The following article is the fourth in a five-part series on The Top Five Ways for Health Plans to Manage Oncology Drug Costs While Improving Member Treatment Options.

Cancer care is rapidly evolving as new delivery methods and treatment options come online at an aggressive daily pace. The growing number of treatment options, combinations, and additional lines of therapy simultaneously increase the complexity in making an evidence-based determination for how to treat a patient’s cancer.

Health plans must now employ specific strategies to harness data to ensure that optimal patient outcomes, as well as quality and cost metrics, are achieved. However, aggregating oncology data from multiple sources is a difficult task. Gaining immediate, actionable insights from the data is even more challenging.

A data science-based approach to oncology prior authorization addresses the two biggest challenges associated with making informed and timely patient treatment decisions: speed and evidence. This type of approach requires deep analytics and insights into a health plan’s cancer drug spend to ensure that anti-cancer therapies are based on science and evidence-based protocols, which are specific to the patient’s unique circumstances and needs.

So the question for health plans is this: How can you equip your team with the right data, paired with the proper insights and actions?

Oncology Analytics is a different kind of partner for oncology prior authorization. We provide access to current, evidence-based, disease-specific analytics on all cancer types and treatment options, backed by board-certified oncology physicians and pharmacists.

Our data science teams utilize advanced data models and machine learning to better understand outcomes in all areas of cancer treatment to ensure that your members receive the right treatment at the right time and at the right cost. Our comprehensive approach to real-world data and analytics is based on the organization and normalization of clinical data such as EMR progress notes, pathology and lab reports, biomarker data, histology, and stage of cancer. Clinical data is then combined with claims data to provide unique insights and benchmarks focused on health plans’ oncology spend, trend, and provider network performance.

Specific to creating a long-term, scalable strategy for real-world data and analytics, Oncology Analytics offers critical technology solutions that address the primary challenges and gaps health plans face in advancing a data-driven strategy for oncology utilization management:

  • e-Prior authorization (ePA) – Data-driven through advanced analytics, Oncology Analytics helps health plans determine the right anti-cancer therapies, then tailors our oncology ePA platform to allow treating oncologists to initiate and manage their prior authorization requests securely through our cloud-based software, which eliminates manual faxing and phone calls, while improving operational efficiency.

  • Oncology Insights™ – Our next-generation, real-world data analytic software solution, Oncology Insights, combined with oncology-focused clinical expertise, equips health plans with superior insight into their provider network, cancer drug trend and spend, cancer treatment decision-making capabilities, and powerful comparative benchmarks.

Oncology Analytics understands the complexity involved in the management of cancer treatment options caused by the rapid pace of research and new drug introductions that are changing the oncology landscape daily. We are committed to the ongoing review and analysis of oncology treatments, their outcomes, and adverse effects to ensure that all cancer treatment recommendations provide the patient with the opportunity to achieve the best possible outcome.

To learn more about how Oncology Analytics can help your organization leverage real-world data and analytics for oncology prior authorization, please contact us.

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