NotifiUs provides a service called the Quality Improvement for Oral Oncolytic Adherence (QIOOA). It is based on the NotifiUs patient engagement platform and is designed to formalize an oral oncolytic pharmacy prescription program within a healthcare providers organization, support financial navigation to assist cancer patients with finding alternative, lower cost medicines, leverage secure communications to improve nursing and care professional training, and with integrated analytics reminds patients to properly take their medications.
Anticancer medications account for the lion’s share of total global drug spending. Oral medications are reported to account for up to 35 percent of the current oncology pipeline. They are one of the fastest-growing areas of cancer treatment, comprising more than 25 percent of anti-cancer therapies.
An estimated 15.5 million Americans are living with cancer, and 1.69 million Americans were expected to be diagnosed with some form of cancer over the past year. The historical mainstay of pharmacologic treatment has been ambulatory, infusion-based chemotherapy; typically involving many hours of stressful treatment such as intravenous chemotherapy sessions that are time consuming, costly, and emotionally draining. Significant investment by pharmacy research and development corporations and accelerated approvals by the Food and Drug Administration (FDA) have generated a new wave of major advancements in oral anticancer therapies in the U.S., and given patients an alternative to the traditional infusion-based treatment with medications that can be administered in the privacy and comfort of their home and perhaps continuing even to work throughout their treatment.
However, there are also significant downsides: self-administration of powerful toxic therapies in an unsupervised home setting can lead to sub-optimal drug adherence and poor management of side effects, and potential adverse reactions and unintended drug interactions. The self-administration of oral oncolytic requires patients to be “organized” and “disciplined” to properly take their meds, over both the short term and long term, without oversight and to promptly report side effects. And to seek consultation when they encounter impediments to taking their meds, as the potential wastage due to premature drug discontinuations is significant.
The use of oral oncolytic by cancer patients continues to grow, despite challenges of cost and self-administration. Healthcare professionals should anticipate operational system changes and needed strategies and procedures (e.g., communications, task flow, relationship building and team coordination) to effectuate improved adherence, planned therapeutic outcomes, and high-value care. Increased oncology services with increased utilization of specially trained oncology pharmacists, nurses, nurse practitioners and physician assistants can help optimize cancer care and help address projected workforce needs in cancer management.
A 2016 survey by the Association of Community Cancer Centers showed that less than half of the cancer centers reported to have a formal oncolytic program or protocol established within their cancer program.