Prostate Cancer Coverage from Every Angle

In-House Specialty Pharmacy and Cost of Therapies for Prostate Cancer

By: Lauren Harrison, MS
Posted: Monday, November 4, 2019

Based on a study of the use of an in-house specialty pharmacy to provide androgen axis inhibitors for patients with prostate cancer, out-of-pocket costs for the drugs varied significantly with insurance plan designs and copay assistance eligibility. Most patients assessed in this study did receive copay assistance, which decreased out-of-pocket costs. Nathan Handley, MD, MBA, of Thomas Jefferson University in Pennsylvania, presented these findings at the 2019 American Society of Clinical Oncology (ASCO) Quality Care Symposium (Abstract 132).

Researchers reviewed any available internal specialty pharmacy records to find all prescriptions for abiraterone or enzalutamide filled between January 2017 and December 2018. Payments were stratified by primary payment (the amount the patient’s prescription plan pays) and copay assistance. Turnaround times were also assessed, and they were stratified by prescriptions needing intervention (prior authorization, copay assistance, or insufficient inventory) and prescriptions requiring no intervention.

During this period, 1,417 prescriptions for abiraterone and enzalutamide were filled for 175 patients through the specialty pharmacy. The average amount paid by primary payer was $9,492.96 for a 30-day supply, and the average copay was $577.53. Approximately 64% of patients received copay assistance. After copay assistance, the average out-of-pocket expense per prescription was $100.83. A total of three patients declined treatment due to cost, comprising 1.7% of the population studied. The average turnaround time was 2.98 days for prescriptions requiring no intervention, in comparison to 3.36 days for prescriptions needing intervention.

“Further studies to determine impact of pharmacy type on access to specialty medications are indicated,” the investigators proposed.

Disclosure: Dr. Handley reported no conflicts of interest. Disclosure information for the other authors can be found at

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