Ali McBride provides some ideas to promoting oral adherence.
The question really goes into how you are looking or evaluating these patients. We have seen the development of nurse navigators come out where we're seeing nurses actually work on compliance or adherence outcomes. In some cases, insurers are doing that same type of adherence outcome with oral oncolytics as well.
Other times, we're seeing health systems do that work in addition to the work being done by specialty pharmacy.
In some cases, patients can get based on actual reference articles, up to 9 to 11 calls during that first month of therapy just for follow up. That can cause an issue when you're looking at patient in a clinic.
They can be confused one person saying one thing, another phone call calling to something else, and the patient can be confused especially during the initial diagnosis of their disease state.
If there would be a way, my BAG, or big audacious goal for oral adherence, they would be to have some type of feasibility, to have some type of electronic healthcare record which can integrate specialty pharmacy, payers, and also the health system that work together to really address these issues with compliance.
If we're all on the same boat looking at the best outcomes for patients with adherence‑based monitoring, that would provide the best means to continue patients on treatment, and then provide for outcomes following up with that.
That, to me, would actually come with an integrated healthcare system in which many are twiddling down to maybe a few right now. We're seeing Cerner and Epic become one of those.
That would provide easy documentation working with our insurers, and all specialty pharmacies which we're seeing this integrated growth occur, but also with the health systems which are prescribed in those therapies for continued treatment.