Presenter: Stephanie Evangelisti, PharmD, MS, BCOP, Oncology Pharmacy Director, Grand Valley Oncology (Community Hospital), CO
Co-Authors: Brenda Butchko, CPhT, Grand Valley Oncology, CO; Alisha Reynolds, Grand Valley Oncology, CO
Background: Rules adopted in 2008, but repealed in 2020, by the Colorado State Legislature and State Board of Pharmacy, allowed patients with cancer or the patient’s family member to donate previously dispensed oral cancer medications to pharmacies for the purpose of redispensing to patients who cannot afford their prescribed medications.1 Because 16% of the population in Mesa County, Colorado, live below the poverty line, Grand Valley Oncology opted to participate in this drug recycling program to increase access and minimize waste of expensive oral cancer medications.
Objective: To determine the impact of the Cancer Drug Repository Program in terms of increased patient access to oral medications used in the treatment of cancer, including side-effect management, and decreased pharmaceutical waste.
Methods: Donations of noncontrolled medications received between January 1, 2019, and December 31, 2019, were reviewed by a pharmacist to ensure that the following conditions were met: used in the treatment of cancer, including side-effect management; stored in the original, unopened, sealed, and tamper-evident packaging; properly stored at room temperature; and within expiration date. If a patient undergoing cancer treatment was uninsured, underinsured, or demonstrated significant financial need, then a financial counselor would meet with the patient to review applicable medication access programs, such as the Cancer Drug Repository Program, manufacturer assistance programs, and grants. The patient, if eligible to participate, was required to acknowledge receipt of donated medication.
Results: A total of 34 medications were donated to the Cancer Drug Repository Program between January 1, 2019, and December 31, 2019. The total average sales price (ASP) for these donated medications was $569,592. Six patients were deemed eligible to participate in the program based on financial need and availability of donated medication; 12 prescriptions (ASP, $240,854) of the available 34 were dispensed to these individuals at the time of repeal.
Conclusion: Financial toxicity can be a significant burden to individuals diagnosed with cancer and their families. Although assistance was limited based on the availability of donated medications, the practice still promoted improved access to oral cancer medications. Resources, such as the drug recycling program, should be utilized to help increase patient access to, and minimize waste of, expensive oral cancer medications. This project was undertaken as a Quality Improvement Initiative at Colorado West Healthcare System (Grand Valley Oncology) and, as such, was not formally supervised by an Institutional Review Board.
- Colorado Department of Regulatory Agencies; State Board of Pharmacy. Rule 3.00.80 Return or Exchange of Drugs, Prescriptions, Medical Devices, and Medical Supplies for Dispensing or Donation. HB15-1039, General Assembly of the State of Colorado, 2015.