NCODA’s View: This article highlights some of the challenges and issues that exist when you separate patients from the care and services they require. Cancer patients can be particular affected by this fragmentation and will benefit greatly by the expertise and capability of receiving their medications from their oncologist with a dedicated dispensing department. Having direct access to the oncologist and the patients medical record maximizes the patients experience and minimizes the waste from medications dispensed that will never be used by the patient. NCODA’s Quality Standard Model highlights this value proposition and creates a win-win scenario for patients and payers.Specialty Pharmacies Proliferate, Along With Questions By Katie Thomas and Andrew Pollack Dispensaries for expensive drugs that treat complex or rare diseases are surging, but their customer service and business practices are under scrutiny.
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April 2015 marks the one-year anniversary for the beginning of National Community Oncology Dispensing Association, Inc. (NCODA). Recognizing the growing separation between direct patient oversight and delivery of therapy, a group of dedicated pharmacists from New York gathered together to reverse the trend. Believing the best place for quality patient care lies with the treating clinician and local care team, the founding members of NCODA reached out to their local payers to establish programs that help to ensure patient care remains at the local community oncology clinic. With a larger percentage of chemotherapy treatments including oral drugs, the current model distinguishes oral therapy from the overall management of the cancer patient by sending patients’ prescriptions to a centralized and de-personalized pharmacy provider in another state or region. “In order to best manage a patient’s care, it is critical to have regular face-to-face interactions and full access to all of a patient’s treatment records” says Michael Reff, RPh, MBA, Founder and President of NCODA.
One year ago, a NCODA member practice collaborated with a large regional payer in the Central NY area to approve dispensing of oral oncolytics to the payer’s members to go beyond the first fill. This allowed the patients being treated with oral cancer therapy to stay connected to their local care team enhancing compliance, improving side effect management, supporting financial stewardship, and driving overall improved patient outcomes. “The first year has been very successful … the staff at the practice have always been helpful, polite, and willing to help with whatever I need, unlike the outside service I was previously mandated to use. I believe patients would benefit from having all their prescriptions filled at a practice such as The Patient Rx Center because they have made things much easier for someone who is dealing with so much” says Jennifer R., a 37 year old woman fighting cancer, from Syracuse, N.Y.
NCODA has since successfully employed the same quality model for patients at affiliated practices in other geographical areas to bring about similar collaborations. A recent agreement between a large cancer practice in the Albany, NY area has resulted in a successful collaboration to allow patients’ oral drug therapy management to remain with the practice. The same cancer practice is currently in collaboration with a second payer. “When we prioritize quality patient care and patient satisfaction in managing our patients, it is a win-win for everyone involved” states Nancy Egerton, PharmD, BCOP. “The momentum is building, and we have set a model which all of our NCODA affiliates can follow as we continue to reshape the oral cancer therapy treatment continuum,” continued Mr. Reff.
NCODA is a grass roots, not-for-profit organization focused on driving the positive changes needed to better prepare community oncology practices to establish and sustain the dispensing oral oncolytic agents. In the last 12 months, the founding members of NCODA have endeavored to re-shape the treatment delivery model, eliminate clinical fragmentation and improve the efficiency of patient care. NCODA has developed Quality Standards to include Patient-Centered, Positive Quality Interventions, Fundamental Practice Elements and Health Information Technology. These standards, as well as sharing of best practices, assist NCODA affiliates as they navigate the new landscape when starting or working to streamline an already established in-office oncology dispensing program.
NCODA continues to recruit new affiliate practices. NCODA membership currently spans the country and includes over 29 practices with 1,500 providers. “We are making these positive changes for our cancer patients in order to help community practices create an environment where they can offer the best, most efficient care possible. We are doing this by partnering with regional and national payers to keep the site of care where it belongs… at the local clinic” said Mr. Reff.
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Contact: Jim Holmes, RPh Director – Communication & Strategic Development, NCODA M: 518.265.5213
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March 19, 2015 (Syracuse, NY) – The ever changing environment of new treatment options for cancer patients is rapidly moving to a mix of intravenous and oral therapies. The increase in oral treatment options has led to many challenges in the current model of obtaining and delivering quality patient care. The National Community Oncology Dispensing Association, Inc. (NCODA) has been hard at work, collaborating to develop new standard practices to bring together efficacious patient care and efficient patient management to maximize satisfaction for patients, providers, payers and all stakeholders.
NCODA is a grass roots, not-for-profit organization focused on driving the positive changes needed to better prepare community oncology practice to efficiently dispense oral oncolytic agents. In the last 12 months the founding members of NCODA have partnered together to build a framework of quality standards to best serve the needs of community practices to efficiently dispense oral cancer therapies and implement pharmacy driven interactions to positively affect the quality of patient care. “We believe the best model to eliminate clinical fragmentation and to promote comprehensive oncology care is one where all drug treatment modalities such as intravenous, subcutaneous, and oral, shall be provided at the site of care” says Michael Reff, RPh, MBA President and Founder of NCODA. With Quality Standards focused on being Patient-Centered, Positive Quality Interventions, Fundamental Practice Elements and Health Information Technology, NCODA brings together win-win solutions for all stakeholders involved in optimizing the treatment of cancer patients with oral therapies.
Since its beginning in early 2014, NCODA has collaborated with large regional payers to negotiate for patient care continuum beyond the first fill. NCODA was the first advocacy group to successfully navigate this type of collaboration on a local level and is in discussions with both large regional and national payers. “I was confident in joining NCODA because of their proven success in collaborating with payers and their common sense commitment to improving patient care” said Linda Frisk, PharmD, Arizona Oncology. NCODA continues to support its affiliated practices across the country to negotiate similar agreements. A Patient Satisfaction survey has been created and developed by NCODA in combination with The Community Benchmarks Program at Syracuse University’s Maxwell School to quantify the metrics which patients, providers and payers are interested in.
NCODA’s rapidly growing membership is comprised of like-minded community cancer centers from across the country currently including over 25 practices and over 1,100 providers. “We believe that the best site of care for the treatment of all cancer patients is with their oncologist”, said Mr. Reff,“and our mission will create the environment that results in positive change for the cancer patient in the community setting.” NCODA will always be independent for its stakeholders, as it formulates a collaborative drug therapy management model which is so vitally important to the increasing demands for treatment with oral chemotherapy in community oncology practices.
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