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Although oncology medications hold great promise, costs for such treatments are rising rapidly, says Rebecca Shanahan, executive vice president and general manager of Aetna, Inc. subsidiary Aetna Specialty Pharmacy. She says that on a national basis, 50% of all specialty drug spending is on oncology medications and adjunctive therapies — and cancer medications are driving specialty spending up 20% per year. Shanahan spoke at an April 6 audioconference on "Oncology Management Strategies for Health Plans and Employers" sponsored by Atlantic Information Services, Inc.

One of the key focuses of Aetna Specialty Pharmacy is medication compliance, Shanahan says. She asserts that 94% of patients receiving drugs through specialty pharmacies are compliant, compared with just 53% of retail customers. To improve compliance, the insurer provides new patient teaching and assessment, injection training and support, compliance monitoring and physician communication.

Shanahan also identified several strategies for health plans working to manage oncology treatment costs through specialty pharmacy. They include more carefully timing chemotherapy in order to match patients' blood cell count and maximize their window of response; reimbursing physicians more for prescribing "preferred regimens," and using step therapy to help ensure that patients will be successful on treatment.

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