Avella Specialty Pharmacy: Overcoming Oncology Adherence Barriers

Eric Sredzinski, PharmD, AAHIVE, vice president, clinical affairs, Avella Specialty Pharmacy, is involved in a National Institutes of Health trial evaluating adherence and persistence in renal transplant patients that was recently accepted for publication, and also recently contributed to Avella’s newest publication, “Dispensing Excellence.”

Specialty Pharmacy Times sat down to talk with Dr. Sredzinski about the controversial topic of pricing for oncology medications, as well as common patient reimbursement hurdles and Avella’s technologically savvy efforts to break down patient adherence barriers.

SPT: Is the creation of accountable care organizations (ACOs) the main motivating force behind the recent acquisitions of community oncology practices by hospitals, or is specialty drug cost a more influential driver of this consolidation trend?

ES: The cost of oncology products, whether in IV or oral form, is impacting the care landscape significantly. It will be interesting to see, because if a capitation cost to manage patients with an ACO is provided, treating an oncology patient with a drug that could cost over $100,000 per year could really bend or break that model of cost-containment. So, yes, we do see hospitals buying up some oncology groups, and I think that some oncology offices are looking to expand their degree of care or their range of offerings.

SPT: Do you think any of that has to do with 340B pricing?

ES: 340B is certainly a little bit of a different topic. I think when you talk about 340B and the intent of 340B, the issue is really to try to understand the definition of which patients qualify If you look at the Federally Qualified Health Center (FQHC) or hospitals that have a disproportionate share of patients, those hospitals are allowed to qualify for 340B drug pricing and then pass those cost savings to the patients. However, what we’re seeing is really a change in that model where you’re having third-party groups presenting claims data to FQHCs and showing them that they can save significant dollars and build a revenue stream with 340B. So I think the difficult piece today is that the Office of Pharmacy Affairs hasn’t yet really stepped forward and defined what a patient is. For instance, should a hospital be dispensing drugs for an employee and utilizing 340B inventory? It will be interesting to see this year, because I don’t think it’s a very sustainable model.

SPT: In your opinion, which oncology medications in the pipeline seem the most promising?

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