Valuable insights from community physicians on emerging therapies
Some emerging therapies are showing improved survival outcomes – like their use in non-small cell lung cancer where “the past few years have seen a paradigm shift with the emergence of several novel or later-generation TKIs with improved CNS penetrance. Such agents have promising levels of activity against brain metastases.”
Yet data is necessary to demonstrate those improved outcomes and what conditions are necessary from the provider’s perspective to ensure access and delivery to the appropriate patient population, including reimbursement.
Cencora created an Emerging Therapies Working Group to help address specifics around certain therapies by inviting community practice physicians who represent the wide variation of practice size and scenarios to support diverse patient populations. The group meets to understand new clinical management requirements for emerging treatment options, identify the economic and reimbursement barriers potentially experienced by a specific therapy, as well as the patient and caregiver support needed around that treatment.
In a recent working group session, the participants were able to determine the actual cost and therapy – using clinical trial data versus real world evidence as seen within their practices, including the breakdown between treatment drug costs, pre-meds or supportive care costs, ancillary costs, resource utilization, and hospital admissions. The biopharmaceutical manufacturer was able to understand the costs practices were already billing for and the additional costs incurred to inform formulary decisions.
As a part of this working group, they also looked at considerations like Medicare versus the EOM for unique reimbursement concerns, and the costs of training for practice or hospital staff.
With the feedback from the community practice physicians, manufacturers have a more accurate representation of the actual cost for an emerging therapy and can use those insights to create a more effective integration into the community setting, including developing GPO contracts.
If your biopharmaceutical company is interested in learning more about how the Emerging Therapies Working Group can assist with your contracting and support of the patient and practice, contact sales@intrinsiqanalytics.com.
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