A Financial Analysis of Pharmacist Interventions for Patients Using Self-Administered Biologics in a Centralized Specialty Medication Clinic at a Veteran's Affairs Hospital
by Ryan Simonet, PharmD, Jacob Richie, PharmD, Ellina Seckel, PharmD, BCACP, DPLA, Andrew Wilcox, PharmD, DPLA, Amanda Margolis PharmD, MS, BCACP
Objective: A centralized specialty medication management (CSMM) clinic led by clinical pharmacy practitioners (CPPs) was implemented to address gaps in patient education, improve home-use of biologic medications, enhance patient safety, and contain costs. The CSMM CPPs completed medication counseling and disease-specific monitoring for patients prescribed any of the 12 specialty medications over the first year of therapy.
Objective: To determine the cost avoidance due to CPP interventions from a CSMM clinic at a Veterans Affairs hospital.
Methods: Patients who completed at least one encounter with the CSMM clinic within the first 13 months of service were included in this retrospective review. Chart review was conducted on included patient encounters, including CPP interventions that were documented and categorized. Estimated costs were determined through literature review and the VA National Acquisition Center drug contract prices.
Results: 73 patients were included with 251 unique documented encounters. Overall, 103 CPP interventions were documented, of which 13 interventions (12.6%) had cost avoidance implications. The CSMM CPPs’ interventions resulted in an overall cost avoidance of $57,432 for the evaluation period. The intervention type with the greatest cost avoidance was replacement of products ($22,511), followed by therapy changes and dose corrections. The cost avoidance related to CPP interventions was 149% compared to the cost of the pharmacist to run the clinic (0.2 full time equivalent CPP salary and benefits).
Conclusion: A CSMM model for patients initiating a specialty medication can effectively lead to health-system cost avoidance through CPP-led interventions.
Keywords: Pharmacists, Patient Safety, Medication Therapy Management, Veterans, Inpatients, Counseling, Biological Products, Hospitals, Pharmacy
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2023 November/December Table of Contents
Objective: A centralized specialty medication management (CSMM) clinic led by clinical pharmacy practitioners (CPPs) was implemented to address gaps in patient education, improve home-use of biologic medications, enhance patient safety, and contain costs. The CSMM CPPs completed medication counseling and disease-specific monitoring for patients prescribed any of the 12 specialty medications over the first year of therapy.
Objective: To determine the cost avoidance due to CPP interventions from a CSMM clinic at a Veterans Affairs hospital.
Methods: Patients who completed at least one encounter with the CSMM clinic within the first 13 months of service were included in this retrospective review. Chart review was conducted on included patient encounters, including CPP interventions that were documented and categorized. Estimated costs were determined through literature review and the VA National Acquisition Center drug contract prices.
Results: 73 patients were included with 251 unique documented encounters. Overall, 103 CPP interventions were documented, of which 13 interventions (12.6%) had cost avoidance implications. The CSMM CPPs’ interventions resulted in an overall cost avoidance of $57,432 for the evaluation period. The intervention type with the greatest cost avoidance was replacement of products ($22,511), followed by therapy changes and dose corrections. The cost avoidance related to CPP interventions was 149% compared to the cost of the pharmacist to run the clinic (0.2 full time equivalent CPP salary and benefits).
Conclusion: A CSMM model for patients initiating a specialty medication can effectively lead to health-system cost avoidance through CPP-led interventions.
Keywords: Pharmacists, Patient Safety, Medication Therapy Management, Veterans, Inpatients, Counseling, Biological Products, Hospitals, Pharmacy
Download PDF
2023 November/December Table of Contents