As cancer care becomes increasingly driven by complex, high-cost therapies, health systems are rethinking how tightly oncology and pharmacy are integrated.
At Mount Sinai Medical Center in Miami Beach, Fla., leadership sees pharmacy not as a downstream support function but as a core pillar of its oncology growth strategy — particularly as it prepares to expand services through its new Braman Comprehensive Cancer Center.
According to Mount Sinai Medical Center President and CEO Gino Santorio, pharmacy was embedded early in the cancer center’s planning because medication access has become inseparable from high-quality oncology care.
“Cancer treatment is increasingly complex and medication-driven,” he said. “It’s essential to build a model that supports timely access to new therapies and helps manage high-cost medications.”
Integrating specialty pharmacy from the outset, he added, reduces administrative burden on oncologists and helps remove barriers that can delay treatment starts.
Another immediate impact of closer pharmacy-oncology alignment is faster access to treatment.
Mr. Santorio said tighter coordination allows teams to address common delays — including benefits verification, prior authorizations and financial assistance — earlier in the process, helping patients begin therapy on more predictable timelines.
“Closer alignment allows us to move faster on the practical barriers that often delay treatment,” he said, highlighting fewer handoffs and more parallel workflows across prescribing, authorization and dispensing.
Historically, fragmented processes between those functions created friction and unnecessary delays. Under the cancer center’s new model, those steps are more tightly integrated, reducing bottlenecks and creating a smoother path from treatment decision to treatment initiation.
For Steven Hochwald, MD, chief of surgical oncology and director of the Braman Comprehensive Cancer Center, closer collaboration between oncology and pharmacy strengthens education, side effect management and adherence support, helping patients feel more guided throughout their care journey.
From a clinical standpoint, pharmacy involvement allows care teams to respond more quickly to how patients tolerate therapy, adjusting regimens when needed while keeping care coordinated across disciplines.
Pharmacy also plays a key role behind the scenes, Dr. Hochwald said, ensuring medications are available on time, prepared accurately and delivered safely — all of which supports consistent treatment scheduling and throughput.
Beyond access and experience, Dr. Hochwald said pharmacy helps support growth by enabling the safe delivery of increasingly advanced therapies while improving throughput across infusion and treatment services. Embedded oncology pharmacists round with medical teams, manage toxicities, monitor drug interactions and help evaluate biosimilars and other cost-effective alternatives that maintain quality while improving sustainability.
Mr. Santorio added that many health systems underestimate pharmacy’s influence on patient experience and long-term oncology performance.
Early pharmacy engagement, he noted, informs broader strategic decisions — including service-line expansion, provider recruitment and financial planning tied to emerging drug pipelines.
“Pharmacy leaders bring essential insight into the specialty drug landscape and emerging treatment pipelines,” he said.
As oncology volumes continue to rise, Mount Sinai has focused on building a pharmacy model designed to scale alongside demand. Mr. Santorio said this includes embedding pharmacists within multidisciplinary care teams, leveraging the health system’s EMR to streamline workflows, and developing standardized clinical pathways that support efficiency and consistency.
Dr. Hochwald said the model also helps manage complexity at scale by standardizing how new therapies are evaluated, initiated and monitored — while still tailoring care to individual patients. Risk stratification, multidisciplinary review of new treatments and barrier removal all play a role in maintaining quality as volumes grow.
As the Braman Comprehensive Cancer Center prepares to open, Mount Sinai leaders said they will closely track how effectively pharmacy and oncology are working together in practice.
Key measures include how quickly patients start treatment, patient satisfaction, coordination between infusion and pharmacy teams, and how responsibly high-cost therapies are being utilized.
Dr. Hochwald said the goal is to ensure expansion does not come at the expense of safety, experience or financial sustainability.
Both leaders emphasized that oncology-pharmacy alignment should be treated as a strategic priority.
Dr. Hochwald said strong results depend on aligned leadership across departments and a growth-oriented model built from the outset, rather than retrofitted once volumes increase.
Mr. Santorio added that pharmacists remain an underutilized asset in cancer care, particularly in patient education, adherence support, medication safety and side effect management — areas that can meaningfully improve outcomes and reduce preventable complications.
“Do not underestimate the value pharmacists bring to the patient experience,” Dr. Hochwald said, noting that the human side of medication support often plays a major role in how patients experience cancer care.
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