Trends in Medically Integrated Dispensing Among Oncology Practices

Area of Science:

• Oncology
• Health Services Research
• Pharmacy Practice

Background:

• Medically integrated dispensing (MID), or in-office dispensing, in oncology practices is an emerging model.
• While potentially improving care coordination, concerns exist regarding overprescribing and inappropriate prescribing.
• Limited data exists on the prevalence and characteristics of this care model.

Purpose of the Study:

• To analyze historical trends in medically integrated dispensing (MID) within oncology practices.
• To understand the prevalence and evolution of MID from 2010 to 2019.
• To identify characteristics of oncologists and patients associated with MID.

Main Methods:

• Linked IQVIA oncologist data with National Council for Prescription Drug Programs pharmacy data (2010-2019).
• Analyzed data for commercially insured patients with common cancer types and Medicare billing summaries.
• Calculated national prevalence of MID and analyzed provider and patient characteristics.

Main Results:

• The percentage of oncologists in practices with MID increased from 12.8% to 32.1% between 2010-2019.
• Dispensing practices grew significantly for both community (7.6% to 28.3%) and hospital-based oncologists (18.3% to 33.4%).
• Dispensing oncologists had higher patient volumes, fewer Medicare beneficiaries, and treated patients with higher risk/comorbidity scores and from areas with higher Black populations.

Conclusions:

• Medically integrated dispensing has seen substantial growth in oncology practices over the last decade.
• The increasing adoption of MID necessitates ongoing evaluation of its reach, clinical impact, and economic implications.
• Further research is crucial to fully understand the consequences of this evolving care model.