Oncology treatments are not what they were a decade ago. Drugs that target specific molecular pathways in a cancer cell are being added to or replacing once standard therapies, requiring a new model of patient care. Medco Health Solutions, Inc. (NYSE: MHS) today announced new offerings within its Advanced Oncology Solutions™, that include treatment pathways decision support with embedded pharmacogenomic testing and nutrition recommendations for cancer patients.
Treatment Pathway Connections is the newest component in Medco's Advanced Oncology Solution's platform, which coordinates care among physicians, pharmacists, case managers and payers, and informs them of evidence-based protocols before and during treatment. eviti®, a web-based oncology decision-support program developed by ITA Partners, Inc.®, will power the treatment plan decision-support function of the platform.
"Through eviti, our treatment pathway program is able to align quality care with reimbursement, reduce complexity, provide transparency and improve workflows for physicians and payers," said Jeff Ulanet, vice president oncology. "Our goal is to reduce the gaps in care that negatively impact patient outcomes and can lead to unnecessary treatment costs."
Medco is the first PBM to offer this independent, comprehensive oncology decision support approach that contains more than 1,000 evidence based treatment regimens for more than 120 cancer types, displaying efficacy, costs, toxicity and compliance with the patient's plan language – all at the moment of prescribing. ITA Partners, which employs a team of oncologists, oncology nurses, insurance professionals, actuaries, software designers and engineers has specialized in oncology decision support for almost a decade. With eviti, not only are oncologists empowered to make more informed treatment decisions, but payers have instant visibility into treatment details before the treatment begins. Treatment Pathway Connections, supported by eviti, will allow Medco to offer its suite of oncology services at the optimal time in the care process, at the point of treatment prescription, ensuring that patients receive the right treatment at the right place with the right support.
"Medco's decision to utilize our independent, unbiased decision-support platform – eviti – to extend the value of its oncology offering is testament to the growing need for a holistic approach to improving care and outcomes. eviti will be at the forefront of the treatment selection process addressing the clinical complexities and financial challenges of an evolving cancer landscape," said Eduardo Beruff, president and chief executive officer for ITA Partners | eviti.
Cancer Game Changers
The science is advancing rapidly and Medco has been among the first to incorporate innovations such as genetic testing on a widespread scale when certain drugs are prescribed. Cancer drugs have been among the most prominent medications with companion diagnostic testing and ties to pharmacogenomics. Medco has a personalized medicine program related to tamoxifen, as well as a program for BCR-ABL testing in patients with chronic myeloid leukemia using imatinib (Gleevec®), dasatinib (Sprycel®) or nilotinib (Tasigna®). Testing of tumor tissue itself for a specific genomic signature or biomarkers is necessary to confirm that several other new and investigational cancer drugs are used appropriately. DNA Direct®, a Medco subsidiary, has genetic counselors who advise physicians, patients, and payers about the best approaches for using genetic testing and molecular diagnostics. When Treatment Pathway Connections identifies the need for a pharmacogenomic test within the care regimen, an otherwise complex process can be streamlined.
Medco's Advanced Oncology Solutions holistic approach extends beyond the context of chemotherapy treatment decisions to identify and address nutritional concerns for cancer patients. Treatment Pathway Connections will incorporate tools that trigger access to nutrition recommendations that address weight loss, and treatment related side effects through TherapEase Cuisine, Medco's online tool for cancer meal planning, or to acute at-home care, such as intravenous hydration or nutrition therapy for patients whose digestive systems have been compromised from radiation or chemotherapy through Critical Care Systems, Medco's home infusion nursing services.
Oncology's Economics & Outcomes
A recent study in the Journal of the National Cancer Institute projects that there will be more than 18 million cancer survivors in the United States by the year 2020. The number of patients surviving cancer has increased, changing many forms of cancer from a terminal condition a generation ago into a chronic disease that is managed. In 2010, oncology drug price inflation surged to 11.5 percent largely from high cost targeted therapies. Expensive new cancer drugs for this increasing numbers of patients could drive cancer drug spending as much as 15 percent a year through 2013. At this accelerated rate, oncology will likely rise to the second or third largest trend-driving category by 2015, following only diabetes and central nervous system (CNS) treatments. While costs of these new medications are high, adherence to the prescribed treatment is paramount for helping to drive overall healthcare costs down.
"Although many of these new therapies may be oral chemotherapy drugs targeting cancer cells directly, they still retain many toxic properties of traditional infusion therapies, which could cause a patient to stop taking the medication," said Dr. Milayna Subar, national practice leader at the Medco Oncology TRC. "Adherence to prescribed medication is important for all patients, but when treating cancer, it takes on an even greater importance. Our oncology specialist pharmacists are trained to review the medications that have been prescribed, in the context of the clinical setting and co-morbidities, to help patients manage side effects, adapt their diets and suggest ancillary therapies to help them remain on their treatment and out of higher cost settings such as emergency rooms and hospitals."
Medco Health Solutions, Inc.