OSEM™ Oncology Side Effect Management Value-Based Care Model
Preventing avoidable oncology spend before it becomes a claim.
OSEM™ by Reliefco, a division of un(cancer), helps health plans and pharma partners identify high-risk oncology patients early, intervene at home, and measure outcomes directly in claims data.
Cancer drug costs may be fixed. Side-effect costs are not.
For a 1M-member health plan, treatment-related side effects can drive ER visits, hospitalizations, opioid prescriptions, oral complications, and infection-related admissions. Much of that spend remains hidden across medical, pharmacy, and dental claims.
Estimated annual oncology side-effect burden in a 1M-member plan.
Estimated avoidable PMPM spend target.
Estimated high-risk mucositis patients annually.
Identify → Intervene → Monitor → Measure
A closed-loop platform that connects claims intelligence, home-based prevention, RN navigation, and actuarial measurement.
Identify
AI reads across medical, pharmacy, and dental claims to flag high-risk oncology members early.
Intervene
Preventive oral care kits and support products are delivered to the patient’s home before peak risk.
Monitor
RN check-ins and 24/7 triage help divert avoidable ER visits before complications escalate.
Measure
Outcomes are validated in the payer’s own claims data against a matched control cohort.
Most oncology support is reactive. OSEM™ is preventive.
Existing solutions often engage after symptoms have already escalated. OSEM™ is designed to reach patients before preventable side effects become high-cost claims.
Early intervention
Protocol activates before symptom escalation, not after the patient reaches the emergency department.
Home-based support
Physical products are delivered directly to the patient when prevention still matters.
Cross-silo visibility
Medical, pharmacy, and dental claims are viewed together so hidden spend becomes measurable.
Payer deployment. Pharma validation. Built for value-based oncology.
(un)cancer's model is supported by prior national payer deployment and strategic pharma collaboration.
Cigna Medicare Advantage
4,022(un)cancer's prior national payer deployment enrolled 4,022 oncology patients and generated strong patient-reported symptom relief and satisfaction outcomes.
Daiichi Sankyo + AstraZeneca
(un)cancer was selected to support oral toxicity prevention for Dato-DXd, one of the highest oral-burden ADC therapies.
- Protocol activates at treatment initiation.
- No referral or prior authorization burden.
- Designed to protect treatment continuity.
A structured pilot measured in your own claims data.
OSEM™ is designed to prove outcomes inside the payer’s data environment before broader deployment.
Enroll & baseline
Identify eligible members, validate baseline risk, complete RN enrollment, and ship the intervention.
Active support
RN check-ins, 24/7 triage, replenishment, and monthly reporting dashboards.
Measure & reconcile
Claims reconciliation against a matched cohort, with savings reviewed before shared-savings payment.
Shared savings, measured in claims.
OSEM™ combines a PMPM operating model with shared-savings alignment. (un)cancer participates in upside only when documented reductions are achieved.
Illustrative all-in PMPM program cost.
Documented savings retained by the health plan.
Illustrative ROI range for high-risk oncology cohorts.
Outcomes and ROI figures are illustrative and should be validated against each payer’s own claims data.