Impact of Pharmacy Intervention on Prior Authorization Success and Efficiency at a University Medical Center

Cutler, Timothy W.; She, Yifan; Barca, Jason; Lester, Shawn; Xing, Guibo; Patel, Jigna; Melnikow, Joy

doi:10.18553/jmcp.2016.22.10.1167

Cited by 11 publications

(17 citation statements)

References 6 publications

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“…After incorporating phoned or faxed prescriptions, electronic prescriptions were still associated with a 10% increase in first-fill adherence [24]. An evaluation of a centralized, pharmacist-led prior authorization initiative in a university-based medical center showed that use of the centralized system improved prescription approval rates and significantly reduced time to approval [25].…”

Section: Discussionmentioning

confidence: 99%

Impact of Online Prescription Management Systems on Biologic Treatment Initiation

Hawkes

Mittal

Davis³

et al. 2019

Adv Ther

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IntroductionPharmaceutical firms have begun offering online prescription management systems to facilitate prescription processing. This study evaluated the impact of the HUMIRA Complete Pro (HCPro) online prescription management system on the rate of abandonment and the time to first fill for patients prescribed adalimumab (ADA). A retrospective cohort analysis of patients initiating ADA treatment with or without use of the HCPro online prescription processing system was used to evaluate the impact of HCPro on treatment initiation outcomes.MethodsPatient-level data for patients with an ADA prescription processed through HCPro were mapped to Symphony Health claims for patients initiating ADA between January 2012 and January 2015. The sample included patients aged ≥ 18 years with a diagnosis of Crohn's disease, ulcerative colitis, rheumatoid arthritis, psoriasis, psoriatic arthritis, or ankylosing spondylitis who had data available 3 months before and after their first ADA claim (index date). Baseline characteristics, prescription abandonment rate, and time-to-first-prescription fill were compared between patients with a prescription processed through HCPro (HCPro cohort) and those without (non-HCPro cohort). The odds of abandonment were evaluated in the 3 months following the index date using a multivariate logistic regression model.ResultsThe study included 24,767 patients (535 HCPro; 24,232 non-HCPro). HCPro patients had a greater frequency of initiation at a specialty pharmacy (66% vs. 56%; P < 0.001) and enrollment in AbbVie’s patient support program (71% vs. 51%; P < 0.001) as well as a lower copay for ADA ($206 vs. $265; P = 0.011). HCPro patients had a lower abandonment rate (6.4% vs. 13.9%; P < 0.001) and reduced days to prescription fill (7.0 vs. 14.4; P < 0.001). After controlling for baseline characteristics, abandonment odds were 43% lower for patients using HCPro (odds ratio = 0.57; P = 0.004).ConclusionInitiating ADA treatment with an online prescription management system (HCPro) significantly reduces the odds of abandonment and time to first prescription fill.FundingAbbVie Inc., Chicago, USA.

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Section: Discussionmentioning

confidence: 99%

Impact of Online Prescription Management Systems on Biologic Treatment Initiation

Hawkes

Mittal

Davis³

et al. 2019

Adv Ther

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“…As key learned intermediaries between prescribers and patients, pharmacists’ opportunities to advance care for virtually any illness include 4 1) assisting prescribers’ improvement in medication selections, doses, routes of administration, and product formulations; 26 2) monitoring of efficacy and adverse effects; 27 3) providing patient education, both about the disease as well as about treatments, including proper use of medications as well as devices; 28 and 4) helping resolve medication access and insurance issues. 29…”

Section: Opportunities For Pharmacists In Cluster Headachementioning

confidence: 99%

Cluster Headache: Opportunities for Pharmacists to Improve Care

Wenzel

Smith

Clark

2020

Journal of Pharmacy Practice

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Cluster headache (CH) is a primary headache (PH) disorder characterized by recurrent attacks of severe/extremely severe unilateral pain and associated symptoms. While less prevalent than other PHs such as migraine, CH impact is substantial given the agonizing pain, negative effect on daily productivity, impaired mental health, and increased costs. Cluster headache is not optimally treated and few clinical trials are available to model therapy, especially dosing and administration. Pharmacists are well positioned to help prescribers and CH individuals with several key opportunities. Subcutaneous sumatriptan (SC SM) lower than the FDA-approved 6 mg per attack, specifically 2 mg and 3 mg, can be considered; literature describes these doses’ benefits. Moreover, lower doses may improve patient access to this treatment-of-choice. Despite the SC SM’s FDA-approved dose limit of 12 mg per 24 hours, the maximum CH dose has not been examined; this limit merits reevaluation since literature and clinical experience illustrate treatment exceeding this limit. Oxygen therapy for CH remains unfamiliar to, and under-utilized by, clinicians and CH individuals. Pharmacists can facilitate prescribing, distribution, and administration of oxygen via education. Patient education for the various CH medication devices, including oxygen, is paramount. Narcotics remain widely prescribed for CH, without supporting evidence, but with considerable abuse and diversion risks. Pharmacists are positioned to help guard against narcotic usage and to direct care toward medications endorsed by CH guidelines. Since the optimal method to initiate and discontinue drugs which may decrease CH attacks’ remains unknown, pharmacists can educate clinicians and individuals with CH to make fully informed decisions.

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“…When patients incur a lapse in coverage or an insurance rejection for their medication, pharmacists and pharmacy technicians can efficiently navigate the process of ensuring medication access and affordability. Pharmacist-led PA processes have been shown to improve approval rates and significantly reduce time to PA approval [46]. High medication access rates have been reported in integrated specialty pharmacy models [33,47].…”

Section: Integrated Health-system Specialty Pharmacist Rolementioning

confidence: 99%

An Integrated Health-System Specialty Pharmacy Model for Coordinating Transitions of Care: Specialty Medication Challenges and Specialty Pharmacist Opportunities

et al. 2019

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Adherence and persistence to specialty medications are necessary to achieve successful outcomes of costly therapies. The increasing use of specialty medications has exposed several unique barriers to certain specialty treatments’ continuation. Integrated specialty pharmacy teams facilitate transitions in sites of care, between different provider types, among prescribed specialty medications, and during financial coverage changes. We review obstacles encountered within these types of transitions and the role of the specialty pharmacist in overcoming these obstacles. Case examples for each type of specialty transition provide insight into the unique complexities faced by patients, and shed light on pharmacists’ vital role in patient care. This insightful and real-world experience is needed to facilitate best practices in specialty care, particularly in the growing number of health-system specialty pharmacies.

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Impact of Pharmacy Intervention on Prior Authorization Success and Efficiency at a University Medical Center

Cited by 11 publications

References 6 publications

Impact of Online Prescription Management Systems on Biologic Treatment Initiation

Impact of Online Prescription Management Systems on Biologic Treatment Initiation

Cluster Headache: Opportunities for Pharmacists to Improve Care

An Integrated Health-System Specialty Pharmacy Model for Coordinating Transitions of Care: Specialty Medication Challenges and Specialty Pharmacist Opportunities

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