Oncology pharmacists have a new tool for helping them better treat their patients. The Association of Community Cancer Centers (ACCC) has released a new publication, “The Practical Cancer Pharmacy,” designed to help hospital cancer pharmacy and financial teams move past the short-term orientation of considering only cost when deciding which drugs to purchase.
“Pharmacists and other providers need to really understand the value that these products have for their patients, which may be different than the assessment of them on a national level or from the payer’s perspective,” George Silberman, a consultant who worked with the advisory board of the ACCC to write the workbook, told The Oncology Pharmacist. “The acquisition price may not reflect the cost to the institution. For example, an oral product would require fewer resources than an IV product. Those resources need to be factored in.”
The workbook is accompanied by 3 webinars, which will cover a practical approach to pharmacoeconomics. We now have more anticancer options than ever before. ACCC’s goal is to help hospital cancer programs accurately assess the true value associated with these drug-based therapies.
“As hospitals continue to face increasing pressures to provide the highest quality care for the lowest possible cost, understanding the true value of the health services they provide to patients is critical for their continued viability,” said ACCC president Thomas L. Whittaker, MD.
With healthcare reform and increased cost-consciousness, oncology pharmacists are faced with continued pressures to adhere to budgetary restrictions and keep down the costs of drugbased therapy. Whereas some pharmacists may approach this task with the required level of sophistication, some may translate the requirement to keep costs down into an overly simplistic rule of selecting drugs with the lowest purchase price.
An emphasis solely on purchase price ignores the reality that there are numerous other “costs” associated with drug use, including dosing, treatment side effects, and costs needed to support the use of a drug. Consequently, providers who rely entirely on drugs that initially cost less often may spend considerably more because of the additional staff, space, and supportive resources that these drugs can require.
Timothy Tyler, who is director of pharmacy services at the Desert Regional Medical Center in Palm Springs, California, helped develop the workbook. He said this type of tool may be highly beneficial in preserving the most appropriate treatments for each individual patient. “One of the biggest concerns facing pharmacists today is the drug shortage. It is impacting everyone in the pharmacy,” Tyler said in an interview with The Oncology Pharmacist. “In the current scenario with drug shortages, it helps to look at things through an economic viewpoint and offer analyses.”
“The Practical Cancer Pharmacy” begins with an overview of pharmacoeconomics. Using the principle that the best way to learn is to do, the workbook includes an exercise in which readers will conduct a pharmacoeconomic analysis. The text, presented in nontechnical terms, makes the subject matter more accessible to those with little familiarity with formal methods for health technology assessment. Readers gain sufficient grounding in the discipline so that they can both understand pharmacoeconomic studies done by others and contribute to pharmacoeconomic analyses undertaken at their institutions.
The workbook explores the 7 major steps involved in estimating the cost-utility of one oncology drug compared with another:
- What type of pharmacoeconomic analysis is best?
- How should the analysis be designed?
- Who is the client for results?
- How should the relevant factors be measured?
- Where do you get the data?
- How do you build the model and interpret results?
- How should you present the findings to decision makers?
Although no oncology drugs are mentioned by name, through a series of assignments the workbook helps the reader build a decision-analytic model to estimate the relative cost-utility of 2 hypothetical drugs indicated for recurrent, metastatic breast cancer patients. The discussion centers on measures of costs, outcomes, and patient preferences. In addition, the reader learns how to compute the cost-effectiveness ratios of 2 hypothetical antiemetics.
The publication and archived webinars are available through ACCC’s Center for Provider Education and ACCC’s Oncology Pharmacy Education Network (OPEN). They can be accessed at www.accc-cancer.org/openweb.