About This Project

Oral agents offer benefits to both patients and providers. Because patients self-administer oral anticancer drugs at home, travel to treatment and time spent in the cancer center or physician office can be reduced. However, oral therapies present challenges in terms of patient compliance with treatment regimens, monitoring of side effects, and the cost of treatment.

For this project, Steps to Success: Implementing Oral Oncolytics, ACCC identifies barriers and effective practices in starting patients on an oral oncolytics regimen. The project describes how different organizations approach, manage, and track the process of providing oral therapies to their patients.

Project Objectives:

Conduct a survey of ACCC membership to gain a multidisciplinary perspective on the benefits and challenges, as well as trends, in initiating oral oncolytic therapy.
Create tools that cancer programs can utilize when starting a patient on an oral oncolytics regimen or for monitoring treatment.
Provide webinars on hot topics as identified by project survey findings.

Key Recommendations

Step 1. Take a multidisciplinary team approach.

A multidisciplinary team approach ensures all departments are actively engaged in care, no pieces are missed, and resources are not wasted on duplication.

Step 2. Assign responsibilities.

Assigning roles—regardless of job title—ensures that each person knows what he or she is responsible for and that nothing falls through the cracks.

Step 3. Collaborate with specialty pharmacy.

If your cancer program relies primarily on outside specialty pharmacies for oral oncolytics, develop strong collaborations through proactive communication and frequent follow-up with them.

If your cancer program has an on-site dispensing specialty pharmacy, develop parallel processes when oral oncolytics need to be dispensed by an outside specialty pharmacy.

Step 4. Provide financial advocacy services.

Given the high out-of-pocket costs associated with oral oncolytics, providing effective financial advocacy services is crucial for community cancer programs and the patients they serve. Proactively screen and identify patients who are at high risk for developing financial toxicity.

Step 5. Develop a robust patient education program.

Schedule a dedicated patient education office visit. Be sure to assess health literacy and understanding before reviewing important information.

Step 6. Put in place effective practices for monitoring for adherence & toxicity.

Effectively assessing for potential toxicity begins when pharmacists are able to review the patient’s medication list for potential drug-drug interactions. Studies have shown that pharmacists often make recommendations and provide interventions that can lead to safer doses or avoidance of serious interactions. When monitoring for toxicities, ensure that the right members of the team are reviewing the information and are notified when warning signs are present.

Step. 7. Maximize the use of technology.

Find ways to maximize the use of technology to streamline workflow processes and improve communication.

Fast Facts

It is estimated that 25-50 percent of therapies in the oncology pipeline will only be available in pill form.
Up to 80 percent of patients are non-adherent with their oral oncology agents, putting these patients at risk for serious, even life-threatening, side effects.[1]
For patient success in complying to oral therapy a team approach is needed.[2]
40 states and the District of Columbia have enacted oral chemotherapy access laws, with more actively campaigning for oral parity.[3]

[1] Bankhead C. Some Cancer Patients May Overdo Oral Meds. MedPage Today. Oct. 13, 2013.http://www.medpagetoday.com/HematologyOncology/Chemotherapy/42241.

[2] D’Amato S. Improving Patient Adherence with Oral Chemotherapy. Oncol Issues. Jul.-Aug. 2008:42-45.

[3] State Patients Equal Access Coalition.

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About This Project

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Key Recommendations

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