New research from Pragya Kakani, PhD, sheds light on how physician–pharmacy integration is shaping the cost and delivery of high-cost oral cancer treatments. Using national Medicare data and a stacked event study design across 204 oncology practices, the study evaluates what happens when physician groups launch in-house pharmacies, a model that has rapidly expanded across oncology.
The study finds that physician–pharmacy integration produces measurable improvements in both cost and access:
- 1.0% reduction in point-of-sale drug prices paid by plans at in-house pharmacies.
- 6.2% increase in patients successfully filling new prescriptions for high-cost oral cancer drugs.
- Faster treatment initiation, driven largely by shorter prior-authorization timelines.
- No evidence of harmful substitution toward higher-cost regimens or reduced use of low-cost therapies.
These results suggest that integration can generate operational efficiencies, streamline communication between clinical and pharmacy teams, and support patients during complex treatment initiation, especially when high-cost specialty medications are involved.
The study also shows that oncology practices with in-house pharmacies do not gain significant bargaining power over insurers or PBMs, which helps explain the observed price reductions.
As oncology continues shifting toward orally administered and ultra-expensive therapies, this research provides evidence that integrated dispensing models may help improve access, reduce delays, and support patients during the start of their treatment journey.
Read the full article here.
