Solutions that Put Patients First
It has been estimated that oncologists would need 29 hours a day to keep up with the research and findings of new cancer treatments that enter the market each day. Oncology Analytics relieves this burden through a combination of technology-enabled services, supported by our dedicated clinical team of board-certified oncology physicians and pharmacists.
e-Prior Authorization for Pharmacy and Medical Benefit Drugs
Used by oncologists to support 5 million health plan members in the US and Puerto Rico, Oncology Analytics’ ePA platform covers the full spectrum of therapeutics, across all cancer types and stages, including chemotherapy, immunotherapy, radiation therapy, genetic and molecular testing, and supportive care agents. Our extensive anti-cancer protocol library is continuously updated with the latest evidence-based information, which provides the most current options for value-based treatment paths for every patient case.
Oncology Analytics employs teams of board-certified medical oncologists, hematologists, and radiation oncologists, ensuring your providers will only speak to a true peer when discussing a member’s care. Our clinical oncology team has deep expertise in medical and pharmacy benefits as it relates to cancer drugs and focuses daily on identifying and evaluating new trends and researching appropriate therapy combinations, including biosimilars where applicable.
THINGS HAVE CHANGED
Since 2018 alone, the FDA approved 121 new cancer indications, including 49 novel cancer drug entities. The FDA has even launched a Real-Time Oncology Review (RTOR) program, which allows the FDA to review early drug data in advance of a formal application. Under this program, one oncology drug gained FDA approval within two weeks of the application filing.
Checking the box that cancer therapy is supported by the National Comprehensive Cancer Network (NCCN) alone for coverage determinations is no longer enough. With so many NCCN supported options, health plans need to ensure their providers choose the most cost-effective option, tailored to provide the best outcome for the patient’s specific cancer. Oncology Analytics takes a more comprehensive approach by reviewing not only NCCN but also FDA approvals, peer-reviewed journals using the Centers for Medicare & Medicaid Services (CMS) coverage rules, and the guidance of our internal oncologists, who have decades of experience caring for patients.
At Oncology Analytics, each oncology review is evaluated using a patient-first approach, which balances the specific clinical need of each patient against comorbidities, toxicities, and cost. This approach facilitates our ability to provide treatment recommendations that reflect the most current evidence-based findings, even when there is a delay between when research is presented and its inclusion in NCCN.
Oncology Analytics’ ePA platform has achieved a provider satisfaction score of over 95% by the 4,000 treating oncologists and their teams who use the platform daily. The submission process for prior authorization requests is completely automated and eliminates the need for faxes and burdensome administrative processes. Network providers can access the platform standalone or via integration into a health plan’s existing portal via single sign-on (SSO).
To learn more about our patient-first approach, please watch the following video.
“Oncology Analytics’ real-world data approach to utilization management is truly unique in the marketplace. We believe that it will provide significant value and efficiency to Gateway in managing both our medical and pharmacy benefits.”
Eric Yarnell, Vice President of Pharmacy, Gateway Health
Health Plans are tasked with achieving optimal patient outcomes, with a focus on quality and cost. However, aggregating oncology data from multiple sources is a difficult task. Gaining immediate, actionable insights from the data is even more challenging.
Oncology Insights™ is an analytics software solution, which organizes and normalizes 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.
Oncology Insights™ centers on three key areas:
- The Provider Performance Scorecard, which uses objective criteria and extensive drill-down capabilities to measure how provider prescribing patterns for oncology therapies are performing across the health plans network, as well as against other providers outside of the network using de-identified benchmark data.
- The Drug Spend & Trend module, which provides insight and analysis into the trends surrounding health plan drug expenditure over time, including total costs of care for oncology patients.
- The Oncology Population Management module provides insight into changes in cancer incidence and prevalence over time.
By using Oncology Insights™, health plans get access to a multi-disciplinary advisory team, consisting of board-certified oncology pharmacists and clinical analysts, who help interpret the data and surface immediate actionable insights. Our data science teams utilize advanced data modeling, machine learning, and predictive analytic algorithms to better understand outcomes in all areas of cancer treatment to ensure that your members receive the right treatment at the right time and the right cost.
To learn more about Oncology Insights™, please watch the following video.
“This partnership brings focused oncology expertise to our prior authorization process. By offering this service, oncologists can consult with their peers and nationally recognized experts to confirm that they are providing the best care and value for their patients.”
Scott Schnuckle, HealthPartners Senior Vice President, Pharmacy and Business Development, HealthPartners
Oncology Pharmacy Consulting Services
The explosive growth of treatment options in oncology means that the stakes for patients, providers, and health plans have never been higher. Health plans have small windows to carefully evaluate the appropriateness of new therapies and make needed course corrections.
WORK WITH AN EXPERT
Oncology Analytics’ team of board-certified oncology pharmacists can help you successfully navigate the world of anti-cancer drugs. These experienced professionals can assist by delivering a highly focused set of oncology pharmacy resources, which keep health plans up to date on the rapidly changing cancer therapy landscape. Through this increased awareness, health plans can improve cancer care for their members and develop more cost-effective approaches to high-quality care.
SERVICES WE OFFER
Oncology Analytics has both deep experience and a robust repository of effective tools and methods to guide health plans through the rapidly changing oncology drug landscape successfully. We have identified several high-value areas for oncology pharmacy optimization, and offer an 11 month consulting program which includes the following:
“It’s critical that Humana members receive effective and affordable cancer care. This expansion with Oncology Analytics is a great example of how Humana values our long-term relationships with partners who continue to innovate, drive quality, and add value for our members.”
Dr. Bryan Loy, Humana’s Corporate Medical Director of Oncology, Laboratory, and Personalized Medicine Strategies, Humana