The Value of Innovation in Oncology Management

Identifying unaddressed challenges to better ensure quality, cost and access

BRIEFING
May 28, 2020
Vice President, Specialty Strategy and Client Solutions, CVS Caremark

To meet the quadruple aim of health care – better quality, lower cost, and improvements in both patient and provider experience – the important first step is identifying the unaddressed challenges. This helps build a framework for developing strategies and solutions that address the areas of need. While treatments themselves are incredibly important, research that helps identifiy where the gaps are is critical, because it enables us to ensure clinically appropriate access and services to improve health outcomes, and develop comprehensive solutions that help payors manage costs.

Each year, the oncology community comes together at the American Society of Clinical Oncology’s (ASCO) meeting to unveil the latest research in cancer care. While the meeting is most known for debuting breaking advancements in cancer treatments, the data presented goes far beyond. At this year’s meeting, we will be presenting data reinforcing the importance of innovative specialty management in cancer care. Here, we share some of the highlights the data revealed.

Digital Engagement Helps Support Patient Adherence

It is not uncommon for a patient on specialty medications – especially when they first begin treatment – to experience unpleasant side-effects. As a result, treatment non-adherence is all too common, and an ongoing challenge for patients and health care providers. Secure messaging has been shown to improve medication adherence in patients. In one abstract to be presented at the ASCO meeting, we examine how digital engagement in the form of secure two-way messaging from a nurse helped improve patient adherence to an oral chemotherapy drug known for significant adverse side-effects.

Secure 2-way messaging improved adherence to an oral chemotherapy known for significant adverse side-effects.

Our research found that using CVS Specialty’s secure two-way messaging platform to determine whether patients were experiencing common medication side effects enabled nurses to get involved quickly, leading to an improvement in patients’ symptoms and adherence to therapy.https://meetinglibrary.asco.org/record/189440/abstract. Secure two-way messaging is one of the digital and online engagement tools CVS Specialty uses to help plan members better manage their conditions. 

Precision Treatment: Better Outcomes, More Cost-Effective Care

An important unaddressed challenge in improving outcomes for patients with lung cancer is earlier diagnosis. Currently, patients are frequently diagnosed late, by which time the disease has advanced or metastasized. However, once a patient has been diagnosed, treatment targeted to their clinical and genetic profile can increase survival rates when compared to conventional treatments.

Broad genetic gene sequencing tests help support use of targeted therapies by identifying the best treatment for each patient.

Results of our analysis being presented at ASCO, found that by identifying the broader genomic landscape of a patient’s tumor early on, physicians can make timely and precise treatment decisions, which ultimately can lead to better outcomes and more cost–effective care for both the patient and the payor.https://meetinglibrary.asco.org/record/190309/abstract. Broad-based genetic sequencing is part of our Transform Oncology Care program, which aims to provide targeted strategies for every step of the cancer care journey. 

The Challenge to Increasing Biosimilar Prescribing

Biosimilars are the fastest-growing class of therapeutic products in the U.S. Despite the availability and proven efficacy and safety of biosimilars, their uptake has been slow.https://www.fda.gov/drugs/biosimilars/industry-information-and-guidance. This is, in part, due to patent litigation and pay-for-delay strategies by brand manufacturers that often delay the launch of many of these products, even after they’ve been approved by the U.S. Food and Drug Administration.https://www.centerforbiosimilars.com/news/biosimilars-council-white-paper-condemns-patent-abuses-defends-patent-settlements. As part of the research we are presenting at the ASCO annual meeting, we surveyed oncologists to evaluate their willingness to prescribe biosimilars.https://meetinglibrary.asco.org/record/189711/abstract. While those surveyed deemed biosimilars to be safe and effective, physicians reported there were still certain factors that affected their willingness to prescribe. Given the potential of biosimilars to create competition and therefore lower cost, we continually monitor the pipeline, to optimize the use of lower cost therapies, and expanding our value-based provider contracts in order to help improve patient access.

Data can Improve Patient Care Journey, Payor & Provider Tools

We will also be presenting data from Novologix, CVS Health’s proprietary technology platform, which demonstrated that by engaging oncology practices through an enhanced payor-provider partnership and training providers on the prior authorization tool, we can help facilitate higher-quality oncology care.https://meetinglibrary.asco.org/record/190753/abstract. As part of another study, we surveyed patients on their cancer treatment history and care experience, as well as how they worked with their health care providers.https://meetinglibrary.asco.org/record/187212/abstract.

There is a compelling opportunity to develop a data-driven oncologist selection tool that helps primary care providers direct their patients to high-quality and lower-cost oncologists.

We also surveyed health care providers for information on their practice, their process for referring patients to an oncologist, and how they engage with their patients. There were two key findings. First, there is a compelling opportunity to develop a data-driven oncologist selection tool that helps primary care providers direct their patients to high-quality and low-cost oncologists. Secondly, it is important for providers to initiate the conversation around an advanced directive at the start of a patient’s cancer care in order to help those close to the patient fully understand their desires for end-of-life care.

Do you want to learn how we are innovating to improve oncology outcomes? Ask Us
BRIEFING
May 28, 2020
Vice President, Specialty Strategy and Client Solutions, CVS Caremark

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