A report recently released by McKesson on the state of community oncology highlights the current challenges facing physicians, administrators, and clinical staff who work in community practices.
The "Advancing Community Oncology Report" details these challenges as well as opportunities for growth through perspectives from five key opinion leaders and one patient, as well as insights collected from a survey of community oncologists and practice administrators and staff, plus findings taken from the inaugural McKesson Accelerate conference. Together, these insights offer ways in which biopharma companies can collaborate with and improve access for community practices, as well as areas of strategic action needed to change the future of community oncology for patients.
“Cancer care in the United States is at a pivotal moment, with over half of cancer patients now treated in community settings. This shift creates both opportunities and added complexities for community providers and biopharma companies working to expand access to cutting-edge therapies,” said Jason Hammonds, President, Oncology & Multispecialty, McKesson. “Through our oncology services, we are focused on bridging the gap between scientific breakthroughs and day-to-day oncology care. This report offers a unique opportunity to hear directly from the community practices at the front lines of cancer care, as well as key leaders in the space, on how biopharma can actively support these providers in accelerating the future of cancer care for patients.”
Survey Results
The report also included findings from a double-blind national survey of more than 100 community oncologists and 100 practice administrators and staff regarding the unique hurdles of community oncology practices. Survey respondents noted that among their top challenges are timing, specialized staffing, infrastructure constraints, and reimbursement.
Two-thirds of community oncologists and 70% of administrators/staff believed that biopharma companies recognize the day-to-day challenges that community oncology practices face, but only 56% of early-career physicians agreed.
The majority of physicians—especially physicians with smaller practices—found CAR T-cell therapy to be the most challenging type of treatment to access and administer in the community setting, followed by bone marrow transplant, gene therapy, and bispecifics. Physicians who are self-employed particularly reported (90%) that they found it challenging to access novel oncology therapies in the community setting vs 76% who are employed in the community by a hospital or health system. Expanded financial assistance programs and improved drug access for uninsured or underinsured patients were recommended to improve access to oncology therapies, including novel agents.
Most physicians (78%) found it difficult to keep up with the pace of change in clinical practice due to limited time availability, constantly changing clinical guidelines, and not enough time to attend conferences. Some physicians reported that it would be helpful if the clinical staff, not just the providers, were also educated on newer drug therapies.
Compared with physicians whose challenges mostly revolved around a lack of time and specialized staff, administrators and staff tended to focus on more patient financial constraints and reimbursement challenges.
Eighty-five percent of responding physicians, along with 78% of administrators/staff, noted that it is difficult to access clinical trials in the community setting. Physicians recommended increasing financial incentives for patient participation, adding specialized and support staff, and using protocols that work better within community workflows to increase clinical trial enrollment in the community. The majority of respondents also believe that artificial intelligence and technology solutions will make it easier for more patients in the community setting to participate in trials in the future, which aligned with an acceptance of artificial intelligence overall. Physicians from larger practices were willing to engage with biopharma on clinical trial design to improve clinical trial access and enrollment.
“As therapies become more targeted and clinical trial needs continue to evolve, community practices will play an increasingly critical role in making sure innovation translates into meaningful access for patients. The insights in our Advancing Community Oncology Report highlight practical, near-term opportunities for biopharma to expand its impact in these care settings,” said Michelle Lockyer, Chief Strategy Officer, Oncology, McKesson.
Physicians noted shifts in the patient population over the past decade, including more patients being diagnosed with cancer at younger ages, more patients with chronic cancers requiring long-term management, and an increased demand for cancer screening. Administrators and staff also noted changes in the types of cancers seen most at their practices. Both groups noted an increase in patient volume and resource allocation.
Administrators/staff (76%) and self-employed physicians (90%) especially agreed that it is difficult to provide adequate education to their patients about oncology treatments. The majority of physicians and administrators/staff showed an interest especially in education specifically for young patients and survivors about risks, screening, and living with cancer, as well as support groups and programs.
Disclosure: For full disclosures of the study authors, visit mckesson.com.
