For Patients Treated with Oral Chemotherapy, Rocky Mountain Cancer Centers’ In-House Pharmacy Truly Delivers
There’s not much about chemotherapy that’s easy or pleasant. But for those patients who need oral chemotherapy, Rocky Mountain Cancer Centers has found a way to take some of the stress and headache out of the process: A centralized, in-house pharmacy. That delivers.
“We take care of prior authorizations, financial assistance, counseling, dispensing the drugs, following up, and doing refills,” says Matthew Schulz, PharmD, oral oncology pharmacist at Rocky Mountain Cancer Centers. While the in-house pharmacy is centralized, and located in Denver, most medications are delivered to RMCC’s clinics, or to the patient’s home, within three to five working days, Schulz says.
The coordinated system lets patients get drugs faster, which means they can start treatment sooner.
Since 2014, RMCC’s centralized pharmacy has filled prescriptions for more than 2,200 patients. The majority of those prescriptions were for oral chemotherapy drugs, Schulz says, although the pharmacy also provides medications to ease treatment side effects.
In most cases, the in-house pharmacy can provide medications at lower cost than commercial pharmacies. In addition, RMCC staff can not only verify a patient’s coverage before dispensing the drugs, but also can explore options and resources to help patients offset the often high cost of chemotherapies. “It is our goal to ensure they pay the lowest possible price for the drug,” Schulz says. If for some reason we can’t provide the most affordable copay here at our pharmacy, we send it to the pharmacy that can accomplish that goal.”
This spring, the pharmacy added a full-time nurse to help educate patients about the medications they are taking, and monitor for side effects. “The nurse will follow up with calls at critical time intervals, such as day seven, or day 14, after initially taking the medication, to assess side effects,” Schulz says. “That intervention can make all the difference. If you don’t manage side effects and the patient ends up in the hospital for dehydration, that can delay treatment.”
Schulz estimates that about 40 percent of chemotherapy drugs are delivered orally now, with many more in the pipeline. “A decade ago, it was about 5 percent.”
Oral chemotherapies have a lot of advantages for patients, Schulz says. “You can avoid having to go to the doctor’s office every week for hours. Instead you can be at home taking a couple pills in the morning.”
But there is a downside, he says. “The drawback is that we don’t know for sure that patients are taking it correctly. When they are sitting in the chair and you’re administering chemotherapy, you know it’s being given correctly.”
That’s one reason RMCC nurses and pharmacists check in with patients frequently. It’s essential to monitor compliance and make sure medications are being taken the right way, at the right time.
RMCC’s in-house pharmacy is more than just convenient, it’s a treatment advantage, Schulz says. “We’re getting drugs to patients much more quickly. And the patient has one-on-one communication with nurses, doctors, and the whole team. I really think the system just provides superior care.”