The pilot also reduced cancer drug costs by 20% compared to UnitedHealthcare's cancer drug costs nationally, and all treatments were evidence-based and in alignment with the recommendations of the nation's leading cancer centres.
This tool incorporates real-time guidelines from the National Comprehensive Cancer Network (NCCN) into the oncologists' decision-making process.
The online program showed physicians all available NCCN-recommended options during the request; choosing any one of these options resulted in an immediate approval. NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) are trusted by health care professionals around the world to help them determine the best way to treat cancer patients.
UnitedHealthcare automatically approves coverage for all regimens that align with NCCN Guidelines. The online tool was developed by eviCore healthcare, which manages UnitedHealthcare's injectable chemotherapy programme.
Details of the study, "Transforming Prior Authorization to Decision Support," were published Oct. 18 in the peer-reviewed publication, Journal of Oncology Practice. The article was co-authored by Dr. Newcomer; Robert W. Carlson, M.D., CEO of NCCN; and Richard Weininger, M.D., senior strategic advisor and former chief medical officer of eviCore healthcare.
The programme will help advance cancer research and patient care by contributing to a database that will enable UnitedHealthcare to identify top-performing regimens by cancer type. The company plans to publish comparative results late next year.
This online programme was piloted by all medical oncology practices in Florida that are part of UnitedHealthcare's care provider network. The pilot was conducted over one year, from June 2014 to June 2015.
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