Dr Jenny Craven Evaluates Cost of New Therapies, Ways to Gain Stakeholder Support

Jenny Craven, PharmD, BCPS, of the University of California (UC) Davis Health speaks on the integration of building an Emerging Therapy Committee (ETC) through a cost consideration lens to further evaluate the adoption process of new therapies. Craven was a keynote speaker alongside Sarah Bajorek, PharmD, MBA, BCACP, of University of California, Davis Health, for the AMCP 2024 session, "Taming Million Dollar Drugs - A Healthcare System Emerging Therapies Program," where she addressed the roles and responsibilities of stakeholders to ensure patient eligibility and reimbursement strategies.

Craven operates as the senior clinical pharmacist and pharmacy lead for emerging therapies at UC Davis. She has been a part of successful, real-world evidence of patients that completed treatment by applying the techniques and tools addressed in ETCs.

Transcript

Emerging therapies can be expensive. How would you integrate cost considerations into the evaluation and adoption process for new therapies, considering our focus on affordable care?

So yeah, cost definitely, we can't not talk about these agents without speaking to the cost. They are half-a-million dollars to over $4 million at this point and rising per dose. I think that will be a challenge for many patients and health care systems to make sure that they are able to be sustainable.

I think when it comes to costs to the health care system, it's really making sure that the cash flow is available. We have to upfront the cost to these agents for the patient's dose, and then we wait a long time until we get the reimbursement back.

There may also be cost sharing with the patient, so if they have a plan and they haven't met their deductible, there's a maximum to their plan. Those are considerations that we need to think about as well as we move along the process. I think overall cost is definitely that giant elephant in the room.

Gaining buy-in from stakeholders across a large health care system is crucial. How can transparency be established and trust in the ETC's decision making process for clinicians and other stakeholders who might be unfamiliar with gene therapies?

I think that has been a really big barrier to maybe a lot of health care systems or programs is that that buy in, and that making sure that there's some accountability here and ensuring that we're not operating without some sort of a plan in place.

That structure is provided by the Emerging Therapies Committee, and by our template that we're using, to ensure that we're not missing anything, and that we've thought about everything from every angle. I think that has helped to instill confidence and trust within our administration and our P&T [Pharmacy and Therapeutics] committees and how we're reviewing these agents. I think that will really change the way that we think about drugs in the future.

Actually, somebody at the panel session asked me a question: how can we apply this to other agents and has this made it easier for wanting to onboard other agents? I definitely think it has, we've already had a lot of the big conversations and I think just really instilling that confidence in the process.