Identifying unaddressed challenges to better ensure quality, cost and access
We believe that in order to improve the health care quadruple aim — better quality, lower cost, and improvements in both patient and provider experience — the important first step is identifying the unaddressed challenges. This helps build a framework for developing strategies and solutions that address the areas of need. While treatments themselves are incredibly important, research that helps identify such gaps is critical, because it enables us to ensure clinically appropriate access and services to improve health outcomes for patients, and to develop comprehensive solutions that help payors manage costs.
Each year, the oncology community comes together at the American Society of Clinical Oncology’s (ASCO) annual meeting to unveil the latest research in cancer care. While the meeting is most known for debuting breaking advancements in cancer treatments, the data presented goes far beyond. At this year’s meeting, we will be presenting data reinforcing the importance of innovative specialty management in cancer care. Here, we share some of the highlights:
Digital engagement helps support patient adherence
It is not uncommon for a patient on specialty medications — especially when they first begin treatment — to experience unpleasant side-effects. Treatment non-adherence as a result of that is all too common, and an ongoing challenge for patients and health care providers. Secure messaging has been shown to improve medication adherence in patients. In one abstract presented at ASCO, we examine how digital engagement in the form of secure two-way messaging from a nurse helped improve patient adherence to an oral chemotherapy known for significant adverse side-effects. Our research found that using CVS Specialty’s secure messaging platform to determine whether patients were experiencing common medication side effects enabled nurses to get involved quickly, leading to an improvement in patients’ symptoms and adherence to therapy. Secure two-way messaging is one of the digital and online engagement tools CVS Specialty uses to help patients better manage their conditions.
Precision treatment: Better outcomes, more cost-effective care
Unfortunately, lung cancer patients are frequently diagnosed late with advanced or metastatic disease. However, it’s been shown that targeted therapies can increase survival when compared to conventional treatments. Broad gene sequencing tests help support use of targeted therapies by identifying the best treatment for a specific patient. A CVS Health analysis found that by identifying the broader genomic landscape of a patient’s tumor early on, doctors armed with this information make timely and precise treatment decisions, which ultimately can lead to better outcomes and are more cost effective. The findings are an example of the types of analytics CVS Health is evaluating consistently to inform programs focused on transforming the oncology experience for patients and their support teams.
The challenge to increasing biosimilar prescribing
Biosimilars are the fastest-growing class of therapeutic products in the United States. Despite the availability and proven efficacy and safety of biosimilars, their uptake has been slow. This is, in part, due to patent litigation and pay-for-delay strategies by brand manufacturers that often delay the launch of many of these products, even after they’ve been approved by the U.S. Food and Drug Administration. As part of the research we are presenting, we surveyed oncologists to evaluate their willingness to prescribe biosimilars. While those surveyed deemed biosimilars to be safe and effective, physicians reported there were still certain factors that affected their willingness to prescribe. Given the potential of biosimilars to create competition and therefore lower cost, we continually monitor the pipeline to optimize the use of lower cost therapies and expand our value-based provider contracts in order to help improve patient access.
Data can improve patient care journey, payor and provider tools
We will also be presenting data from Novologix, CVS Health’s proprietary technology platform, which demonstrated that by engaging oncology practices through an enhanced payor-provider partnership and training providers on the prior authorization tool, we can help facilitate higher-quality oncology care. As part of another study, we surveyed patients on their cancer treatment history and care experience, as well as how they worked with their health care providers. We also surveyed health care providers for information on their practice, their referral process for their patients to an oncologist, and how they engage with their patients. There were two key findings. First, there is a compelling opportunity to develop a data-driven oncologist selection tool that helps primary care providers direct their patients to high-quality and low-cost oncologists. Second, it is important for providers to initiate the conversation around an advanced directive at the start of a patient’s cancer care in order to help those close to the patient fully understand their desires for end-of-life care.
This research is part of our ongoing focus on helping transform the health care experience for all patients while addressing challenges of oncology management for payors.