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TOP - December 2012 VOL 5, NO 8 published on December 20, 2012 in Cancer Center Profile

The Changing Role of Oncology Pharmacy

Onco360 is an oncology pharmaceutical services company dedicated to advancing the continuum of pharmaceutical cancer care for patients. To that end, the company has developed specialized clinical and supportive care oncology pharmacy care programs and services that are managed by board-certified oncology pharmacists (BCOPs) with the goal of providing quality services and improving outcomes for patients.

Onco360 provides services to more than 1800 oncologists; 43 major BlueCross/BlueShield programs; commercial, Medicare, and Medicaid managed care payers; hospital systems; and the National Comprehensive Cancer Network (NCCN) Centers of Excellence through its national network of certified and JCAHO-accredited OncoMed pharmacies.

The Oncology Pharmacist spoke with Burt Zweigenhaft, CEO of Onco360, about the company and the future of oncology pharmacy.

What role do you see Onco360 playing in the current healthcare environment?
Burt Zweigenhaft (BZ): We don’t believe the market has fully grasped the potential value of oncology pharmacists, outside of some of the better-known hospitals and NCCN centers like MD Anderson or Roswell Park.

What keeps us awake at night is the ASCO-projected shortage of 4000 treating oncologists, and the corresponding aging of America fueled by 10,000 new Medicare beneficiaries a day until 2020; this will create a cancer care access crisis. Additionally, delivering cancer care will become exponentially more complex as we move to personalized medicine. Thus, the greater focus on patient care plan personalization, based on the specific tumor diagnosis using predictive sciences and targeted, evidence-based guidelines, will be the norm.

So, a stagnant supply of 12,000 oncologists will have twice as many cancer patients to manage, and, given the science, twice the evidence work components to review to develop the best plan of care. Thus, the opportunity for the oncology pharmacist; preferably, the BCOP.

We predict that the only viable solution to the projected patient cancer care access crisis will be oncology pharmacists functioning as physician extenders and working in concert with treating oncologists or hematologists. This will allow experts in oncology drug care to support physicians in formulating the best treatment care planning, and, just as importantly, the ongoing management of patients to minimize side effects and adverse events to drive a desired outcome for the patients.

We researched the cancer care pharmacy marketplace and thought to ourselves, why can’t the great multidisciplinary approach in an NCCN cancer center be deployed outside the 4 walls of the hospital? We decided we could provide community and smaller regional hospital systems with the same intensive oncology pharmacist clinical support and patient care infrastructure outside those 4 walls.

We also recognized that the Onco360 service model was different than the traditional specialty generalist pharmacies that typically manage single, high-cost, self-injectable, and biological pharmaceuticals for patients on a predictable 30-, 60-, or 90-day therapy  schedule. To create our service model we held extensive one-on-one meetings with key opinion leaders in pharmacy, pharma, and treating physicians to engineer a solution that addressed the gaps in care and service.

How do your services translate to better outcomes for patients with cancer?
BZ: Our BCOPs are well trained and experienced. Their expertise helps cancer patients through the challenges of undergoing treatment.

OncoMTM, our Medication Therapy Management program, is built around the customized care and attention that each patient needs in order to stay compliant with his or her regimen, minimize adverse events, and improve outcomes.

By marrying our just-in-time dose dispensing with our clinical expertise, we seek to minimize drug waste to manage a very dynamic disease and treatment regimen by focusing on quality measures.

How is the relationship between oncology pharmacists and patients changing?
BZ: The major change will be that an oncology pharmacist will be much more directly involved in patient care. This reflects how the multidisciplinary teams operate at Cancer Care Centers.

The American Cancer Society estimates there will be 1.7 million new cancer cases in the United States in 2013. This fact, coupled with the predicted shortage of oncologists, presents an opportunity for oncology pharmacists to be more involved with interventions and patient management.

We believe that BCOPs will be well equipped to fill that clinical gap, to provide the personal attention and care that every patient not only needs, but also deserves. So clearly, the depth and level of interaction between patients and oncology pharmacists will undoubtedly continue to increase over the coming years. This multidisciplinary partnership will be a part of every accountable care organization or oncology medical home model that emerges.

How will this changing relationship affect the training needed for oncology pharmacists?
BZ: We are working with several schools of pharmacy, including the University of Buffalo, to develop 1-year and 2-year oncology pharmacy tracks that include hands-on residency and other programs. We expect programs like this will foster a learning environment where oncology pharmacists can be trained and integrated into the cancer care community to address the shortage of oncologists.

Clearly, a higher level of education, training, and experience will be necessary to prepare pharmacists for an expanded role within the continuum of care. We feel this need will be best served by BCOPs, which is why we support our pharmacists in their pursuit of such rigorous certification, as it will ultimately best serve our patients and physician partners.

What are the biggest challenges facing the field of oncology pharmacy? Are compounding issues and safety part of these challenges?
BZ: In addition to the challenges already noted, the unknown effect of healthcare reform and the new world of accountable care will require oncology pharmacy to move beyond dispensing of medications. It’s no secret that cancer costs are out of control, and more and more focus will come from managed care and the government in terms of pharmacy partners that can help control those costs without compromising care. Expect comparative effectiveness and value-based contracting to become common.

The heightened concern over compounding and pharmacy safety brought on by the unfortunate meningitis tragedy will certainly add to those challenges. We see stepped-up state and federal regulation around cancer pharmacy standards in terms of storage, dispensing, and waste.  Oncology pharmacy must be prepared to not only meet but also exceed the minimum requirements for safely compounding and dispensing cancer drugs.

What are you excited about right now in the field of oncology pharmacy?
BZ: I am most excited about the shift toward accountable care and, as a natural extension, the increased need for meaningful cost containment. As the head of an organization, I am working with my team to build our oncology medical home model.

We’ve built our company by creating a model that fits the disease of cancer and addresses the needs of oncologists by leveraging the partnership opportunities BCOPs can bring to improve quality and outcomes for patients. In doing so, we have a unique ability to define the value oncology pharmacy can contribute to the cancer care solution.


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Last modified: July 22, 2021