Bedside to Bench: The Many Ways of Being a Nurse | Health Sciences

Bridging the Gap: Ensuring Equitable Access to Oral Anticancer Medications

Dr. Sarah Belcher, an assistant professor at the university of Pittsburgh School of Nursing and school of Medicine, dedicates her career to improving the lives of cancer patients. Driven by a passion for addressing the complexities of medication adherence, Belcher has transitioned from bedside nursing to research, aiming to unravel the challenges patients face when taking oral anticancer medications.

belcher’s journey began with her clinical doctorate at the University of Pittsburgh. While initially aiming for a career as a clinical nurse specialist, a conversation with a mentor sparked a realization: her inquisitive nature and problem-solving skills were better suited for research.”she said, ‘You know you’re a scientist, right?'” Belcher recalls. “She identified in me that inquisitive nature of a scientist and that way of thinking about problems and wanting to understand how things work,” she shares.

Finding her niche within the School of nursing’s vibrant research community, Belcher honed her expertise and focused her research on mitigating barriers to accessing oral anticancer medications. Her experience as an oncology nurse deeply informs her understanding of the unique challenges patients face.

Belcher’s latest research, to be presented on February 21st as part of the 2025 series of Senior Vice Chancellor Research Seminars, delves into the specific difficulties patients encounter when taking oral anticancer medications. While these medications offer convenience compared to intravenous treatments, a multitude of obstacles exist.Financial constraints, insurance requirements, and side effects can all contribute to difficulties in adhering to medication regimens.

“the initial study told us that we’ve got a group of patients that, for reasons that we’re still trying to understand, are struggling [with adherence]. But, they know how significant these pills are. They want to be taking them,” Belcher explains. “We want to know if and how cancer medication adherence differs from other chronic illnesses and what special things need to be considered as we think toward interventions to support, in an equitable way, the patients who are taking them,” she adds.

Belcher’s commitment to interdisciplinary collaboration is evident in her involvement with various centers and programs at the University of Pittsburgh, including the UPMC Hillman Cancer Centre’s Biobehavioral Cancer Control Program, the school of Medicine’s Palliative Research Center, and the Center for pharmaceutical Policy and Prescribing. This collaborative approach allows Belcher to gather diverse perspectives and expertise, ultimately benefiting patients.

While Belcher’s current role doesn’t involve direct patient care, her foundation as a clinical oncology nurse remains central to her research. “I have patients’ faces that come to mind when I design studies,” she shares.”I think about this person or that person and things that were realy influential in terms of how outcomes might have been different based on barriers that they faced during their cancer care. It matters to me that I’m doing this work in a way that’s meaningful to people.” This patient-centered approach ensures that her findings have a tangible impact on improving the lives of those facing cancer.

What is the Impact of State Parity Laws on Patient Access to Oral Anticancer Medications?

archyde interviews Dr.sarah Belcher, Assistant Professor of Health and Community Systems at the University of Pittsburgh School of Nursing and school of Medicine.

Archyde (A): Good day, Dr. Belcher. Thank you for joining us today. Your work focuses on improving patient outcomes in oncology care, notably in the area of medication adherence.

Bridging the gap: Oral Anticancer Drugs and Access in Oncology

The landscape of cancer treatment has dramatically shifted in recent years,with oral anticancer medications becoming increasingly prevalent. While these medications offer numerous advantages for patients, such as convenience and improved quality of life, access remains a significant concern.Dr. Sarah Belcher, a leading expert in oncology care, sheds light on the challenges surrounding oral drug access and the crucial role of state parity laws in ensuring equitable treatment.

“The way benefits are structured in many health plans frequently enough creates an inequitable situation,” explains Dr. Belcher, “Pharmacy benefits, which frequently enough dictate coverage for oral drugs, frequently require higher out-of-pocket expenses for patients compared to medical benefits covering infused or injected therapies.” This disparity can considerably impact affordability and, ultimately, patient adherence to vital medications.

fortunately, a growing number of states have implemented parity laws aimed at addressing this disparity. These laws strive to ensure that insurance companies offer equal cost-sharing for both oral and infused anticancer medications, thereby promoting equity in access.Dr. Belcher, citing research published in JAMA Oncology, notes that these laws have shown promise in reducing out-of-pocket costs for some patients, but emphasizes the need for continued research to fully understand their long-term impact.

“Medication adherence is a critical factor in treatment success,” stresses Dr. Belcher,underscoring the multifaceted challenges that can impede adherence,including financial burdens,socioeconomic factors,psychological impacts,and clinical complexities. Her journey from bedside nursing to clinical and research pursuits stems from a deep-seated desire to understand these challenges and develop evidence-based solutions to improve patient outcomes.

For individuals navigating the complexities of cancer treatment, Dr. Belcher offers invaluable advice: “Be proactive and informed.Don’t hesitate to engage in open dialog with your healthcare team, asking questions and expressing concerns. Explore all available resources, including financial assistance programs, patient advocacy groups, and support services. Above all, stay informed about advancements in cancer care to make well-informed decisions about your treatment.”

Dr. Belcher’s dedication to improving cancer care shines through her tireless efforts in research and advocacy. Her insights provide a roadmap for patients and caregivers, empowering them to navigate challenging circumstances and strive for optimal treatment outcomes.

Bridging the Gap: Ensuring Equitable Access to Oral Anticancer Medications

Advances in cancer treatment have ushered in a new era of hope, with oral anticancer medications offering a less invasive and often more convenient alternative to customary therapies. however, despite these advancements, disparities in access to these life-saving medications persist, raising critical questions about equity and fairness in healthcare.

Accessibility challenges encompass a range of factors, including geographical location, socioeconomic status, and insurance coverage. Patients in underserved areas may face limited access to oncologists or pharmacies that carry these specialized drugs.Furthermore, the high cost of oral anticancer medications can create a significant financial burden for many patients, forcing them to choose between their health and other essential needs.

To bridge this gap and ensure equitable access, a multifaceted approach is required. Expanding access to affordable healthcare insurance is crucial, as is increasing the number of oncologists and healthcare providers in underserved areas.

Policy initiatives aimed at reducing the cost of these medications, such as drug price negotiation and increased openness, are also essential. furthermore, raising awareness about the importance of early detection and treatment can empower individuals to seek care sooner, potentially improving outcomes and reducing the long-term cost of care.

what specific challenges do patients face when taking oral anticancer medications?

Archyde (A): Dr. Belcher, thank you for taking the time to speak with us today. Coudl you start by briefly describing the current landscape of oral anticancer medications in the US?

Dr. Sarah Belcher (SB): Thank you for having me. The use of oral anticancer medications in the US has indeed expanded significantly in recent years,offering patients increased convenience and improved quality of life. However, this growth has also highlighted significant disparities in access and affordability for thes vital medications.

A: Your research focuses on medication adherence and access. What specific challenges do patients face when taking oral anticancer medications?

SB: Patients encounter a multitude of obstacles when it comes to adhering to thier oral anticancer medication regimens.Financial constraints are one of the most significant barriers. High out-of-pocket costs and varying insurance coverage for oral drugs compared to infused therapies can lead to patients skipping doses or stopping treatment altogether. Additionally, complex medication regimens, side effects, and lack of social support can also contribute to poor adherence.

A: It seems like state parity laws have been proposed to address these disparities in access. Could you explain what these laws entail and how they aim to improve patient access to oral anticancer medications?

SB: Absolutely. State parity laws aim to address the disparity between insurance coverage for oral and infused anticancer medications. Many health plans делегаты cover infused therapies under medical benefits, which generally have lower out-of-pocket expenses for patients. In contrast, oral drugs are often covered under pharmacy benefits, requiring patients to pay more. Parity laws strive to equalize cost-sharing for both types of medications,promoting more equitable access.

A: How effective have these laws been so far, and what more needs to be done?

SB: Research published in JAMA Oncology has shown that these parity laws have the potential to reduce out-of-pocket costs for some patients. However, the long-term impact is still not fully understood. We need continued research to assess the efficacy of these laws, identify potential gaps, and ensure that they are addressing the most pressing access issues for patients. Moreover, policy advocacy and collaboration among various stakeholders, including healthcare providers, patients, and policymakers, are crucial to enhancing the reach and impact of these laws.

A: You’ve mentioned the importance of interdisciplinary collaboration in your work. How does this approach benefit patients and improve cancer care?

SB: Interdisciplinary collaboration allows me to gather diverse perspectives and expertise, which ultimately enriches the quality and impact of my research. By working with centers and programs across the University of Pittsburgh, such as the UPMC Hillman Cancer Centre’s Biobehavioral Cancer Control Program and the Centre for Pharmaceutical Policy and Preserving, I can ensure that my findings have a tangible impact on improving cancer care and patient outcomes.This collaborative approach also fosters a more comprehensive understanding of the complex challenges faced by patients and helps in developing multifaceted solutions that address these issues effectively.

A: Thank you, dr. Belcher, for sharing your insights and passion for improving cancer care.Your work is truly making a difference in the lives of patients.

SB: Thank you for having me. It’s an honour to contribute to this vital field, and I’m committed to continuing my work to ensure that all patients have equitable access to the treatment they need.