The American Society of Clinical Oncology (ASCO) opposes payer-imposed utilization management policies that restrict patient access to high-quality, high-value cancer care. In a statement released today, ASCO asserts that in modern cancer care there is frequently a lack of interchangeable clinical options, and that optimal cancer care requires patient access to the most medically appropriate drug at the most opportune time based on the highest quality evidence. For this reason, according to ASCO, high-quality clinical pathways are payers’ best first option to ensure appropriate utilization of anti-cancer drugs and the delivery of high-quality, high-value care yielding optimal benefits and outcomes.

The American Society of Clinical Oncology Policy Statement on the Impact of Utilization Management Policies for Cancer Drug Therapies reviews current utilization management policies that public and private insurers use to control the use of anti-cancer drug therapies, including prior authorization requirements, restrictive formularies, step therapy (fail-first requirements), and specialty specific tiers. In the statement, ASCO also recommends ways to ensure these policies promote rather than hinder patient access to high-quality, high-value cancer care.

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