As cancer drug costs have continued to rise, the impact on the total cost of care continues to be a challenge.

Under the Oncology Improvement Model (EOM), practices implement more initiatives to reduce drug cost compared to the Oncology Care Model (OCM), when practices implemented fewer initiatives to affect drug costs , he explained. Stuart Staggs, Vice President, Transformation and Shared Services, McKesson.

Under the OCM, drug costs accounted for approximately 62% of total costs, but this proportion has increased to 72% now in the EOM.

This transcript has been lightly edited for clarity.

Transcription

How do practices that address drug spending reduce the total cost of care?

Abt Global, which was formerly Abt Associates, released the final results for the cancer care model throughout the performance period 11. They said that after 6 years of the cancer care model — of course, the purpose of the model is not to reduce costs , because costs will continue to rise — but they said that over that 6-year period, we’ve decreased the cost per episode, but of course the savings in the cost per episode have been outpaced by (monthly payments for improved oncology services) and outpaced by performance . payment. So, it consumed all the benefits, so they came out negative for OCM.

It was really interesting, too, as they factored in costs over time in that model, how much the total cost increased over 6 years for cancer care. The total cost of care went up 25% in 6 years, and then 20 percentage points of that 25%, you know, 80% was related to drugs. It is something where the cost of medication is prominent. I think in the OCM we saw that 62% of the total cost was the cost of drugs. In the oncology improvement model, we see with just the seven diagnoses—obviously the high-cost diagnoses are very acute, very complex—(drug costs are) about 72% of the total cost.

The things that we’re doing to really reduce the total cost of care with drug initiatives are traditional things that we’ve always done with grouping and dose rounding. We’re looking at using therapeutic exchange appropriation and then reducing pegfilgrastim in the metastatic setting, and we’re also looking at bone health. Those kinds of regular things that were done in OCM, and then what we’re doing now, on top of that, is because it’s a very fluid drug environment, we have a pharmacy solutions team that’s always looking at care evidence-based, the best clinical outcomes, the least amount of side effects, and what’s more, what are the best cost-effective drug alternatives. And they work with practices to make appropriate exchanges for patients entering the program and beyond.

We’re always looking at what drug opportunities are coming up. We don’t see anything now. If you look at 2020 and OCM, biosimilars have had a big impact there, but we’re not seeing anything that distinct in EOM yet, just because of timing. But it’s something that we’re always looking at, and what is the cumulative number of initiatives that we can put in place to eliminate (drug costs) because, again, it’s going to be a bigger improvement with a lot of initiatives within the EOM versus of one hand as if it were an OCM for the drug cost side of the equation.