Model Validates Cost Savings With Cannabis in Mitigating Symptoms for Patients With Cancer

Brooke Worster, MD, MS, FACP

A health care cost impacts model was created by EO Care to shed light on the costs of care when cannabis and cannabinoid-based treatments are used to mitigate symptoms resulting from cancer treatments, according to Blake Zenger, MBA, and Brooke Worster, MD, MS, FACP.

EO Care offers a digital health platform to give affordable, clinician-created guidance for cannabinoid-based treatments. To estimate the cost impacts of evidence-based clinically guided cannabinoids to alleviate symptoms of cancer as well as chronic pain, sleep disorders/insomnia, and anxiety, EO Care created a model that was reviewed by Milliman. Milliman deemed the cost impacts model reasonable in the estimation of the theoretical health care cost impacts of using evidence-based, clinically guided cannabinoids to mitigate symptoms of cancer.¹

“[EO Care] wants to give patients a very specific product in a specific dose [with] a way to take it that is a safe starting point,” Worster said in an interview with OncLive^®. “That’s what patients are looking for. They hear the generic [guidance of], ‘go to the dispensary or ask about this’ and that is still incredibly confusing. The uniqueness of EO Care is trying to give real-world guidance to people in real time.”

As the reclassification of cannabis from a Schedule I to Schedule III drug pends,² the model may be even more relevant, and Milliman recommended that once adequate data become available, an observational case-control matched study of EO Care’s intervention be conducted.¹

“It’s important to understand that the model that’s being addressed by the Milliman report is intended for employers and payers. From the perspective of an oncologist, they need to know that there is evidence from the data that shows there are cost savings associated with the appropriate clinically guided administration of cannabinoids,” Zenger said. “When they are using these EO Care services, they’re not adding to the cost of care for the patients.”

Zenger, a strategic advisor to EO Care and former CIO of Equity Healthcare, was joined by Brooke Worster of Jefferson Health in the interview. Worster is an associate professor of medicine, division director of Supportive Oncology, chief medical officer at EO Care, and director of the Cannabis Medicine, Science and Business Master’s Program, Institute of Emerging Health Professions, all at Jefferson Health in Philadelphia, Pennsylvania.

In the interview, Zenger and Worster dove into the report and what oncologists should know about the administration of cannabis to mitigate symptoms resulting from cancer treatment.

OncLive: What unique services does EO Care offer to patients with cancer?

Worster: The biggest issue with cannabis use is that there is not any real connectivity to health care in general. Patients will want to use cannabis for all kinds of things [whether they have] cancer or not and they may or may not feel comfortable talking to their physician about it. The physician may be open to it—most of them are—but they don’t have a lot of data on how to guide people. The reality is the science is behind what is happening in the real world.

What is so unique about EO that, to my knowledge doesn’t exist anywhere else, is that [they] help give very specific guidance to patients using the data that are out there with a focus on minimizing any risks. [This entails] understanding what other medications patients are on, what they’re looking for, want to avoid, [and] other health problems they have, and [recognizing] there are products on the marketplace that are very potent that can cause a significant burden of adverse effects.

What were the key takeaways from Milliman’s review of the theoretical cost impact model methodology for cannabinoid-based treatment?

Zenger: We created an economic model and had Milliman review it [because] one of the groups that EO care is approaching with these solutions are employers and health plans—payers. Even though from our perspective, the services that are provided by EO care are the right thing to do independent of the cost of them, employers and payers often need confirmation that [they do] not add to their costs. Especially based on what’s happening with health care costs in general, putting in a new program [where payers] are being approached by 50 different point solutions every year about what [they] should put in this year and what [they] shouldn’t [is difficult].

One of the barriers to entry for any of [the programs] is [the question,] ‘Is this going to cost us more money or save us money?’ The economic model was about a couple of things—the research that’s been done is somewhat limited because of the Schedule I status of cannabinoids and cannabis. We wanted to create an economic model based on the best literature that we could find. From the literature we looked at prevalence rates for cancer and chronic pain, the efficacy rates of treating these conditions with cannabis, and a number of different factors.

We also wanted to make sure that there was an independent review of the methodology. A lot of those 50 vendors who are approaching employers will make claims such as ‘We can save you 25% on your health care costs,’ which is ridiculous. We wanted this to be reasonable, conservative, documentable, and defensible. [Therefore,] we had Milliman, which is a very reputable independent organization, do the review. They came back with a very clear statement [that] the model was a reasonable approach for measuring the impact of cannabinoids on lowering health care costs, which is what we were hoping for.

What would you like fellow oncologists to know about the EO Care model reviewed by Milliman?

Worster: This is geared more towards employers and payers in that space, but what is important for oncologists to understand is that cannabis can be helpful to reduce symptom burden in patients with cancer who are receiving active treatment [and] keep them on track for cancer treatment. It’s not going to [cure] the cancer or make a patient feel ‘all better,’ but if we can keep patients out of the emergency department [ED] and hospital because their nausea, vomiting, or pain is better controlled, that’s a good thing. That’s where this report dovetails into what is important to oncologists, in terms of how we can avoid those outcomes that [everyone] in medicine wants to avoid.

Zenger: Perhaps the most prevalent reason patients are readmitted to the hospital is because of dehydration during cancer treatment. When patients are being treated for cancer, those symptoms can be minimized [when cannabis is used in a proper way], which keeps one of those readmissions from happening. It’s the same thing for the ED—there are other reasons why patients are going to the ED, but one of the reasons that patients go is because they’re dehydrated during treatment. This is a way of better managing those symptoms.

References

1. Independent review of EO Care’s model for quantifying theoretical healthcare cost impacts in the United States. Milliman Report. Published May 2024. Accessed July 30, 2024. https://www.milliman.com/-/media/milliman/pdfs/2024-articles/5-10-24_independent-review-of-eo-cares-model.ashx
2. Kessler CD, Bleifer CB, Babin R, Daly T. Cannabis in 2024: HHS rescheduling recommendation and SAFER banking. Akin. February 23, 2024. Accessed July 30, 2024. https://www.akingump.com/en/insights/alerts/cannabis-in-2024-hhs-rescheduling-recommendation-and-safer-banking