Patients using oral oncology medications (oncolytics) can now receive them, with peace of mind, through McFarland Clinic’s in-office dispensary.
Oncology Services Director Lynn Lanning said the dispensary project started after she learned about in-office dispensing at a national oncology administration conference.
“It peaked my interest because I knew how much we were struggling with accessing and getting patients oral oncolytics that are very expensive, and we weren’t able to dispense them out of our office,” she said. “It became apparent that there was really something missing in that delivery of care.”
After learning about the new initiative, Lanning said there were only three dispensaries across the state, outside of the University of Iowa. Since then, the use of oral oncolytics has increased and is predicted to continue growing, Lanning said.
“At that time, almost 10 to 15 percent of our (oncology) drugs were oral. Now, in just about five years, they are at 20 to 25 percent,” she said. “(Health officials) are really predicting that by 2025, that almost 50 percent of the (oncology) drugs are going to be in oral form.”
Lanning said when providers give patients infusion therapy, those patients are sitting in a recliner inside the clinic and drugs are administered by a nurse. When it came to oral medications, that personal connection with patients was lost.
“I knew how we had to manage our patient’s oral medicine was in a detached, impersonal manner,” Lanning said. “It just didn’t feel right and didn’t feel like part of the oncology care that we were providing when we were administering our drugs infusionally within our practice.”
She began creating a plan for McFarland Clinic’s own in-office dispensary, which included bringing a pharmacist and pharmacist technician to help.
The dispensary’s Pharmacist Andrea Ketcham, PharmD and Technician Gina Buzzell, CPhT have been instrumental in helping patients, physicians and nurses with the new addition to Oncology Services.
Ketcham provides counseling and consultations for physicians and patients. Buzzell assists with prior authorizations and co-pay assistance for medications, which was previously left for the nursing staff to do.
Improving the Process
Ketcham said traditionally, when a patient is prescribed an oncolytic medication it has to be sent to a specialty pharmacy, which is usually out of state. That pharmacist, whom the patient has never met or spoken to, calls them and asks for their information.
“That cold call to get private, personal information after, maybe, finding out their diagnosis is a really tough call,” Buzzell said. “I can’t imagine receiving it.”
Buzzell said the in-office dispensary staff typically sees the patient at their visit when medication is discussed, so it’s much easier to gather the personal information without the impersonal phone call from an out-of-state pharmacist.
Another disadvantage of the traditional system was that patients had to wait up to two weeks to receive their package of medications, and may have needed to stay home waiting for the package to be delivered.
The in-office dispensary lets patients get their medications in a much more timely manner.
“Many times we need a medication now (for patients),” Ketcham said, “and in most cases we needed it yesterday.”
Another benefit of the dispensary is the ease and access to counseling that patients can receive. Ketcham said patients can call and ask questions, voice concerns that come up, and even allow Ketcham to speak with their physician if their medication is causing side effects or other issues.
“When those questions or concerns come up, we can dive into the whole picture,” she said. “At a traditional retail pharmacy, a pharmacist doesn’t have your medical record or know what your labs look like.”
Lanning said in-office dispensaries are beginning to be utilized by clinics across the nation to provide better care for patients. Some may see this as the future of medicine, she said, but implementing this now will help patients and providers as the growing trend of oral oncolytics continues to rise.
“It is not only the future (of medicine),” she said. “The future is now.”
The future of medicine is not the only important part of this new addition to McFarland, Lanning said. It is another way for patients to know their providers truly care about every aspect of their treatment.
“We care about all of your cancer care,” Lanning said.