New clinical and technological developments in oncology are revolutionizing patient care, which is driving a possible migration towards outpatient settings within the specialty, according to experts at a session presented by The American Journal of Managed Care June 17.
The session’s findings were published by AJMC Aug. 21. Here are six takeaways from the session:
1. Bispecific antibodies and chimeric antigen receptor T-cell therapy are a few of the treatments behind the push to outpatient within oncology, the experts said. Implementing these treatments requires “robust infrastructure and comprehensive education,” including developing triage processes and ensuring support systems are solidified to manage patients outside of the traditional inpatient setting.
2. There are seven FDA-approved CAR T-cell products available for commercial use, and some have been approved in earlier lines of care. This is creating major shifts in the treatment of blood cancer, specifically.
3. Reimbursement challenges persist for CAR T and bispecific therapies, the experts said, continuing a pattern of resistance for inpatient procedures as well. Experts underscored the importance of closely monitoring payers and contracts, particularly for Medicare and Medicaid beneficiaries. Some recommended creating a dedicated reimbursement team for these treatments or engaging a reimbursement specialist to navigate the intricacies of payments.
4. Advancements in non-small cell lung cancer treatment are also rapidly shifting cancer care. Testing for NSCLC using next-generation sequencing is vital for patients with this condition, although there is still a need to integrate these results seamlessly into electronic medical records for more comprehensive patient management. Integrating these treatments will also require stronger infrastructure between clinicians and pharmacies.
5. The experts also discussed the growing role of home infusion for oncology care, emphasizing the need for specialized training for clinicians delivering this care.
6. There will also be a heightened need for collaboration between academic and community practices as these treatments become more prolific in outpatient spaces.
“As we are thinking about this movement and where patients are going, we really need to look at the patient as a whole, the journey as a whole, communicate more, develop protocols where we can, and standardize our algorithms,” said Clayton Irvine, PharmD, senior manager of oncology cancer care at Mayo Clinic in Rochester, Minn., at the session. “Then from a financial side, where does [treatment] make the most sense, not just for the institution, but for the patient? I think that would really help drive some of this as we look at downstream impacts.”
