Prescription medications are frequently used in treating cancer, and Winship Cancer Institute of Emory University’s specialty pharmacies offer pharmaceutical drugs and highly trained pharmacists to help ensure the drugs work as effectively as possible. In fact, people with cancer treated by Winship are 25% more likely to take their medications as prescribed when they obtain them from Winship’s in-house pharmacies than if they fill them at a big-box external pharmacy.
“Our pharmacy plays such a critical role in the outcomes of our patients, based on their adherence rates and the oversight we provide them,” says Ryan Haumschild, PharmD, MS, MBA, director of pharmacy services for Winship and Emory Healthcare.
Instead of your prescription getting sent to an external pharmacy that isn’t familiar with your electronic health records (EHR), medical history, care plan or your provider, “At Winship, we’re all working on the same team,” says Haumschild. “Using our in-house pharmacies and pharmacists provides a more timely approval process, more patient-specific counseling on the medication therapy and better oversight that can be documented in the EHR, which enables better adherence to treatment.”
Tailoring Medications for Individual Patients
Winship’s pharmacists and providers want to ensure every patient can function at their best, so a lot of decision-making based on patients’ reported outcomes and quality of life goes into selecting which medications Winship’s specialty pharmacy will offer them. “We want them to be able to go home and be active members of their family, their workforce and for themselves,” says Haumschild.
Winship’s pharmacists look at individuals’ treatment history and past medications. If they have had past toxicities, a new medication can be selected that avoids particular side effects. If it’s a new medication for them, it’s important that the dose can be optimized and adjusted as needed to reduce any type of side effect there might be. “In cancer,” says Haumschild, “information is changing so rapidly that having pharmacists that can stay up on that information is critical and a big difference-maker for patients.” He adds, “Cancer also inherently has many different biologic agents that require special oversight and expertise as it relates to prescribing and dosing for optimal outcomes.”
Haumschild recalled a patient who liked to cook and bake for their family, but had some nausea and vomiting from chemo. “We considered how we could get them on supportive care medications early on so that they don’t feel those side effects based on their chemotherapy regimen, and they’re still able to bake and cook for their family, and really create joy in their life.”
Haumschild says this is something unique at Winship’s specialty pharmacies. “Offering a tailored treatment plan for the patient that takes into consideration not only the treatments they’ve been on, not only their unique cancer, but also some of those activities of daily living and functional perspectives that help their mental wellness and their physical well-being.” He adds that tailoring the drugs to individual patients can reduce readmissions or reduce any type of side effects that potentially could cause that patient to go to the emergency room.
An In-House Pharmacy Unique to Georgia
Winship’s specialty pharmacy is the first health system-owned specialty pharmacy in Georgia accredited by the Utilization Review Accreditation Commission (URAC), a Washington, DC-based health care accrediting organization that establishes quality standards for the entire health care industry. URAC’s accreditation means “we’re providing cutting-edge care and meeting the highest quality and safety standards as the only NCI-designated Comprehensive Cancer Center in the state of Georgia,” says Haumschild.
Another distinctive characteristic of Winship’s specialty pharmacies is that their pharmacists not only have a doctorate degree in pharmacy, but they are also board-certified in oncology with a postgraduate year and residency training in cancer medications. A clinical pharmacist is assigned to each of Winship’s disease working groups and hematology/oncology clinics—including myeloma, bone marrow transplant, breast cancer, lymphoma, gastroenterology, leukemia, head and neck cancer, lung cancer and many more tumor types.
Any time a new medication comes forward, Haumschild says the pharmacy seeks input on it from both community oncology and academic providers. “We get their input and we present information that deals with safety, efficacy and cost-effectiveness,” says Haumschild, “and then we make a shared decision if we want to include that medication on our formulary and how it should be incorporated into our treatment pathways.”
Compared with outside pharmacies, Haumschild says, “By integrating state-of-the-art pharmacies with innovating compounding facilities, residency-trained and board-certified pharmacists providing oversight in clinic with cancer-specific knowledge, and a URAC-accredited specialty pharmacy that meets the highest quality of safety standards for oral and self-injectable chemotherapy, Winship’s specialty pharmacy is truly the difference-maker when compared to other outside pharmacy services.”
Innovative Medications and Clinical Trials
“We try to carry medications that offer innovative treatments that not all cancer care providers are going to have because of Winship’s renowned experts, diverse patient base and research integration,” says Haumschild. He explains that Winship’s specialty pharmacy also tries to make sure to have “the right drug on hand for the right patient at the right time.”
A formulary evaluation review examines the impact of a new medication and whether it will add value to the current standard of care. The next question is how much of it to carry based on prescribing habits and the number of patients in the community with a particular type of cancer treatment need.
Winship’s pharmacists also play an active role in educating patients about available clinical trials and which drugs are used in them. “Our pharmacists not only get to be part of developing the treatment orders for a clinical trial,” says Haumschild, “we also give the recommendations when we’re looking at a patient that it might be a better option for them based on their unique disease background and the therapies they’ve tried in the past.” Knowing some of the unique side effects associated with the medications in a clinical trial, Haumschild says “we can help make sure that patient is set up for success in taking the medication.”
All these factors together add up to personalizing medications and offering innovative medications for Winship’s patients—and ensuring their best possible outcomes.
About Winship Cancer Institute of Emory University
Winship Cancer Institute of Emory University is Georgia’s only National Cancer Institute-designated Comprehensive Cancer Center, a prestigious distinction given only to the top 3% of cancer centers nationwide for conducting cancer research and providing training that is transforming cancer care, prevention, detection and survivorship. Winship discovers, develops, delivers and teaches some of the world’s most effective ways to prevent, detect, diagnose and treat each patient’s unique cancer. Cancer care at Winship includes specialists with deep expertise and experience in cancer; multidisciplinary evaluation, treatment planning and care coordination that caters to each patient’s individual needs; therapies supported by the latest advances in cancer research; and comprehensive support services.