Oncology Care: Controlling Costs, Improving Value and Enhancing Care

  • Cancer breakthroughs can mean better quality of life for patients.

In recent years, unprecedented strides in oncology care have been made – with many treatment options now available in the marketplace that are extending lives and delivering hope to those impacted by cancer. As survival rates improve, cancer care costs are also soaring. In fact, cancer care now accounts for 29 percent of U.S. health care costs each year. In a recent article published online in Evidence-Based Oncology, CVS Health reviews the factors contributing to rising costs of oncology care and explores strategies to improve its value.

Several factors are driving oncology care inflation:

  • There is a robust pipeline of new oncology drugs and expanding indications for existing therapies, which often come with higher price tags.
  • Oncology drugs are improving survival rates for patients, and as a result, patients are often taking therapies for longer durations.
  • There have been several regulatory process changes that are facilitating faster FDA approvals for new, “breakthrough” therapies, which are usually very costly but don’t always deliver better outcomes.
  • There is a large disparity and variation in drug utilization between oncology practices, resulting in major differences in the cost of cancer care treatment.
  • Off-label drug use, while permitted by the FDA for chemotherapies, is increasing and generally includes the newer, more costly therapies.
  • There has been consolidation of oncology care providers leading to a reduction in available care options for patients. This can lead to higher costs as patients are primarily accessing care in more costly settings including hospital outpatient centers.

At CVS Health, we work with our health care partners and clients to help manage the cost of oncology care while ensuring access to vital and appropriate therapies for patients. Our approach promotes evidence-based cancer care, lower-cost but clinically equivalent treatment options and a holistic patient care model that helps patients adhere to therapy. This has helped to reduce cancer care costs by 18 percent. Across the health care industry, emerging value-based models are promoting higher quality and more efficient cancer care with the goal of reducing total health care costs.

In addition, efforts are underway to determine the value of cancer drugs and treatment regimens. These new efforts aim to increase patient and physician education and help them collectively make more informed care decisions.

We believe there is further opportunity to better control and predict costs without sacrificing patient access and care. As we expand our cancer care approach with innovative payer solutions, we can help ensure that patients have access to the right drug at the right time and place, while striving to improve care and health outcomes and lower overall treatment costs.