New Breast Cancer Cost Savings Attainable for Health Plans

Alignment to oncology treatment guidelines significantly lowers patient and plan costs

BRIEFING
October 28, 2021
Vice President, Specialty Strategy and Client Solutions, CVS Caremark

More than 4 out of 5 plan members with breast cancer received therapies aligned to clinical pathways, yielding a significantly lower total cost of care.

The findings show the average cost of care in six months for breast cancer patients who met these guidelines was $18,964 compared to $25,769 for those who didn’t.

Savings of up to 26% when aligned to breast cancer guidelines $6,800 PMPM* cost reduction for breast cancer patients
Savings of up to 26% when aligned to breast cancer guidelines
$6,800 PMPM* cost reduction for breast cancer patients

Costs for cancer care and management are expected to rise sharply by 2030. https://cebp.aacrjournals.org/content/29/7/1304 As treatments for oncology expand and costs continue to rise, managing appropriate therapy selection becomes more important than ever for health plans. And having more members follow the most cost-effective treatment regimens will help support better patient experiences and be one of the most valuable contributors to control every plan’s cost challenge.

At CVS Health, our Transform Oncology Care (TOC) solution is designed to help enable better visibility to the most up-to-date guidelines and aligned therapies can be approved almost immediately. This can help control costs for health plans and improve the provider experience while improving the quality of oncology care for patients. At the same time, this helps ensure better treatment for patients by encouraging expanding access to novel therapies to the right patients at the right time.

We offer health plans flexible cost-control and quality improvement strategies through:
Checkmark

Full guideline alignment: The ability to adopt clinical pathways that offer a comprehensive range of treatment options

Checkmark

Support at each treatment stage: Frequent touchpoints and data sharing to help keep patients on appropriate therapies with greater adherence and earlier identification of adverse events. This support helps drive better patient experience as well as cost savings

We offer health plans flexible cost-control and quality improvement strategies through:
Checkmark

Full guideline alignment: The ability to adopt clinical pathways that offer a comprehensive range of treatment options.

Checkmark

Support at each treatment stage: Frequent touchpoints and data sharing to help keep patients on appropriate therapies with greater adherence and earlier identification of adverse events. This support helps drive better patient experience as well as cost savings.

Want to know how Transform Oncology Care can help you better control cancer costs for your plan while helping improve the quality of care for your members? Ask Us
BRIEFING
October 28, 2021
Vice President, Specialty Strategy and Client Solutions, CVS Caremark

* Per member per month

106-56197A