Empowering the Front Lines: How NPs Are Shaping Oncology Care

Synopsis 

1. Nurse Practitioners (NPs) Play a Central Role in Oncology Care from initial diagnosis to treatment planning and patient education. They are often the first point of contact for newly diagnosed patients and are responsible for ordering and managing therapies. 

4. Access Barriers Remain a Major Challenge and administrative hurdles like prior authorizations delay treatment and increase provider burden. Pharma companies can help NPs and patients by offering interim access solutions and collaborating on streamlined support programs. 

Andrew Burkus, IQVIA Digital: Donna, thank you so much for taking the time to speak with us today. At IQVIA Digital, our mission is to improve patient outcomes as we collaborate with healthcare stakeholders to ensure that messaging is timely, relevant, and impactful.  

As part of our efforts, we are focused on how data and technology are transforming engagement with healthcare professionals. A key theme is personalization—ensuring that pharma outreach is aligned with the needs and preferences of healthcare professionals.  

To truly understand how effective these efforts are, it’s important to hear directly from those on the front lines of patient care—like yourself— as you represent the very audience we aim to support through these innovations. 

We’re grateful for your perspective and excited to learn from your experience. To start, could you please introduce yourself and share a bit about your role at Mount Sinai Health System? 

Donna Catamero, Mount Sinai Health System: I'm currently the Associate Director of the Multiple Myeloma Research program at Mount Sinai Hospital where I oversee clinical trial portfolio and our clinical research staff.  

I am a nurse practitioner by training. I've been with Mount Sinai for almost 15 years. I did take a two-year sabbatical where I worked for Celgene in Medical Affairs, working on the CAR-T launch in Multiple Myeloma.  

But I returned to both the academic and the clinical setting. As an NP, I work with 10 oncologists in our program and I'm part of the care team. We participate in huddles, we discuss treatment plans and decide the best practices for our patients.  

Burkus: Thanks for that great overview. To set the stage for our audience: In oncology, nurse practitioners (NPs) and physician assistants (PAs) play a pivotal role in patient care, including prescribing responsibilities. A recent study found that 44% of NPs and PAs are authorized to prescribe chemotherapy, while nearly all—98%—can prescribe both intravenous and oral medicationsⁱ . With the NP workforce projected to increase by more than 40% over the next decade, it's clear that these clinicians will continue to be essential in delivering high-quality care to individuals living with cancerⁱⁱ .

Does this breakdown of treatment decisions reflect your experience at Mount Sinai? How involved are you and your colleagues in clinical decision-making, particularly at the point of diagnosis and when selecting treatment options? 

Catamero: This absolutely aligns with what's going on not only in my practice, but across our health system. NPs and PAs are typically responsible for ordering all care treatments, including chemotherapy. In fact, you will have some physicians admit that they don't even know how to enter a treatment order. So, they will rely heavily on their NPs.  

As I mentioned in my introduction, we huddle every morning to discuss potential treatment options for the patients that we're going to be seeing for the day.  We have a vital role in these huddles, and we often bounce ideas off of the physicians and the care team for treatment planning.  

So, I can say absolutely- our voices are heard when we're discussing patient care. And our involvement really starts beginning as we are often the first clinicians a patient will meet as a new patient. And we follow patients throughout their treatment journey: we're doing most of the patient education on disease state, on treatment management, including side effects and how their treatment is given.  

We are really involved with the day to day and bringing the treatments to the patient.  

Burkus: That’s a great point, and it aligns with recent insights we’ve seen. Qualitative research shows that NPs and PAs spend over 50% of their time on direct patient careⁱⁱⁱ . In contrast, studies show that physicians often spend significantly less time in direct patient interaction—with some specialties reporting as little as 15% of their workday dedicated to patient-facing activities^iv. 

This reinforces the critical role you and your peers play—not only in care delivery but also as key consumers of the content and resources our industry provides. You're often the ones facing the challenges we aim to address through our communications and support tools. 

With that in mind, how do you prefer to receive updates from healthcare brands—especially when it comes to new therapies or clinical information? And specifically in the digital space, what makes an interaction meaningful and useful to you as you seek information to support patient care and decision-making? 

Catamero: Speaking for myself, I like to obtain my information live either in a conference or walking along the exhibit hall and asking questions directly to industry leaders.  

I also do a lot of research on my own through articles and, speaking for myself and my colleagues, it has been more challenging to attend these conferences as funding from employers has been limited. Nurses often must self-fund to attend conferences to stay up to date.  

Digital information can sometimes be challenging, especially if it's email communications as these things can get buried in our inboxes.  

Burkus: That’s very helpful—thank you. You touched on something important: the unique needs of NPs and PAs when it comes to accessing relevant information. 

Over the past few years, I’ve noticed a gradual but meaningful shift in how promotional budgets are being allocated—more content and tools are now being tailored specifically for advanced practice providers (APPs). It feels like a necessary and long-overdue evolution. 

From your perspective, have you seen this shift reflected in your interactions with pharma brands? Are you receiving content or resources that truly support your role and help you work more efficiently? And ultimately, do you feel these efforts are contributing to better patient outcomes in your practice? 

Catamero: Yes, so my take home message is for you when engaging with APPs: our needs are going to be similar to physicians. We need to understand the mechanism of action, the efficacy, the safety. Please don't dumb it down for us.  Again, we are the ones putting in these orders and getting the treatments to the patients, so we need that same information.  

I also think what we need to know as APPs specifically is more information catered towards us for patient support programs to help with our patients because we are the ones supporting them through this process.  

Burkus: Let’s shift focus to the evolving landscape of medical science—and how that evolution shapes brand engagement with healthcare professionals. 

In oncology, 10 first-in-class therapies were approved last year alone^v. While these innovations offer new hope, they also add complexity to clinical decision-making, especially as treatments become more specialized. This underscores the growing need for clear, accessible educational resources for both providers and patients. 

At the same time, brands face challenges: smaller patient populations, narrower provider audiences, and significant access barriers. In fact, over half of new-to-brand prescriptions in 2022–2023 were initially rejected, and fewer than 30% of patients remained on therapy after 12 months^vi.  As precision medicine advances, equally precise support is needed to help patients and providers navigate these hurdles to getting and remaining on therapy.  

From your perspective, are you seeing more delays between prescribing and treatment initiation? What tools or resources have been most effective in overcoming these barriers—and where could the industry do more to support your team and your patients? 

Catamero: I think prior authorizations have been the most challenging to getting the treatments to the patient and this puts a lot of administrative burden on the APPs to complete the prior authorization process. This often leads to treatment delays, which we know can affect patient outcome and cause patients a lot of anxiety.  

There have been several studies that show that just the prior authorization process alone can delay patients up to several weeks to get what is deemed to be the best care options even as patients will fit the FDA guidelines for approval.  

But we are still facing these hurdles, and I think you can ask any Oncology APP and they would tell you that it is a challenge to get these authorizations, and, in my institution, we often do see delays in treatment because of access challenges.  

As I think about patient assistant programs, one program that I recall allowed us to get the first round of treatment to the patient while we are working on authorization. Otherwise, we still see delays in getting many therapies to our patients- we have seen great outcomes, yet we cannot get these drugs to our patients.  

What I would ask from our industry partners is some type of greater collaboration where we can get drugs to the patient faster through assistant programs or supplying the first month of therapy while we work out authorization hurdles for eligible patients.  

Burkus: Thank you for sharing that perspective—it really underscores the emotional and logistical challenges patients face after a cancer diagnosis. Knowing there is a treatment available, yet being delayed by paperwork and administrative hurdles must be incredibly frustrating—for both patients and providers like yourself. 

Your insights today have been invaluable. As NPs and PAs, you are on the front lines of care, especially in complex fields like Oncology. This conversation helps us at IQVIA Digital and our clients to better understand how we can support you through more meaningful collaboration. 

As we wrap up, I would love to hear any concluding thoughts or key takeaways you would like to leave with our audience. And again, thank you so much for your time and for the important work you do every day. 

Catamero: Of course. And again, my take home message is your APPs are the ones ordering the therapies, educating your patients. And we need to be educated too but we often get overlooked. Provide us with platforms where we can access the information we need and direct us to where we can easily find this information.  

Conclusion
As the healthcare landscape continues to evolve, the role of nurse practitioners and physician assistants in oncology and many therapeutic areas is more critical than ever. Their deep involvement in patient care, treatment planning, and therapy management positions them as essential partners in driving better outcomes for patients. To truly support these frontline providers, healthcare brands must deliver clinically relevant, easily accessible information and collaborate on solutions that reduce barriers to care. By recognizing and responding to the unique needs of NPs and PAs, the industry can foster stronger partnerships and ultimately improve the provider experience as they work tirelessly in support of their patients. 

References
i Oncology Advanced Practice Providers Chemotherapeutic Prescribing Practices | Blood | American Society of Hematology.  November 2021. 
ii Nurse Anesthetists, Nurse Midwives, and Nurse Practitioners : Occupational Outlook Handbook: : U.S. Bureau of Labor Statistics. Accessed May 2025 
iii https://www.thenursingbeat.com/articles/pas-and-nps-spend-much-less-time-with-patients-than-they-want-heres-why 
iv https://jamanetwork.com/journals/jama/fullarticle/2809190.  September 2023 
v IQVIA Institute for Human Data Science. Global Trends in R&D 2025: Progress in recapturing momentum in biopharma innovation. March 2025. Available from www.iqviainstitute.org  
vi IQVIA Institute for Human Data Science. Understanding the Use of Medicines in the U.S. 2025: Evolving Standards of Care, Patient Access, and Spending. April 2025. Available from www.iqviainstitute.org