Oral Adherence and Access in Long-Term Targeted Therapy

Panelists discuss a case-based scenario involving a man in his seventies with an excellent, durable response to single-agent osimertinib for more than two years, managed in a community clinic, who has chronic low-grade dermatologic toxicity and fatigue, quietly skips doses when his rash flares, and says he is tired of taking pills. Panelists describe adherence support without an infusion visit to anchor contact, including early check-in calls after teaching, scheduled weekly calls for reluctant patients, caregiver permission and involvement, alarms and pill diaries, home nursing for medication teaching, and social work to uncover what lies behind nonadherence. The conversation reinforces treating the rash rather than stopping therapy. Panelists then address specialty pharmacy coordination, prior authorization, copay assistance and manufacturer programs, and the reality that community and rural practices often lack this infrastructure, along with keeping patients informed while coverage is pending.