Perceptions of Healthcare Workers on the Cost and Safety of Oral Oncolytic Agents for Patients: A Survey of Healthcare Worker

Abstract

Specific Aims: The number of newly approved agents continues to increase with over 800 new oncology agents in the pipeline and 25% of these being oral agents. Oral chemotherapy agents have advantages including patient convenience, prolonged drug exposure, and non-invasive administration. These advantages come at a premium that many patients cannot afford leading to change or therapy abandonment.

Methods: This is a descriptive, non-experimental, cross-sectional study of healthcare professionals in hematology/oncology patient care across the United States. Data was collected using a 35-item online questionnaire to measure quality improvement areas when using oral chemotherapy agents.

Results: Results of 503 survey respondents comprised of pharmacists (54%), physicians (5%), advanced practitioners (4%), nurses (10%), pharmacy administrators (15%), social workers (2%), and other professionals (9%). Treatment abandonment due to cost is seen by 46.6% of respondents. The most common agents abandoned due to cost included capecitabine, abiraterone, and palbociclib. Prior authorization delays occur in 1-2 patients weekly creating a 4-6 day wait to initiate therapy and 24.0% of respondents spend more than 30 hours weekly resolving these issues. The most utilized medication assistance programs include Manufacturer Assistance Programs, Disease-Based Foundations, and Manufacturer Co-Pay Cards.

Conclusions: This survey addresses healthcare worker perspective on prevalence of and issues relative to chemotherapy and indicate a high incidence in abandonment of therapy, delay in therapy initiation, and significant resources allocated to issues associated with the cost of oral chemotherapy agents. Further evaluation is required to resolve issues in therapy and minimize impact on patient care.