Pharmacist Interventions in The US Oncology Network Cut Cancer Care Costs by Nearly $9 Million

Key Clinical Summary

• Pharmacist-driven initiatives within The US Oncology Network reduced total cost of care (TCOC) by nearly $9 million.
• The study analyzed more than 5600 patients participating in the Centers for Medicare & Medicaid Services’ (CMS) Enhancing Oncology Model (EOM).
• Cost-saving measures included pembrolizumab dose banding, biosimilar interchange, and preferred use of zoledronic acid.

An analysis from The US Oncology Network demonstrates the significant financial impact of pharmacist-led medication initiatives within the EOM. Across 5 practices and more than 5600 patients, these targeted interventions reduced total cancer care costs by nearly $9 million between July 2023 and December 2024.

Study Findings

The study evaluated the role of ClinicalReview pharmacists (CRPs) in implementing medication optimization strategies under the EOM, a two-sided risk-based payment model designed to enhance cancer care quality while reducing spending.

Seven CRPs working across 5 EOM-participating practices reviewed treatment orders for over 5600 patients. They identified 1271 potential cost-saving interventions, with 1180 accepted by oncologists. These changes produced a total TCOC reduction of $8 982 235.

Key initiatives included monoclonal antibody (moAB) dose rounding, pembrolizumab dose banding, therapeutic interchange to preferred biosimilars, use of a preferred PD-1 agent in metastatic non–small cell lung cancer (NSCLC), limiting use of long-acting growth factors in metastatic settings, and prioritizing zoledronic acid.

Beyond the 6 predefined initiatives, CRPs generated an additional $1 201 326 in medication savings through optimized drug selection. Within the Network—representing roughly half of all EOM providers nationwide—drug costs accounted for an average of 63% of total care expenditures, underscoring the economic relevance of pharmacist-driven review.

Clinical Implications

These findings illustrate how pharmacist-led medication management can support the financial viability of value-based oncology care. By addressing drug utilization—the largest single driver of oncology costs—CRPs play a pivotal role in helping practices achieve EOM performance goals and improve patient affordability.

The success of pembrolizumab dose banding and preference for zoledronic acid as cost-saving strategies may serve as a model for other health systems navigating CMS payment reform. Moreover, consistent implementation across multiple practices suggests scalability of pharmacist interventions within large oncology networks.

Conclusion

Pharmacist-driven medication initiatives within The US Oncology Network’s EOM participation led to substantial cost reductions, highlighting their potential to advance the goals of value-based cancer care. As the national cost of cancer treatment is projected to surpass $245 billion by 2030, pharmacist engagement offers a practical path to sustaining high-quality, affordable oncology care.

Reference

Kendzierski D, Basilio A, Cantley M, Roman A, Keisler M, Hough S. Remote clinical pharmacist impact on reducing total cost of care in Enhancing Oncology Model–enrolled oncology practices. Presented at: 2025 ASCO Annual Meeting; May 30-June 3, 2025; Chicago, IL.