To promote the use of lower-cost generic chemotherapy drugs, Calabria says HAP has worked to increase—not decrease—the provider reimbursement for generic oncology drugs. Cutting reimbursements would be a "disincentive" for physicians to use generics, according to Calabria.
"This isn't a utilization management program," he explains. "We don't want to discourage generic usage by not reimbursing correctly."
Calabria acknowledges that oncology cost and treatment management is a "new frontier. It's emotional." Among the hoped-for outcomes of the program is that the pathways provide physicians and patients with the clinical support they need to feel more comfortable with getting ready for end-of-life care. "At some point we need to stop treatment when there's no support for it anymore."
Calabria expects the HAP program to get underway later this year.