

Jensen emphasizes the significant impact of drug shortages on cancer care and stresses the importance of finding a balance between cost-effectiveness and ensuring the continued availability of essential medications. She explains how advocating for stronger and improved collaboration with manufacturers can help mitigate drug shortages.

This transcript has been lightly edited for clarity.

Transcript

How are providers and medical centers working to reduce the cost burden on patients and the US health care system while still providing quality care?

I think really optimizing on opportunities, like implementing generics once they become available in the market at a volume that your institution can support or implementing biosimilars where we can, where we know that the safety and efficacy are considered equal, and they clearly offer a lower cost of care.

Sometimes, 505(b)(2) generics may make sense for your institution as well. However, that's kind of a tricky and complicated market as well, so proceed with caution there. Wherever we can focus on those cost-effective care pathways while considering creating care pathways can truly be the best sequences of care. We should consider where we can optimize the use of generics before we advance to some of our more expensive branded agents as well.

What impact have drug shortages had on cancer care costs?

A very large impact. Obviously, when we have a drug shortage, we have huge disruption if we have to change patients off their current regimen to potentially less safe, more toxic alternatives. That's huge. That also requires such a large pharmacy support and labor to get those conversions made, so that's a huge impact.

Obviously, when we have to buy noncontracted agents, that's higher costs on the system that might not even be improving reimbursement, unfortunately. That's sort of an institutional burden, cost that sometimes goes uncompensated, that can be very detrimental to certain institutions.

I really think it's important to balance here. We can't do a race to the bottom with every drug. We can't go to the lowest cost so that manufacturers aren't incentivized to produce agents. We have to find a middle-ground balance and really work with our manufacturers, and work with our federal government too.

The Strategic National Stockpile should contain more active pharmaceutical ingredients and should contain more cancer chemotherapy drugs while being mindful of how we can partner with manufacturers to improve those things so that we don't run into these shortages that have very big patient impacts.