Cancer treatments are evolving but the high costs coupled with high copays and coinsurance of new approaches has been a challenge, forcing many patients to choose less effective or less convenient treatment routes.
When most people hear the word “chemotherapy” they think of intravenous chemotherapy, which requires a cancer patient to visit a clinic or other medical office and receive drugs that are delivered with an IV inserted into a large vein.
Oral chemotherapy is a lesser known but rapidly growing treatment approach that allows patients to receive their therapy in the form of a tablet or capsule. Oral therapy not only offers patients a broader range of treatment options, but also allows patients to receive their treatment in the convenience of their own home.
While intravenous chemotherapy is largely covered by insurance programs, oral chemotherapy is costly and can be challenging to afford.
“One oral chemotherapy drug can cost as little as $200 a month or as much as $17,000 a month,” says Director of Pharmacy Services and Research at Dayton Physician Network Joshua Cox, Pharm.D., BCPS, R.Ph. “Beyond that, prescriptions typically have no out-of-pocket cap so patients have to pay for the drug every time they pick it up.”
The cost of oral chemotherapy drugs has prohibited some patients from taking them. As many as 10% of patients fail to pick up their prescription medication to begin treatment because they are unable to cover the cost.
Cancer treatment is dynamic in that as a patient responds or doesn’t respond to certain drugs, their treatment protocol and prescriptions change. This can leave patients who are being treated through oral chemotherapy with leftover pills.
“For years, we’ve had patients bring in expensive oral chemotherapy medications they’re no longer using and ask if they can donate them to patients who are unable to afford them,” says Dr. Cox.
“However, legislation has historically prevented us from re-administering these drugs and the pills would end up in the trash.”
Cox is currently serving his second term as a member of the State of Ohio Board of Pharmacy. In the third quarter of 2019 Cox and his fellow board members started reviewing statutes around drug repository programs that would enable pharmacies to accept unused cancer medications donated by patients and dispense them to other patients in need.
“The Board of Pharmacy reviewed the statutes that were passed by state legislators, and we were able to change the rules to allow for drug repository programs to now include cancer drugs,” says Cox. “These actions created the possibility for cancer drug recycling programs to exist in the state of Ohio.”
The revised code for operating a drug repository program went into effect on October 3, 2019 and Dayton Physician’s Network was the first network in the state of Ohio to adopt a cancer drug recycling program.
Making a difference
“The Dayton Physician Pharmacy Team started accepting oral chemotherapy drugs in October 2019 and was very quickly receiving tens of thousands of dollars of donated drugs into our inventory,” says Dr. Cox. “We have now re-dispensed tens of thousands of dollars of those drugs to patients in need.”
Dayton Physician’s Network is leading the way in innovating not only the way patients have access to medications but also the way to high quality and high value care through comprehensive cancer treatment programs that include an integrated hematology and oncology team, chemotherapy classes, and after hours cancer care.
“The cancer drug recycling program is providing treatment to cancer patients who otherwise would not have received these medications due to an inability to pay,” says Cox. “It is making a huge difference in our community.”
“I want people who are currently being treated for cancer or those who have a loved one who is being treated to know this program is out there so if they identify an opportunity to donate, they know where to take unused medications,” says Cox. Any patient with unused oral chemotherapy drugs can donate to a pharmacy with a cancer drug repository like the one at Dayton Physicians Network.
“I also want anyone who is receiving treatment for cancer and in a situation where they are struggling to pay for medications to know this program is available,” says Cox. “Cost should no longer be a reason a cancer patient does not get the treatment they need.”