Physician-pharmacy integration not associated with change in the care of cancer patients

May 23 2024University of Southern California However, little is known about how this integration affects drug utilization or expenditures, along with other aspects of the patient experience.

The study's lead author Genevieve Kanter, a senior fellow at the USC Schaeffer Center for Health Policy & Economics and associate professor at the USC Sol Price School of Public Policy, said the results were surprising, given the negative effects observed from other types of integration in health care.

But the current study's authors say that with integration, they actually observed an increase in days' supply of drugs instead of a decrease. Since reimbursements increase with each additional pill, oncologists may have been responding more to the additional revenues from increasing days' supply instead of the increased flexibility permitted by on-site pharmacies. In addition, there was no change in patients' adherence to medications.

Study examined outcomes for a range of cancer patients Researchers conducted an observational study of oncologists and commercially insured patients treated by these oncologists between 2011-2019. Oncologists were tracked longitudinally through the study period, and patients were followed for 6 months after their initial diagnosis.

The authors found no changes in either oral drug spending or intravenous drug spending when they looked at all the cancers combined. However, when they examined the subsample of patients with breast cancer – the biggest group of cancer patients in the study sample – they found substitution between oral and IV drugs. Researchers found a 69% increase in oral drug expenditures, and concurrently a 34% decline in IV drug expenditures.

Future research should focus on hospital-based oncology practices "Proponents of medically integrated pharmacies in oncology practices believe the benefits include improved safety and quality, decreased time to fill prescriptions, and decreased waste. Others are concerned that these pharmacies may increase inappropriate use of expensive oral cancer therapies," said David Debono, Carelon's national medical director for oncology and a co-author of the paper.

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