In a conversation from this year's Healthcare Advocate Summit, Randy Falkenrath demystified the oncology medication management model and explained how specialty pharmacist can help patients access care.
Although the oncology drug market is growing at a rapid pace, with new cancer drug approvals being rolled out monthly and indications for existing drugs being rolled out even faster, the expansion of the market has created challenges for patients and pharmacists alike.
Upon receiving a cancer diagnosis, patients must navigate 2 problems: processing their emotional reaction to the news and overcoming barriers associated with the current oncological medication management model. The latter adds another layer of complexity to an already difficult patient journey.
Drug Topics sat down with Randy Falkenrath, founder of Epiphany Solutions-Specialty Pharmacy Consulting, at the Healthcare Advocate Summit 2023 meeting to discuss the role that specialty pharmacists play in helping patients overcome the administrative and financial hurdles associated with receiving clinical care.
“It’s an amazing time, if you’re a patient that has been diagnosed, to be able to have access to such a wide range of therapies,” Falkenrath said. “The problem is that the market has diversified and segmented itself in terms of what types of drugs you can get based on your benefit, where you have to get them from a pharmacy perspective, and then the complications around the authorizations and the formulary and the benefit part of that.”
Despite these obstacles, specialty pharmacists are uniquely positioned to advocate for patients seeking care, Falkenrath explained. They have a good understanding of what the patient journey looks like, he adds, as well as how to advance patients along their path to care.
“The unfortunate thing about it is all of us in the industry tend to be driven by the boundaries that are established by a benefit manager, by a health plan, or in some cases around requirements relative to the medication,” Falkenrath said. “But from the role of a pharmacist, they have the opportunity to one, engage in the process, get information more expediently…[and] look at opportunities to support the patient through access to funding.”