A Medically Integrated Pharmacy Care (MIPC) model represents the true integration of pharmaceutical and medical oncology care. At the virtual 2020 Community Oncology Alliance (COA) Community Oncology Conference, Jim Schwartz, RPh, Executive Director, Pharmacy Operations, Texas Oncology, Dallas, discussed this model, which he said provides clarity of focus around complex disease states.
This unique approach to oncology care is centered around 1 care team with 1 care plan, anchored by physicians. The care plan is guided by industry-accepted clinical pathways and uses only 1 patient record. According to Mr Schwartz, using this model leads to exceptionally high patient satisfaction, better adherence to therapy, and improved compliance to care plans.
What Is a Medically Integrated Dispensing Pharmacy Model?
A medically integrated dispensing (MID) pharmacy model is defined as “a dispensing pharmacy within an oncology center of excellence that promotes a patient-centered, multidisciplinary team approach. The MID is an outcome-based collaborative and comprehensive model that involves oncology healthcare professionals and other stakeholders who focus on the continuity of coordinated quality care and therapies for cancer patients.”1
According to Mr Schwartz, it is important to remember the terms “patient-centered,” “multidisciplinary team approach” (including doctors, nurses, advanced practice providers, pharmacists, techs, and team members on the business side), and “continuity of coordinated quality care,” which is the ultimate goal of all cancer care.
From a patient care perspective, an MID model provides clinical decision support at the point of care for all oncology regimen selections, as well as real-time access to the electronic health record (EHR). “Everybody involved in patient care has access to the same information,” Mr Schwartz noted. “Everyone charts in the EHR and can read everything that’s gone on with that patient.”
Patients value the real-time counseling they receive from their providers, whether it is face-to-face or virtual, as well as the consistent follow-up offered throughout the entire cancer care continuum. In addition, the MID model is convenient for patients and provides them with easy access to care.
In terms of the team, the model is a seamless system of support. “The multidisciplinary care team is anchored by the patient’s physician,” Mr Schwartz said. “Trust is very important here, so everything comes from someone associated with the patient’s doctor. The patient knows the people they’re talking to, so they’re more likely to give accurate information and tell the caregivers everything that’s going on with them.”
Patients Need Seamless Care, Physicians Need Control
“Your patients need seamless care,” Mr Schwartz said. “This model improves the patient experience with uninterrupted care delivery.” The drug-filling process is optimized for patients through on-site prescription pickup and best-in-class patient education. He noted, however, that one of the most important aspects is the financial support, as pharmacy benefit and patient assistance support are integrated into the model.
“These drugs, as we all know, are not inexpensive,” he said. “Patients cannot handle this on their own, but a lot of times they’re led to do that by specialty pharmacies. They need us to help them with it just as we do in the clinic.”
Helping patients obtain their drugs—at price—is the most important thing, Mr Schwartz said, adding that financial toxicity is one of the most common reasons that patients become noncompliant when it comes to their prescriptions.
From the physician perspective, an MIPC model allows for consistency in patient care. “Physicians need to know whether a patient got their medication or if it’s being held up,” Mr Schwartz said. “I’ve heard more than one doctor say they prescribed something and a month later the patient didn’t have the medication. [With the MIPC model] the doctor can look in the chart and they know that the patient was able to afford it and that they’re going to be able to take it.”
An MID model also means reduced costs for patients and the healthcare system overall. The integrated pharmacy system platform increases patient access to care by reducing administrative inefficiencies; it cuts down on the amount of resources and expenses spent on chasing external providers, which allows for earlier receipt of the patient’s first prescription. This in turn allows patients to begin their therapy sooner.
Pharmacists working in an MIPC save millions of dollars by identifying erroneous or unneeded prescriptions before they are sent to the patient. In addition, monthly refills are not sent until the physician verifies the patient’s dose and necessity to continue therapy.
In a study on the MIPC model and waste reduction, researchers reported that pharmacist intervention aimed at unnecessary or incorrect prescriptions yielded a cost-savings of $5 million over the course of approximately 18 months. In contrast, reported waste from specialty and mail-order pharmacies (defined as prescriptions filled but not used by the patient for any reason), totaled $6.8 million for patients and the healthcare system.
According to Mr Schwartz, “these are just a couple of the things that a medically integrated pharmacy model can help prevent.”
- National Community Oncology Dispensing Association. NCODA announces the defining of the Medically Integrated Dispensing Pharmacy [press release]. January 27, 2020. www.ncoda.org/medically-integrated-dispensing-pharmacy/. Accessed May 21, 2020.