Pharmacist Involvement Improves Reimbursement of Biologics, Paper Says

Worldwide, biologic drugs in the oncology setting represent a rapidly growing expense. In recent years, many European healthcare systems have entered into Managed Entry Agreements (MEAs) to facilitate access to high-cost biologics. These agreements may consist of price-volume discounts or dose-capping agreements with drug makers, or they may consist of outcomes-based contracts.

A paper recently published in Frontiers in Public Health describes the practice experience of the Department of Abdominal Oncology at the National Cancer Institute of Naples in Italy. In this center, an expert pharmacist was involved in evaluating the economic impact of improving the Italian registry of high-cost drugs, particularly bevacizumab, cetuximab, panitumumab, and trastuzumab.

Working together with clinicians from 2016 to 2017, the pharmacist was involved in collecting patient data, evaluating eligibility criteria, tracking the drugs dispensed, monitoring disease status, reporting adverse events, and providing follow-up. The pharmacist also managed reimbursement requests with drug companies.

During 2016, 473 patients were treated with bevacizumab (versus 373 patients in 2015), 175 were treated with cetuximab (versus 169 in 2015), 139 were treated with panitumumab (versus 86 in 2015), and 45 were treated with trastuzumab (versus 36 in 2015). Reimbursement grew to the equivalent of approximately $1 million in 2016 versus approximately $245,052 in 2015, an increase not attributable to the relatively modest growth in the number of patients treated.

In fact, the authors report, most of the reimbursement increase was attributable to MEA activity for bevacizumab, and the increase was directly linked to more careful monitoring and more timely submission of requests for reimbursement to pharmaceutical companies through the MEAs.

The experience of this center, say the authors, “can be considered as an exploratory report lacking in literature data on the integration of Pharmacists into the clinical multidisciplinary teams. Improving the management of MEA-related issues could represent a successful strategy in the ‘real world’ to improve reimbursements and finally reduce the costs of biologic drugs.”

Reference

Capozzi M, De Divitiis C, Ottaiano A, et al. Funds reimbursement of high-cost drugs in gastrointestinal oncology: an Italian real practice 1 year experience at the National Cancer Institute of Naples. Front Public Health. 2018;6:291. doi: 10.3389/fpubh.2018.00291.