On-Conversation with Jeff Patton, MD, Chief Executive Officer Tennessee Oncology, Chief Medical Officer, RainTree Oncology Services

With all the breakthroughs and advancements oral oncology drugs are offering to patients with cancer, community oncologists recognize there is a crucial link between the acquisition and management of the oral oncologics and the quality of care delivered to their patients. Through collaborative networking and customized assistance, group purchasing organizations, such as RainTree Oncology Services, are offering practices the opportunity to improve the overall revenue model within their pharmacies, enhance practice operational efficiencies, and identify promising new therapeutic strategies. We recently met with Jeff Patton, MD, one of the founders of RainTree Oncology Services, to gain his perspective on the dynamic growth of group purchasing organizations and to find out more about RainTree’s value proposition.

OBR: What are the benefits an oncology practice will have by contracting with RainTree?

JP: Well, we feel that by forging a unified oncology cooperative consisting of the nation’s foremost community oncology practices, that we are creating a dynamic framework for the future. We help practices by providing them with the most advanced therapies to their patients, and we ensure access to the leading insights and up-to-the-minute developments involving community oncology. Historically, patient compliance and adherence to prescriptions have been difficult to monitor. Today, about 35% to 40% of pipeline products are oral with more coming down the pike and only about 40% to 50% of those prescriptions get filled. Our fulfillment rate is over 90% so we offer a huge value proposition for practices.

OBR: How does your strategy work for those who have a retail pharmacy in their practice?

JP: We have three arms. First, we duplicate all the standard GPO services in the oral pharmacy that occur in the infusion suite. By that, I mean, we are building a vast purchasing network that leverages the buying power of premier oncology practices nationwide. As a result, our members can take advantage of improved oral drug acquisition prices in their pharmacies. We are also negotiating typical volume incentive and market share GPO contracts with pharmaceutical manufacturers.

Second, we have pharmacy turnkey services that can broaden a practice’s grasp of oral therapeutic economics and operational efficiencies. So, instead of losing scripts and sizable revenues to specialty pharmacies or drugstore chains, practices can retain these scripts onsite to generate a steady revenue stream. In essence, we help with practice set up, and then we assist in developing a best practices model that is then shared with other practices across the country.

Third, we have a managed care angle. We’re developing a suite of management tools that monitors, tracks, and analyzes complex sets of data related to utilization of oral oncology drugs in the community practice setting. This information can also be shared with other practices around the country and the practices can benchmark.

OBR: What about payers and managed care companies that have a requirement that oral cancer agents be distributed through their wholly owned specialty pharmacy?

JP: Our strategy with specialty pharmacy is to use the “any willing provider” laws in the 23 States that have those laws. In those States, our strategy is to teach physician groups that payers can suggest that the prescription be filled at their specialty pharmacy, but that it is illegal in those States for payers to not allow us to fill it if we meet the criteria that they set forth for a specialty pharmacy. We’re working with consultants to develop a strategy for the States that don’t have any willing provider laws. Once we collect data to show our improved outcomes for patients, it’s going to be hard for the payers to say no.

OBR: There are a lot of oral pipeline products, but many are being studied in niche indications. Can RainTree handle the GPO services for an oral drug that is projected to be low-volume?

JP: Absolutely. If you take 5 or 6 small volume orals, with their price tag per month, there is enough revenue for us to get involved. Even if a few small market drugs are only a “break even” proposition, we will carry and dispense them as a value added service to our patients.

OBR: Your initial focus seems to be on the GPO…

JP: Launch is very critical to the lifecycle of a product. We will have a preferred distributor that distributes the product, and we’ll be the GPO that lays on top of that. Obviously, if a manufacturer wants to do volume incentives or market share contracts, we would administer that contract, but those off-invoice discounts and rebates would go directly to the practice. That’s a big value added to the practice that RainTree can help deliver.

OBR: Please explain the RainTree competitive advantage?

JP: First, if you are one of my patients, do you want to get a call from a call center, or do you want to get a call from one of my nurses or my pharmacist? I don’t think anyone really thinks that nurses from call centers can deliver better care than the pharmacists and nurses located at the point of care in each practices oncology pharmacy. Second, intuitively, who will take better care of these patients: call center nurses with very little clinical information, or my pharmacy techs and pharmacists, who have access to electronic charts and know everything about that patient? Third, we stock drugs. We have them on our shelves so patients don’t have to go through an extended process of authorization and pharmacy visits—which in some cases the pharmacy doesn’t have the drug and it needs to be ordered—that only causes more delay in the patient getting their medication.

We also have adherence and compliance programs to help with prescription fulfillment and we teach practices how to improve their fulfillment rates. Improving capture rate is also one of the big values that we have for practices with a retail pharmacy. When most practices start their pharmacy, prescriptions are still walking out the door because they haven’t changed physicians’ behavior. The best practices we offer allow these practices to keep that revenue in-house and that’s the bottom line.

EDITOR’S NOTE: As many of you may know, AmerisourceBergen Corporation is suing RainTree Oncology Services. Dr. Patton is unable to comment on the litigation at this time.

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