CVS Health Launches New Approach to Oncology Management

CVS Health launched Transform Oncology Care, a program that includes a comprehensive, first-of-its-kind precision approach to oncology management for payers. It uses genomic testing results at the point-of-prescribing to help patients start on the best treatment, faster and in addition, matches eligible patients to clinical trials. Transform Oncology Care also uses CVS Health’s local footprint and unique assets to improve patient outcomes and lower overall costs at every point of the cancer care journey.

Transform Oncology Care includes an innovative precision medicine strategy that increases access to broad-panel gene sequencing tests for patients diagnosed with certain advanced stage cancers. In collaboration with Tempus, a technology company advancing precision medicine through the practical application of artificial intelligence in healthcare, test results will support oncologists as they work to identify the most precise, appropriate treatment regimen for their patients, ultimately helping to decrease progression and reduce unnecessary costs.

The program includes:

• Provider access to the latest National Comprehensive Cancer Network (NCCN) treatment and supportive guidelines provided by CVS Health, helping to provide broader access to the most up-to-date care guidelines in the ever-evolving cancer landscape. Therapeutic regimens that align to NCCN guidelines will automatically receive prior authorization approval, speeding time to the start of therapy for patients;

• Nurse-led care management integrated with payers’ existing programs, to create a more personalized experience for patients and their caregivers and close existing gaps in care;

• Improved local access to screenings and prevention services offered at CVS HealthHUBs, as well as CVS pharmacy and MinuteClinic locations; and

• Value-based contracting with oncology providers to bring greater economic alignment between providers and payers and ensure high quality care and lower costs.

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Under the new CVS Health program, the results from these genetic tests will also be used to match eligible patients to clinical trials. Aetna has adopted the new program for fully insured commercial populations––not Medicare patients at this time––and is rolling it out with participating Aetna provider networks in 12 states. The program will be available to all CVS Health plan clients.

“Timing in cancer care is everything, and when a patient does not get started on the right treatment it can result in progression and higher costs," says Alan Lotvin, MD, executive vice president and chief transformation ffficer, CVS Health. "We are the first company working to make the latest in precision medicine accessible to more patients and further empower informed treatment decision-making based on a patient's genetic profile to give them the best chance for successful treatment and improved quality of life."

Today, the majority of cancers when diagnosed early can be effectively managed, treated, or even cured. For patients diagnosed with late-stage cancers, however, many can benefit from advanced genomic testing, yet very few eligible patients receive this type of testing today. This can inhibit the start of the most appropriate treatment and result in cancer progression and higher costs. For these patients, a web-based provider portal, built into the e-prescribing work flow, informs oncologists of the availability of Tempus' broad-panel gene sequencing tests at diagnosis, which are more comprehensive than the single-gene tests that are used today. The broad-panel tests identify a patient's genomic variants and the therapeutic options specific to their molecular and clinical profile.

"CVS Health is making great strides in advancing patient care, and we are thrilled to contribute the benefits of genomic testing to these efforts," says Ryan Fukushima, chief operating officer of Tempus. "We believe this collaboration has real potential to personalize treatment for patients while also reducing the total cost of care."