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Cost savings opportunities in cancer care

Solutions to address the challenges in oncology landscape


Kjel Johnson, PharmD, Vice President of Specialty Product Strategy


The American Society of Clinical Oncology (ASCO) annual meeting highlights recent research in cancer care. The oncology community will gather this year to explore advances to make care more effective, accessible, equitable, and affordable for patients. CVS Health will present findings from innovative specialty management in cancer care. The research highlights include:


The value of evidence-based guidelines

Clinical pathways focus on standardizing and improving quality of care. Our research shows that National Comprehensive Cancer Network (NCCN) treatment guidelines not only improve outcomes but also drive value - with lower total cost of care for patients with breast and colon cancers.

When comparing patients with breast cancer who received treatments that were NCCN guideline-concordant to those who didn’t receive such therapies, total cost of care was reduced by up to 43 percent for Medicare patients, by savings in chemotherapy and outpatient services.


Lower total cost of care with NCCN guideline-concordant breast cancer treatment:


$5,872 savings for commercial fully insured patients

25% lower cost

$6,946 savings for commercial self-insured patients

28% lower cost

$3,542 savings for Medicare patients

43% lower cost

And the total cost of care for Medicare patients with colon cancer who received NCCN-concordant therapies was 33 percent lower than those who didn’t.

CVS Health helps empower evidence-based decision-making by integrating directly with clinical guidelines, so patients get the best treatment while controlling costs for payors.


The impact of payment strategies and site of care

The shift to value-based reimbursement in oncology continues, due to high variations in care and high treatment costs. A value-based care shared savings arrangement helped improve value for patients with cancer receiving chemotherapy. Pharmacy costs per patient per treatment month were reduced by 5.1 percent. Additionally, patients reported 27.8 percent fewer hospital inpatient days and 70 percent fewer emergency room visits.

Another way to address cost and quality is at the site of care. Our study explored the potential cost savings among select infused cancer therapies in stable patients transitioning from the hospital outpatient setting to the office setting for infusions and found that these patients can save up to $71,169 per patient per year.


Through our research, CVS Health helps ensure clinically appropriate access and services in the evolving field of oncology. We will continue to invest in and develop comprehensive solutions that help payors support the delivery of the most effective, cost-efficient care.