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      New breast cancer cost savings attainable for health plans

      Alignment to oncology treatment guidelines significantly lowers patient and plan costs

       

      Kjel Johnson, PharmD, Vice President, Specialty Product Strategy

      Briefing

      More than 4 out of 5 plan members with breast cancer received therapies aligned to clinical pathways, yielding a significantly lower total cost of care.

      The findings show the average cost of care in six months for breast cancer patients who met these guidelines was $18,964 compared to $25,769 for those who didn’t.

       

      • Savings of up to 26% when aligned to breast cancer guidelines
      • $6,800 PMPM* cost reduction for breast cancer patients

       

      Costs for cancer care and management are expected to rise sharply by 2030.1 As treatments for oncology expand and costs continue to rise, managing appropriate therapy selection becomes more important than ever for health plans. And having more members follow the most cost-effective treatment regimens will help support better patient experiences and be one of the most valuable contributors to control every plan’s cost challenge.

      At CVS Health, our Transform Oncology Care (TOC) solution is designed to help enable better visibility to the most up-to-date guidelines and aligned therapies can be approved almost immediately. This can help control costs for health plans and improve the provider experience while improving the quality of oncology care for patients. At the same time, this helps ensure better treatment for patients by encouraging expanding access to novel therapies to the right patients at the right time.

       

      We offer health plans flexible cost-control and quality improvement strategies through:

      • Full guideline alignment: The ability to adopt clinical pathways that offer a comprehensive range of treatment options 
      • Support at each treatment stage: Frequent touchpoints and data sharing to help keep patients on appropriate therapies with greater adherence and earlier identification of adverse events. This support helps drive better patient experience as well as cost savings

       

      For health plans, managing the complicated cancer journey requires a flexible solution. TOC is here to help plans meet their quality-of-care goals for oncology while helping them control the high cost of therapy.

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      * Per member per month

      106-56197A