Community Oncologist Highlights Persistent Access Barriers to Targeted Breast Cancer Therapies
Key Insights
Dr. Anasuya Gunturi reports that many breast cancer (search) patients struggle to access newer, more effective targeted therapies (search) due to insurance coverage limitations and prior authorization delays.
Transportation issues, language barriers, and lack of digital literacy contribute to high no-show rates in community cancer (search) clinics, particularly affecting culturally diverse populations.
The Lowell community's TeamWalk fundraising event has raised up to $700,000 annually to cover patient transportation, medication co-pays, and other essential needs not reimbursed by insurance.
Breast cancer (search) patients in community settings face significant barriers accessing targeted therapies (search) despite advances in treatment options, according to Anasuya Gunturi, MD, PhD, medical director of the cancer (search) center and chief of hematology/oncology at Lowell General Hospital in Massachusetts. Her experience treating a culturally diverse, traditionally blue-collar population reveals persistent gaps in care delivery that extend far beyond clinical considerations.
"In my practice, it's not uncommon that a lot of my patients do struggle with accessing some of these newer and sometimes more effective treatments for their breast cancer (search)," Gunturi explained during a recent interview. The challenges begin early in the treatment journey and compound throughout the care continuum.
Insurance and Prior Authorization Challenges
The proliferation of targeted therapies (search)—with new agents entering the market monthly—has created a complex landscape of insurance coverage decisions. Gunturi describes a frustrating reality where treatment selection often depends more on insurance approval than clinical appropriateness.
"Once a drug is prescribed, there's a whole process that has to happen with financial clearance and prior authorizations," she noted. "For some patients, they have 'good' insurances and it's a smooth journey to treatment, and for others, for whatever reason, it just takes weeks or months."
This disparity forces difficult clinical decisions. "Sometimes I even have to change the agent because I'm told that their insurance doesn't cover this particular drug," Gunturi said. "I have to resort to, sometimes, probably equally good but may not be the latest in the field."
Beyond the Clinic: Social Determinants of Care
Access barriers extend beyond insurance coverage to fundamental social determinants of health. Gunturi's clinic experiences a high no-show rate, with root causes often traced to transportation issues and communication gaps.
"If we take the time to delve into what happened, it's oftentimes transportation issues, confusion—'I didn't know I had an appointment', even though it's on the portal," she explained. "They're not technically savvy, or English is not their main language."
While interpreter services help bridge language differences, the increasing reliance on digital health tools creates new barriers for patients lacking digital literacy or consistent technology access. "That's what I see on a daily basis," Gunturi added.
Community-Driven Solutions
To address these systemic gaps, the Lowell community has developed innovative local solutions. The annual TeamWalk fundraising event exemplifies how community partnerships can fill critical care gaps.
"What is so special about it is that everybody shows up," Gunturi said. "Many of them walk in memory of loved ones who lost their lives to cancer (search) or those who are still fighting the fight."
The event has raised up to $700,000, with strict guidelines ensuring every dollar directly supports patient care. Funds cover transportation to treatments, medication co-pays before insurance coverage begins, and essential items like wigs that insurance doesn't reimburse.
"They are very specific about what this money can be used for, and I'm so glad that they are so strict, because that means that the patients get it," Gunturi noted.
Call for Systemic Change
Gunturi emphasizes that innovation in cancer (search) treatment must be matched by comprehensive access initiatives. The solution requires multi-stakeholder collaboration across policy, insurance, and community levels.
"Community partnerships, policy changes at the government level, fundraising, partnership with insurance companies to come up with ways to deliver these drugs to patients at a low cost—I think all of the above needs to happen," she said. "Not just publishing better and newer drugs, but making sure that they actually reach everyone."
Her perspective highlights a critical gap between therapeutic advances and equitable care delivery, particularly for vulnerable populations who may benefit most from targeted therapies (search) but face the greatest barriers to access.