Cancer patients benefit from coordinated clinic-to-pharmacy care

Approximately 40% of people will be diagnosed with cancer at some point during their lifetimes. For them, the diagnosis is incredibly stressful, and treatment can be complicated. Patients must often wait days after a cancer diagnosis to get their oral oncology medicine, and they must travel to a specialty pharmacy to pick it up or wait for it to be delivered in the mail to their home. Providers can’t quickly communicate with the pharmacy which can result in fragmented care, delays in access to medication and frustration.

With Prime Therapeutics’ (Prime) IntegratedRx - Oncology program, members can get their medicine faster by obtaining it at the clinic’s in-house pharmacy or affiliated hospital pharmacy, rather than from a central fill specialty pharmacy. The program’s end-to-end coordination across the entire treatment pathway removes roadblocks that can complicate a patient’s cancer care journey. It puts the patient first by driving better quality, reducing drug costs and improving adherence. The result is a better patient and provider experience beyond the first fill.

Prime’s IntegratedRx - Oncology approach streamlines the treatment pathway by integrating care, lowering overall costs and speeding prescription fills for Blue Cross and Blue Shield members and sponsors. This means the provider and pharmacist can be part of the same team, allowing for direct communication and more coordinated care. More than 300 oncology practices will be eligible to participate in the program.

The groundbreaking model is expected to shorten fill times compared to the central fill channel. Prime’s pilot showed an early trend toward waste reduction by enabling in-office dispensation which will be tracked over time.

The IntegratedRx - Oncology program represents Prime’s channel-independent approach of identifying solutions that drive the best financial and quality outcomes for its members. Since Prime’s IntegratedRx model does not restrict Blue Plan members to a specialty pharmacy, it allows the delivery of oncology medications in a way that opens access to a drug channel and provides member-centric care.

Prime is collaborating with multiple national health care companies to operationalize and ensure success of the program, including McKesson Health Mart Atlas, AmerisourceBergen and Shields Healthcare. Prime has also collaborated with NCODA to launch a new Center of Excellence accreditation which aligns with Prime’s required credentialing for the IntegratedRx - Oncology program.

By connecting the care team to the practice pharmacy, IntegratedRx - Oncology removes roadblocks that can complicate the cancer care journey. IntegratedRx is designed to help cancer patients receive their medication in the channel that seamlessly fits in with their care. Since many cancer clinics now have pharmacies integrated in their practice, the pharmacist becomes part of the patient’s team with access to a patient’s full medical record to make sure a patient receives medicine on time. The integrated approach also allows for stronger collaboration to adjust doses or change refill schedules.

The nationwide rollout of IntegratedRx - Oncology builds on a successful pilot program with McKesson conducted in Florida, Minnesota, and Oregon earlier this year. During the pilot, patients experienced improved coordination between pharmacies and insurers and Blue Plan members experienced less confusion and a simpler, less stressful process of receiving their medication.

Beginning with oncology, the IntegratedRx suite of products will streamline medication delivery for various medical conditions. Available to all Blue Plans, several Prime clients will implement IntegratedRx - Oncology beginning Fall 2021.

For more information on Prime Therapeutics’ IntegratedRx - Oncology program please visit, https://www.primetherapeutics.com/products/integratedrx-oncology/

Joseph Leach, M.D., senior vice president, chief medical officer at Prime Therapeutics and practicing oncologist, is responsible for providing clinical leadership and expertise, informing and influencing internal and external stakeholders about Prime’s specialty and total drug management capabilities, contributing to innovation in these capabilities and driving client growth.

Prime Therapeutics LLC helps people get medicine they need to feel better and live well. Prime provides total medicine management solutions for health plans, employers, and government programs including Medicare and Medicaid. The company processes claims, offers clinical services for people with complex medical conditions, serving over 33 million people.