Dispensing oral medications: why now and how?

Abstract

Commun Oncol 2009;6:358–361 © 2009 Elsevier Inc. All rights reserved. H ere are some stark statistics on the oncology drug market and oral oncology prescriptions: In 2007, the world oncology drug market was $40–$45 billion,1 of which $6 billion (13.3%) was oral.2 Overall, 35% of the oncology drug pipeline is for oral drugs.3 The world oncology market is estimated to be $55 billion in 2009.4 It is estimated that the generic oncology market in the US alone will be $35 billion after 2011.5 Although the US drug market is expected to grow 2% in 2009, oncology drugs are expected to grow 15%–16%.6 The US constitutes about 37% of the world drug market.6 The US market for oral oncology drugs is expected to be between $5 billion and $7 billion in 2010 and to continue growing at a 20%–30% annual rate.7 The average unit price of an oral oncology prescription is estimated to be $500.8 So if you decide not to dispense oral oncology drugs, what will that cost your practice and your patients? The first step in answering this question is to analyze your expenses associated with writing prescriptions filled by outside pharmacies. These costs include phone and fax exchanges, which in a nononcology practice cost $5–$7 per contact.8 Forrester Research estimated the number of prescription-related telephone calls at 900 million, with one in three prescriptions requiring pharmacy call backs.9 In a typical practice where physicians see 25 patients per day, that “cost of not dispensing” nears $30,000 annually, not including lost physician time. A recent article in Drug Topics2 gives pharmacists the following instructions for handling oral oncology prescriptions: