In-office dispensing of oral oncolytics: a continuity of care and cost mitigation model for cancer patients.

The high cost of cancer therapies continues to lead to questions of affordability for the healthcare system and to patients. Ensuring patient access to oral cancer drugs presents a unique set of challenges due to the significant cost of these novel agents, healthcare/payer policies, and established distribution practices. The National Community Oncology Dispensing Association, Inc (NCODA) is a grassroots, nonprofit organization established by pharmacists who are directly involved at the community practice level in assisting patients with the acquisition of their oral cancer drugs. Community oncology practices that embrace the NCODA Quality Standards are able to provide exceptional patient care by providing direct access to oral cancer drugs through the in-practice dispensary. Patient continuity of care is ensured by allowing practice staff to manage all aspects of drug therapy-from initial dispense to completion of therapy-and in-practice dispensing allows for improved patient convenience, safety, and compliance. Practice staff in the dispensary area work directly with patients to address the insurance coverage limitations and financial toxicity of procuring these drugs. Medicare patients are not eligible to take advantage of patient assistance and/or co-pay programs that have been established by pharmaceutical companies. Foundations such as the Patient Access Network Foundation have been established to provide assistance to Medicare patients. This case report focuses on a new dispensary in a moderately sized oncology community practice that prescribes to the NCODA Quality Standards and outlines the processes developed to assist Medicare patients in accessing their oral cancer medications.