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Cancer drugs that have gained FDA approval the past few years have been predominantly oral therapies. According to one recent estimate, oral oncolytics represent about 20% of a health plan’s overall spend in oncology — with a huge 25% projected annual growth rate!

Oral oncolytics have moved some cancer treatments from the physician’s office to the patient’s home — and this shift has been accompanied by big benefits and major challenges to overcome. On the plus side, because most of these drugs are newer-generation targeted therapies, which home in on the tumor rather than attacking all of the cells in the area, the side effects are less severe than those of earlier treatments. Patients also can maintain themselves rather than having to visit their physician for infusions or injections. And the process of taking a pill is much more desirable to most patients than is being infused or injected.

However, even though these are life-threatening diseases, patients still have problems with compliance and adherence. And with potential monthly therapy costs ranging from $10,000 to $40,000, plans cannot afford to have noncompliant patients — or patients whose conditions do not warrant these very expensive therapies.  

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LEE N. NEWCOMER, M.D., is senior vice president of oncology for UnitedHealthcare. His unit is responsible for improving the quality and affordability of care for cancer patients covered by UnitedHealthcare. From 1991 to 2000, Dr. Newcomer held a number of positions at UnitedHealth Group, including chief medical officer. His work there emphasized the development of performance measures and incentives to improve clinical care. Prior to rejoining UnitedHealth Group, Dr. Newcomer was a founding executive of Vivius, a consumer-directed health care firm that allowed consumers to create their own personalized health plans. He has also served as medical director for CIGNA Health Care of Kansas City. Dr. Newcomer is a board-certified medical oncologist who practiced medical oncology for nine years. Dr. Newcomer is published in peer-reviewed and industry journals on a variety of scientific and management topics, and he regularly comments on health care issues and trends in national and regional media, including The New York Times and The Wall Street Journal. He also is currently chairman of Park Nicollet Health Services, an integrated system of more than 650 physicians and a 400-bed hospital. Dr. Newcomer earned a B.A. degree in biology from Nebraska Wesleyan University, an M.D. degree from the University of Nebraska College of Medicine and an M.S. degree in health administration from the University of Wisconsin at Madison.

RANDY FALKENRATH is senior vice president of specialty pharmacy and business development for UnitedHealth Pharmaceutical Solutions (UHPS). He is responsible for all aspects of specialty drug management, including pharmacy and medical benefit design, specialty pharmacy network development, market and customer program deployment, and financial performance. He also has responsibility for UHPS customer reporting and analytics, business planning and rebate contract administration. UHPS provides pharmacy management for employers representing more than 15 million individuals and $10 billion in prescription drug spending annually, including $3 billion of specialty pharmacy spend. Approximately 7 million individuals are covered under UnitedHealthcare fully insured products, with the remainder managed under administrative-services-only arrangements with many of America’s largest employers. Mr. Falkenrath joined UnitedHealthcare in October 2005 after two years as a partner in the life sciences practice of Computer Sciences Corp. Prior to joining UnitedHealthcare, he had 22 years of executive leadership experience in the pharmaceutical and medical device industries, with additional years spent running his own consulting business. Mr. Falkenrath received a B.S. degree in organization behavior from Northwestern University and an MBA from Northwestern’s Kellogg Graduate School of Management.

THOMAS McNULTY, Pharm.D., is chief clinical officer for Ancillary Care Management, Inc. (ACM). His clinical leadership facilitates the development of ACM’s sophisticated clinical and care management programs, including the HemoCARE program, which is focused on improving the lives of patients living with bleeding disorders such as hemophilia. Prior to co-founding the company in 1995, Dr. McNulty served as vice president of clinical services for Curaflex Health Services (now Coram Healthcare), where he managed pharmacy and nursing operations, care sales and outcome support, medical advisory relationships, mergers and acquisitions, and cost analysis. He also was responsible for JCAHO accreditation and all aspects of licensure and regulatory compliance. Earlier in his career, Dr. McNulty headed quality assurance and pharmacy management for Preferred Care Health Services, a home infusion company located in Los Angeles. He holds a B.S. degree in pharmacy from Philadelphia College of Pharmacy and a Pharm.D. degree from the University of the Pacific School of Pharmacy.

Moderator: Angela Maas, managing editor of AIS’s Specialty Pharmacy News.

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