Friday, November 05, 2021

Risk-Based Cancer Care: A Specialty Pharmacy’s Role

Today’s guest post comes from Ashleigh Burdette, Senior Director of Clinical Innovation at Biologics by McKesson.

Ashleigh explains how biopharma companies can help patients become more adherent and achieve better health outcomes by partnering with an experienced specialty pharmacy that offers risk-based care. 

To learn more about the risk-based care approach, download the free whitepaper: Risk-Based Care Helps Cancer Treatment Adherence.

Read on for Ashleigh’s insights.

Risk-Based Cancer Care: A Specialty Pharmacy’s Role
By Ashleigh Burdette, Sr. Director of Clinical Innovation, Biologics by McKesson

Why might advanced cancer therapies seem less effective when patients use them at home, compared with the results observed during clinical trials, under controlled conditions?

In real-world situations, nonadherence is often one of the barriers to cancer therapy and can lead to unsatisfactory outcomes. Some patients stop taking medication without consulting a doctor, nurse or pharmacist if unwanted side effects like fatigue or nausea become overwhelming, even when they know the medication can help.

Biopharma companies can help cancer patients become more adherent and achieve better health outcomes by partnering with an experienced specialty pharmacy that offers risk-based care.


Risk-based care is a personalized healthcare approach that allows nurses and pharmacists at a specialty pharmacy to offer cancer patients individualized care, including education and emotional support, to help them continue therapy, despite obstacles. These plans are designed with a single person in mind, not the larger patient population.

Clinicians help cancer patients determine factors that prevent them from taking their medication as prescribed, making it easier for them to remain adherent. Before starting therapy, the patient undergoes an initial risk assessment with a specialty pharmacy clinician. For example, patients who live alone are often at greater risk because they may not have anyone to talk to about health concerns. They may benefit from more frequent phone calls from a nurse, and the risk assessment helps to determine how often the patient should receive calls.

Each patient is paired with a nurse, who manages the patient’s care by phone throughout the therapy journey, helping them address new challenges as their situation evolves. Patients who have regular contact with a nurse are more likely to remain adherent.

The risk-based care approach is empowering for patients and their caretakers and may contribute to optimal clinical outcomes.


Patients only recall about half of what their doctors advise. That information gap may contribute to nonadherence.

Biopharma companies that offer risk-based care through an experienced specialty pharmacy help close that information gap. Through constant communication, this approach allows clinicians to determine what each patient needs to remain compliant, often providing patients with education so that they can follow their doctors’ recommendations.


Many biopharma companies offer front-loaded support, calling cancer patients throughout the first few months of therapy and then stopping before therapy is complete. It may help patients establish a new routine, but if they develop problems after the initial period ends, they may have no one to rely on for support.

With a risk-based care approach, support is ongoing throughout a patient’s entire course of therapy. Clinicians can gauge which patients need more interaction than others, based on their personal needs. The risk-based care model keeps the line of communication open between nurse and patient throughout the entire course of therapy.


In a risk-based care model, nurses and patients speak regularly, developing familiarity and trust over time. Patients begin engaging with their nurses to determine the cause of unwanted side effects, as well as possible solutions. Research from Memorial Sloan Kettering Cancer Center in New York City shows that patients with metastatic cancer who could report their symptoms to a nurse received chemotherapy for two additional months and lived five months longer.


Small problems can quickly intensify when cancer patients don’t have risk-based care: For example, nausea may escalate from vomiting to dehydration to hospital admission. A risk-based care approach helps patients manage their side effects, minimizing nausea before it snowballs into something more, so that cancer patients can continue taking their medication without incident.

Between 33% and 69% of hospital admissions are caused by medication nonadherence, costing the U.S. healthcare system between $100B and $298B each year (Express Scripts, “The Costs of Non-Adherence,” 2015). Managing adverse events with risk-based care helps to reduce or eliminate costs related to hospitalizations or complications.


This is just an overview of the ways that an experienced specialty pharmacy’s risk-based care plan can help patients remain adherent during therapy. In our whitepaper, Risk-Based Care Helps Cancer Treatment Adherence, we delve more deeply into the ways that biopharma companies can offer patients personalized, compassionate care with Biologics by McKesson’s risk-based care plan. The whitepaper also highlights the three key attributes that make our risk-based care plan successful and includes details about our 5-step approach that we based on the American Nursing Association’s nursing process.

Download the full whitepaper now.

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