The Pharmacist’s Role in Value-Based Oncology Models: David Awad, PharmD, BCOP

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As value-based care models expand across the oncology landscape, pharmacists play a growing role in navigating the complex intersection of therapeutic innovation, fiscal responsibility, and patient access. In an interview with The American Journal of Managed Care® (AJMC®), David Awad, PharmD, BCOP, oncology pharmacy manager at Robert Wood Johnson University Hospital, described the balancing act pharmacy teams must perform in the current treatment landscape.

“Pharmacists are great experts in therapeutics and managing medications and side effects,” Awad told AJMC. “But we’re also called to try to be fiscally responsible, not only for the department but for the whole institution, and then that trickles down to [the] payer, which will trickle down to the patient in the end.”

This responsibility becomes more complicated as more novel and expensive therapies enter the market. With multiple drugs now approved for the same indication or target, pharmacists juggle which products to use based not only on clinical evidence but also on cost and payer policies.

“We have, at least in the bispecific space, multiple different drugs that treat the same indication or have the same target,” Awad explained. “How do we know which one to pick? Which one is fiscally responsible for the patient [and] for the organization?”

Answering those questions becomes even more complicated as insurers designate preferred products. According to Awad, pharmacists must manage formulary decisions and drug inventory while ensuring patient access remains uninterrupted. He anticipates a future where, much like with biosimilars or PD-L1 inhibitors, oncologists may be less concerned with the specific product being used as long as the patient is receiving treatment. In that environment, pharmacists will be the ones navigating behind the scenes to align payer preferences, institutional policies, and patient care.

“In the end, once you have so many [options] on the market, they just want the patient to get treated,” Awad told AJMC. “And that's sort of where the pharmacist comes into play in the background.”