sample_data/HCP_Oncologist_Interview.txt

Interview Transcript - Oncologist #1
Date: October 20, 2025
Interviewee Type: HCP (Oncologist)
Location: Major Academic Medical Center
Years in Practice: 15 years

Interview Content:

Interviewer: Thank you for taking the time to speak with us today. Can you start by telling us about your current patient population?

HCP: Sure. I primarily see patients with advanced solid tumors, mostly lung cancer and breast cancer. I probably have about 150-200 active patients at any given time. The majority are on some form of systemic therapy.

Interviewer: When you're considering treatment options for a new patient, what factors influence your prescribing decisions?

HCP: It's really a combination of things. Obviously, the tumor type and stage are critical. But honestly, in 2024, prior authorization has become one of my biggest considerations. I hate to say it, but it's true. "By the time insurance approves some of these therapies, the patient's cancer has often progressed to the point where we need to consider more aggressive options." I've had patients wait 6-8 weeks for approval, and in oncology, that's an eternity.

Interviewer: Can you quantify how often prior authorization is an issue?

HCP: I'd say 8 out of 10 new prescriptions require prior auth. For novel therapies or anything off-label, it's basically 100%. The process is incredibly time-consuming for my staff too. We have two full-time people just managing prior auths.

Interviewer: How does this impact your treatment choices?

HCP: I'm embarrassed to admit this, but "sometimes I'll choose a therapy that I know will get approved faster, even if it's not my first choice clinically." For example, I had a patient last month who would have been perfect for Drug X based on her biomarkers, but I prescribed Drug Y instead because I know Drug Y gets approved in 3-5 days versus 4-6 weeks for Drug X.

Interviewer: Have you noticed any competitors handling this better?

HCP: Yes, actually. Company Z launched a bridge program about six months ago where they provide medication to patients during the prior auth process. It's been a game-changer. "I've switched at least 15 patients to their product line specifically because of this program." My patients can start therapy immediately, and there's no gap in care.

Interviewer: What about efficacy concerns? How do you evaluate if a treatment is working?

HCP: I typically do imaging at 6-8 weeks for solid tumors. If I'm not seeing at least stable disease or ideally some tumor shrinkage, I'll consider switching. But here's the problem - many patients don't make it to that first scan because of side effects or because they're still waiting for insurance approval to even start.

Interviewer: Tell me more about side effects and tolerability.

HCP: That's huge. Even if a drug is highly effective, if patients can't tolerate it, it doesn't matter. I've found that about 30-40% of my patients on newer immunotherapy combinations need dose reductions or delays due to immune-related adverse events. Fatigue, rash, and diarrhea are the most common issues I see. "The patients who do best are those who have really good support systems at home and can come in for frequent monitoring."

Interviewer: What would help you prescribe more confidently?

HCP: Three things immediately come to mind. First, streamline the prior authorization process - maybe a universal form or faster approvals for guideline-concordant care. Second, better patient assistance programs during that authorization window. And third, more real-world evidence about which patients are likely to respond. The clinical trial populations often don't reflect my actual patient population in terms of age, comorbidities, and performance status.

Interviewer: Any other thoughts?

HCP: Just that the landscape is changing so rapidly. Five years ago, I had maybe 5-6 treatment options for advanced lung cancer. Now I have 15-20, which is amazing for patients. But it's also overwhelming. I find myself relying heavily on tumor boards and colleagues for the more complex cases. The guidelines help, but they can't cover every scenario.