The healthcare industry continues to grapple with the dual challenges of managing oncology drug costs while ensuring consistent medication availability for cancer patients. Chelsee Jensen, PharmD, BCPS, senior pharmacy specialist at Mayo Clinic, has outlined several strategic approaches to address these pressing issues.
Cost Reduction Strategies While Maintaining Quality
Jensen emphasizes the importance of leveraging cost-effective alternatives in cancer care delivery. "Implementing generics once they become available in the market at a volume that your institution can support or implementing biosimilars where we can, where we know that the safety and efficacy are considered equal," represents a primary strategy for reducing costs, according to Jensen.
While 505(b)(2) generics may offer potential cost savings, Jensen advises careful evaluation of these options, noting the complexity of this market segment. She recommends developing optimized care pathways that prioritize generic medications before advancing to more expensive branded alternatives.
Impact of Drug Shortages on Cancer Care
The ripple effects of drug shortages extend beyond immediate patient care to create substantial operational and financial challenges for healthcare institutions. Jensen describes the situation as having "a very large impact," particularly when treatment regimens require modification.
"When we have to change patients off their current regimen to potentially less safe, more toxic alternatives, that's huge," Jensen explains. These transitions demand significant pharmacy support and labor resources, while also potentially compromising optimal patient care.
Financial Implications for Healthcare Institutions
Healthcare facilities face additional financial strain when drug shortages force them to purchase non-contracted agents at higher costs. Jensen points out that these increased expenses often go uncompensated, creating a particular burden for certain institutions.
Balancing Cost Control with Supply Chain Stability
Jensen advocates for a measured approach to cost reduction, warning against excessive price pressure that could discourage manufacturer participation. "We can't do a race to the bottom with every drug. We can't go to the lowest cost so that manufacturers aren't incentivized to produce agents," she cautions.
Strengthening Supply Chain Resilience
To prevent future shortages, Jensen recommends enhanced collaboration between healthcare providers, manufacturers, and federal agencies. She specifically calls for expanding the Strategic National Stockpile to include more active pharmaceutical ingredients and cancer chemotherapy drugs, while emphasizing the need for improved partnerships with manufacturers to ensure stable supply chains.
