The landscape of oncology care is evolving as pharmacists take on increasingly vital roles in managing complex cancer therapies, with major cancer centers showcasing innovative models of pharmacist-led patient care. Leading institutions are demonstrating how pharmacists can significantly enhance cancer care delivery while addressing growing patient volumes and treatment complexities.
Expanding Clinical Responsibilities
At Sutter Health, pharmacists have assumed comprehensive clinical responsibilities, including running therapeutic clinics and managing patient disease states. "They read laboratory test results and images, they select clinical pathways, and they do all the work except for diagnosing the disease," explains Sophia Humphreys, PharmD, MHA, BCBBS, director of System Pharmacy Formulary Management & Clinical Programs at Sutter Health.
St. Luke's Cancer Institute has implemented a pioneering pharmacist-run pharmacogenomics and precision medicine program. Sarah Hogue, PharmD, director of Oncology Pharmacy Services, describes their role: "From the moment the test gets ordered and sent off, the pharmacist is receiving those results, interpreting those results, and presenting [patient cases] at tumor boards so that we can make a collaborative decision."
Innovative Care Delivery Models
The Mayo Clinic has developed a novel approach to manage patient volume, where pharmacists handle selected chemotherapy cycles for pre-identified patients. Scott A. Soefje, PharmD, MBA, BCOP, FCCP, FHOPA, director of pharmacy cancer care, notes the success of this model: "This process allows the physician to instead see a new patient, increasing access to the clinic... I have clinics lining up now, going, 'How do I get one of those pharmacists in my clinic?'"
Florida Cancer Specialists & Research Institute (FCS) demonstrates how pharmacists can standardize practices across multiple sites. Chris Elder, PharmD, BCOP, highlights their cellular therapy oncology pharmacist's role in implementing bispecifics maintenance programs, working directly with physicians to establish protocols and operating procedures.
Clinical Trial Management
Pharmacists are playing crucial roles in clinical trial operations, from feasibility assessments to patient screening. At St. Luke's, pharmacists work closely with primary investigators and research coordinators, conducting thorough medication reconciliation to optimize patient eligibility for trials.
"Rather than just saying, 'Oh, nope, this patient can't be on this trial because they're on such and such heart medication,' we actually have the pharmacist call [the patient's] cardiologist," explains Hogue, noting how this approach has increased their trial participation rates.
Provider Status Challenges
Despite their expanded roles, pharmacists face a significant barrier: lack of federal recognition as providers. This limitation affects reimbursement and resource allocation, even as pharmacists demonstrate their value in improving patient care.
Judith Alberto, MHA, RPh, BCOP, from the Community Oncology Alliance, emphasizes the urgency of addressing this issue: "Resources are very scarce, and it's dangerous when you try to spread...your pharmacist and your health care teams too thin. And so, we need that provider status."
Some states have made progress through collaborative practice agreements or direct provider recognition. Washington state recognizes pharmacists as providers, while Idaho grants broad practice capabilities. However, federal recognition remains the key challenge for the profession's advancement in oncology care.
