Medication acquisition program: Successful access to innovative treatment options.

person Vicki Doctor Cancer Treatment Centers of America, Part of City of Hope, Boca Raton, FL info_outline Vicki Doctor, Julian C. Schink, Amber Moran, Neha Gandra, Maurie Markman

Authors person Vicki Doctor Cancer Treatment Centers of America, Part of City of Hope, Boca Raton, FL info_outline Vicki Doctor, Julian C. Schink, Amber Moran, Neha Gandra, Maurie Markman Organizations Cancer Treatment Centers of America, Part of City of Hope, Boca Raton, FL, Cancer Treatment Centers of America, part of City of Hope, Boca Raton, FL Abstract Disclosures Research Funding No funding received None. Background: Targeted treatments are often not available due to clinical, financial, and administrative barriers. Our medication acquisition program (MAP) serves our national network of cancer centers, helping patients gain access to off-label and scientifically appropriate targeted therapy and immunotherapy when access was unavailable due to the following barriers: clinical trial not available, patients with government insurance unable to afford copay, or insurance policy exclusion or denial for an off-label or on-label indication. The use of genomic testing is used increasingly to identify candidates for clinical trials. While our patients are always offered a clinical trial when available, they don’t always qualify. The goal of this study was to examine our success rate in acquiring medications and the clinical outcomes of those therapies. Methods: An IRB approved retrospective review was completed on patients who accessed targeted treatments that had an existing standard of care (SOC) indication in another tumor type or were being denied access for their on-label indication. For purposes of this study, we defined clinical benefit as treatment duration of 4 months or greater. Results: 1,041 referrals were received by our program between 10/1/2015 and 12/31/2021. While not all therapies referred and accessed were started, we have maintained a 99% success rate for access to these therapies with one dedicated oncology nurse. All therapies started were accessed through appeals to payers or through patient assistance programs. Of the 769 patients who started treatment, 507 (66%) were on therapy for 3 months or less, 120 (16%) were on therapy for 4 to 6 months, 64 (8%) were on therapy for 7 to 10 months, and 78 (10%) were on therapy for 11 months or more. 342 of patients starting therapy through MAP went on to progress and of those, 231 (68%) were able to receive another treatment for their cancer and continue treating at our center. Overall, this process has demonstrated a clinical benefit for 262 (34%) patients who were able to stay on therapy for four months or longer. Conclusions: A process for medication access overseen by one oncology certified nurse highly skilled and knowledgeable of access process as well as a lean methodology for execution has made innovative options for precision care accessible to 769 patients with advanced cancer. The number of patients who access and start treatment combined with the overall clinical benefit for these patients demonstrate how this efficient process, facilitated by nominal FTEs, can enable successful alternate access for patients seeking options. Our medication acquisition program has provided our patients access to targeted treatments that would have otherwise not been available while enhancing our center’s ability to offer innovative options to patients who have exhausted SOC options.