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01 · ABSTRACT

Abstract

As cancer treatments become more complex and costly, traditional reimbursement models that reward volume rather than value create significant challenges for patients, providers, and health systems. In response, alternative payment models have emerged to better align financial incentives with quality care, affordability, and outcomes. However, their adoption in oncology remains uneven, especially for innovative therapies such as gene-based treatments and immunotherapies. This systematic review examines two questions: (1) What is the current status of oncology-focused alternative payment models in the United States? and (2) How do these models influence patient access to novel treatments? A structured literature review was conducted using three major databases and guided by a five-dimensional access framework that includes availability, accessibility, accommodation, affordability, and acceptability. Forty eligible studies were thematically analyzed. The results identified four dominant themes: clinical pathways, value-based care, quality measurement, and barriers to implementation. While models such as the Oncology Care Model and the Enhancing Oncology Model show promise in improving coordination and lowering costs, they often fall short in addressing access gaps, particularly in underserved communities. This review offers a new stakeholder-informed process model and highlights the need for proactive planning, standardized metrics, and cross-sector collaboration to ensure that future models are equitable, scalable, and capable of supporting continued innovation in oncology care.

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02 · PUBLICATION RECORD

Article details

JournalMedical Research Archives
IssueVol 13 No 10 (2025): Vol.13, Issue 10, October 2025
SectionReview Articles
Published28 October 2025
DOI10.18103/mra.v13i10.7000
ISSN2375-1924
03 · RIGHTS & REUSE

Rights & reuse

This article is published under a Creative Commons Attribution License (CC BY 3.0) and may be shared or distributed by anyone as long as attribution is given to the journal.

Authors & affiliations

RS

Rayan K. Salih, PharmD

Rutgers University, Ernest Mario School of Pharmacy (New Brunswick, NJ) ; Rutgers Institute for Pharmaceutical Industry Fellowships, Rutgers, the State University of New Jersey (Piscataway, NJ)

RJ

Reyna Jash, PharmD, MBA

Rutgers University, Ernest Mario School of Pharmacy (New Brunswick, NJ) ; Rutgers Institute for Pharmaceutical Industry Fellowships, Rutgers, the State University of New Jersey (Piscataway, NJ)

DP

Dhaval Patel, PharmD

Rutgers University, Ernest Mario School of Pharmacy (New Brunswick, NJ) ; Rutgers Institute for Pharmaceutical Industry Fellowships, Rutgers, the State University of New Jersey (Piscataway, NJ)

EW

Emily Wong, PharmD, MBA

Rutgers University, Ernest Mario School of Pharmacy (New Brunswick, NJ) ; Rutgers Institute for Pharmaceutical Industry Fellowships, Rutgers, the State University of New Jersey (Piscataway, NJ)

VQ

Vanessa Quintero, PharmD

Rutgers University, Ernest Mario School of Pharmacy (New Brunswick, NJ) ; Rutgers Institute for Pharmaceutical Industry Fellowships, Rutgers, the State University of New Jersey (Piscataway, NJ)

TJ

Tim Jurasik, PharmD

Rutgers University, Ernest Mario School of Pharmacy (New Brunswick, NJ) ; Rutgers Institute for Pharmaceutical Industry Fellowships, Rutgers, the State University of New Jersey (Piscataway, NJ)

JY

John M. York, PharmD, MBA, PhD

Rutgers University, Ernest Mario School of Pharmacy (New Brunswick, NJ) ;  Institute of Global Entrepreneur and Rady School of Management, University of California, San Diego (San Diego, CA) ;  Rutgers Institute for Pharmaceutical Industry Fellowships, Rutgers, the State University of New Jersey (Piscataway, NJ)

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