Practice Economics and the Decision to Prescribe Oral Oncolytics

OBJECTIVE: To better understand the impact of practice financial considerations in oncologists' decision to prescribe intravenous (IV) versus oral oncology agents. STUDY DESIGN: A survey of oncology practice managers was used to obtain quantitative and qualitative data on practice characteristics and treatment patterns. Treatment patterns were compared across types of practices to identify statistical patterns. METHODS: A web-based survey was administered to a convenience sample of 225 US-based oncology practice managers. Data were collected anonymously, but respondents were given the option to enter a drawing for a prize upon completion of the survey. Forty surveys were returned (17.8% response rate), and responses were analyzed for differences in practice patterns, particularly the frequency of using oral rather than equivalent IV formulations of oncolytics, across practice characteristics such as ownership structure and the inclusion of a dispensing pharmacy in the practice. RESULTS: Oncology practices that were willing to use oral oncolytics when an equivalent IV formulation was available were also more likely to have an onsite dispensing pharmacy and less likely to pay their doctors profit-based bonuses. They were not, however, less likely to be owned by physicians or to include physicians in profit-sharing programs. CONCLUSIONS: Our results are consistent with oncologists' considering the profit implications of their decisions to prescribe oral or IV formulations of oncolytic agents. As more oral agents are introduced, understanding this and other determinants of prescribing behavior will be increasingly important, and warrants further investigation.