When our latest health reform survey asked employers to rate their biggest cost drivers, specialty pharmacy (86%) and high-cost claims (74%) topped the list. Without a doubt, cancer treatments and drugs are large contributors to those costs. In trying to manage these costs, it’s important to remember what happens outside the clinical care setting can be just as important as what happens inside it.
“[W]ay too often, patients get lost in the system and do not receive the care they need and deserve,” says George Weiner, MD, Director of the University of Iowa Holden Comprehensive Cancer Center, who recently attended a National Cancer Policy Forum workshop focused on helping cancer patients navigate the complexities of the health care system. As you work to control your specialty pharmacy and high cost claims, take some time to determine whether your existing benefit offerings are helping cancer patients get the right care, at the right time, at the right place. If you don’t provide access to patient navigators you may want to consider adding them to your benefits lineup. If you’re one of the 54% of employers that offers health advocate services, you may want to review engagement levels and the services offered to cancer patients and make tweaks as needed.
“[W]hen considering access to care and the health care environment, sometimes we can succeed by modifying the environment that already exists,” notes Weiner. “Other times…we need to bring novel resources into the environment to achieve our goal.” We’re in the midst of an explosion of “novel resources” – the trick is staying current and evaluating what forms of support would be the most impactful for your population.
In his blog post Changing the Environment of Cancer from the Inside and the Outside, Dr. Weiner talks about the importance of patient navigators and shares some exciting developments in cancer immunotherapy. It’s the simplest explanation I’ve read on the topic.