Medco Health Solutions launches Medco TRC for oncology patients

Jan 21 2010

Medco Health Solutions, Inc. (NYSE: MHS) today announced the launch of the Medco Therapeutic Resource Center® (TRC) for oncology patients headquartered in Whitestown, Ind., where specialist pharmacists will manage the company's more than 850,000 patients currently living with cancer, one of the fastest growing segments of healthcare.

The new oncology TRC consists of nearly 150 specialist pharmacists and more than 250 support personnel who will actively participate in the care of cancer patients, identify treatment gaps and address quality of life issues, such as managing side effects of their drugs.  The innovative approach places pharmacists in a more central role in improving health outcomes for patients with common forms of cancer, such as breast and prostate cancers, patients with benign and malignant hematologic conditions, and special needs populations, such as children with cancer.  

Consolidating both traditional and specialty pharmacy oncology medications and organized into teams focused on various tumor treatments, Medco oncology specialist pharmacists will review anti-cancer regimens that include oral cancer medications and supportive therapies, such as anti-nausea treatments and erythropoietin stimulating agents (ESAs).  Pharmacists will oversee the patients' drug therapies holistically, ensuring adequate attention to medication safety and other medical conditions besides cancer. Medco will be incorporating oncology clinical expertise from its specialty pharmacy, Accredo Health, and its TRC in Willingboro, NJ.

"As cancer patients undergo treatment, they are confronted with complex medication regimens that can severely impact their quality of life," said Dr. Milayna Subar, Medco's national practice leader for the Oncology TRC.  "Oncology dedicated pharmacists are in an ideal position to supplement cancer care in the areas of medication compliance, identifying genomic tests for targeted therapies when appropriate, and consulting on evidence-based care decisions."

Coinciding with the launch of the Oncology TRC, Medco will be initiating a new product service offering – Advanced Oncology Solutions (AOS) – aimed at improving the clinical outcomes and cost management of cancer care.  The program combines the clinical expertise of Medco's specialist pharmacists, the "high-touch" delivery activities of Accredo Health, and a sophisticated information network that gives pharmacists a 360-degree view to support cancer patients to keep them on therapy and reduce the risk of medical complications. The enhanced services offered through AOS deliver a uniquely innovative model in the pharmacy benefit management and specialty pharmacy industry, and will provide value to patients, physicians and plan sponsors.    

Advanced Oncology Solutions

Decades of research have been dedicated to treating and curing cancer.  Progress has led to improved survival rates for many cancers that now behave like chronic diseases.  New targeted therapies enable some treatments to seek out cancer cells more directly, sparing healthy tissues and limiting side effects. Yet, it is estimated that cancer killed nearly 560,000 Americans in 2009.  

Cancer patients, who take on average 10 different oral medications, including those used to treat other chronic conditions, are at risk for drug interactions that could render an anti-cancer drug less effective. When enrolled in Advanced Oncology Solutions, information systems alert pharmacists and physicians to potential hazards, the latest clinical expertise, and pharmacogenomic opportunities.

Medco has incorporated genomic testing programs directly into its practice of pharmacy.  This reflects the changing nature of some new pharmaceuticals — cancer drugs are increasingly designed to target cell growth pathways and are paired with genomic tests.  Gleevec® (imatinib), Herceptin® (trastuzumab), and Erbitux® (cetuximab), are among those associated with genomic testing.  Genomic testing of a patient's innate metabolism of a cancer drug, such as tamoxifen, can similarly ensure that patients receive the fullest benefit from their treatments.  Elevating the science of pharmacy is at the core of this new approach to cancer management.

"This singular focus on the cancer patient is what will separate Advanced Oncology Solutions from a less specialized approach to pharmacy," says Jeff Ulanet, vice president of oncology at Medco.  "Our new solution is intended to be transformational and not just an incremental improvement.  We can now provide oral drug oversight across the entire regimen to ensure patient safety and improve outcomes—available at the scale only the nation's largest oncology pharmacy can provide.  Advanced Oncology Solutions will define a new era in our nation's fight to find a cure for cancer and help contain its run-away costs."

Oncology Research

Medco has been actively engaged in three studies over the past year:

• Certain antidepressants impair the metabolism of the breast cancer drug tamoxifen, making it less effective.  Patients using tamoxifen with antidepressants, such as Prozac® (fluoxetine), Paxil® (paroxetine) and Zoloft® (sertraline), had a 1.9 fold higher risk of recurrence than patients using antidepressants that are weak inhibitors of the liver enzyme CYP2D6.  The weak inhibitors of the enzyme include Celexa® (citalopram), Lexapro® (escitalopram), and Luvox® (fluvoxamine).
• Evidence indicates that physicians have adjusted prescribing habits after the FDA published alerts and inserted boxed warnings into product labels for Erythropoiesis Stimulating Agents (ESAs) in 2007.  This resulted in a reduction in the spend for these agents.  Additional studies are planned to determine if this decrease led to any change in ER visits or hospitalizations for this group of patients.
• Assessment of patients with chronic myeloid leukemia should include testing for the BCR-ABL gene and its product.  Physicians are not conducting necessary follow-up gene testing for Gleevec patients to determine whether the treatment is working.  Only 14 percent of patients had the BCR-ABL gene measured for consecutive quarters.  Only 60 percent had evidence of having one gene test performed at any period over 1.5 years.