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The Role of Oncology Pharmacists in Reducing Costs and Streamlining Processes in Cancer Centers

An interview with Andre Harvin, PharmD, MS, MBA

July 2023 Vol 16, No 4 – Online Only

At the Association of Community Cancer Centers 49th Annual Meeting & Cancer Business Summit, Andre Harvin, PharmD, MS, MBA, Executive Director of Pharmacy, Oncology Services, Cone Health Cancer Center, Greensboro, NC, presented a keynote lecture titled, “Robots, Biologics, and Advocates: Lessons from the Pharmacy.” This informative session centered around the instrumental role that pharmacists play in developing and implementing innovative strategies to reduce costs and streamline processes for cancer centers, with the goal of improving the patient experience.

In this interview with The Oncology Pharmacist (TOP), Dr Harvin elaborates on some of the key points from his presentation.

TOP : Tell us about your role and responsibilities at Cone Health Cancer Center.

Dr Harvin: As Executive Director, I oversee the development and implementation of the clinical, operational, and financial programs of the Cancer Center Pharmacies. This involves our imbedded Clinical Pharmacists Practitioner program, which serves to educate, empower, and advocate for patients throughout their cancer journey. I leverage our robotics platforms to ensure that each compounded chemotherapy medication is specially tailored to the individual needs of our patients. It is my responsibility to ensure that our patients receive as much value as possible when it comes to their cancer treatment. This includes helping to ensure that clinical pathways are available for our medical oncologists and providing financial and social assistance to our patients, whenever possible.

TOP : What led to the decision to utilize robotics in your pharmacy and what benefits have you observed?

Dr Harvin: Our decision to explore intravenous (IV) robotics in the pharmacy was part of a larger strategic analysis of available platforms, workforce pressures, and upcoming regulatory requirements. When taken together, we felt as though an investment in IV robotics would best position our pharmacy team for long-term growth. The robotics have helped us to understand throughput to a degree that would only be possible with direct observation. With our current robotics platform, we can see with data how patient flow is impacted by demand and we can identify opportunities for synergism across the different sites and strategies to reduce waste in daily preparation.

TOP : What are some potential barriers to implementing robotics in the pharmacy setting and how might they be overcome?

Dr Harvin: IV robotics is not for every program or pharmacy team. Several barriers exist, including capital funding, space requirements, and staffing pressures. However, these barriers can be overcome under the right circumstances. To address the first 2 issues, I would advise pharmacy leaders to assess IV robotics as part of their updated United States Pharmacopeia (USP) General Chapter 797 Pharmaceutical Compounding – Sterile Compounding and USP General Chapter 800 Hazardous Drugs – Handling in Healthcare Settings strategy. Take the opportunity to assess whether IV robotics makes sense for your long-term strategy and, if you anticipate growth within your oncology compounding demand, where these robotics may be of assistance.

TOP : What do you hope attendees took away from your session regarding the pros and cons of utilizing biologics in the treatment of cancer?

Dr Harvin: I hope they did not find any cons. During my presentation, I stressed the fact that biosimilars meet FDA-approved criteria showing highly similar efficacy, safety, and purity. Patients and providers should feel at ease when selecting a biosimilar, no matter the setting.

What I hope attendees recognized is that we still have work to do to establish long-term adoption of these agents. Outside of the patient and provider dynamic, there is work to be done with our payer partners to establish parity among biosimilars as it relates to reimbursement. We also need to discourage reckless policies that would force patients to utilize white-bagging, and as pharmacy leaders, we need to understand the complex dynamics of pharmaceutical reimbursement.

TOP : You discussed advocacy in your presentation. What advice do you have for oncology pharmacists to help them be more effective advocates for their patients?

Dr Harvin: I give the same advice to all pharmacists that I encounter, regardless of their specialty. As pharmacists, we need to assess where we can be most impactful throughout the patient’s journey. Within oncology, the need is plentiful. Medications are the foundation of most cancer oncology treatment plans. Pharmacists play an integral role in educating patients, including teaching them how to adhere to complex oral regimens. We also help connect them with the financial resources they qualify for, which can help offset the cost of care. The problem tends to be that although critical, we are often difficult resources to justify.

On June 21, 2023, Dr Harvin was named the new Chief Pharmacy Officer for Cone Health.

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