Poster Presentation Joint 2016 COSA and ANZBCTG Annual Scientific Meeting

High-Cost Medications in Recurrent Glioblastoma Patients - Solving a Hospital Dilemma (#308)

Julie Adams 1 , Lorna Cook 1 , Zelda Haskins 1 , Anna Nowak 2 , Arman Hasani 2 , Anne Long 2
  1. chemo@home, West Perth, WA, Australia
  2. Medical Oncology, Sir Charles Gairdner Hospital, Nedlands, WA, Australia

Treatment options for recurrent glioblastoma are limited, with second line chemotherapy offering only modest benefit. Bevacizumab has shown promising results and is offered as a treatment option to this patient cohort. The cost of bevacizumab for recurrent glioblastoma is significant and not covered by the Pharmaceutical Benefits Scheme. Support for the cost of bevacizumab is offered through a pharmaceutical company funded program, private health insurance reimbursement and patient contributions. Within the public hospital sector in WA, health services cannot accept patient contributions towards high-cost medication charges, therefore SCGH sought a solution which would enable their recurrent glioblastoma patients to access treatment. A private hospital-substitute service (chemo@home) was engaged, allowing patients to be referred for bevacizumab infusions. Patients are treated at home by chemo@home registered nurses, with medication supply being obtained from a private pharmacy. Between July 2015 and July 2016 twenty-seven patients received 135 doses of bevacizumab at home. There were no episodes of anaphylaxis-hypersensitivity, no unexpected toxicities and no additional safety concerns identified. Of the 27 patients, 10 were uninsured and 17 had private health insurance. Uninsured patients self-funded both the home visit and the cost of the bevacizumab. Chemo@home applied for reimbursement for the bevacizumab for all eligible patients with private health insurance. All claims applied for by chemo@home were accepted, with the maximum reimbursement for high-cost medication being paid by the fund to the member. Medical oncologist satisfaction relating to the chemo@home referral process, patient treatment and feed-back to the specialist, was high. Patient satisfaction was also very high, with many patients and their families commenting that they valued not only having access to the high-cost medication but also having their treatment in a domiciliary setting with chemo@home which offered them a highly professional, compassionate option that made treatment less intimidating and confronting than the day-unit.