Specialty pharmacists reduced unnecessary costs and waste by evaluating patients’ upcoming visits and current stocks of oncolytics before requesting prescription renewals. Investigators presented their findings at AMCP Nexus 2022.

Pharmacies spend a significant amount of money on oral oncolytics, agents which can be costly for patients, researchers said. Additionally, medication waste often results when routine safety and effectiveness monitoring prompts providers to change treatments.

“Strategies to avoid medication waste could alleviate the financial burden of these costly therapies,” wrote Kristen Whelchel, PharmD, CSP, clinical pharmacy specialist, Vanderbilt University Medical Center, and coauthors.

The retrospective review was conducted among patients who filled oral oncolytic prescriptions at Vanderbilt Specialty Pharmacy from January 2020 through January 2021.

Specialty pharmacists were prompted by a system-generated renewal request to review each patient’s medical record prior to renewing their prescription. Pharmacists determined whether the prescription was appropriate and postponed the renewal if the patient had enough medication on hand to last until their next scheduled visit. Patients were only included in the study if a pharmacist postponed their renewal.

Refill renewals were postponed 167 times across 139 patients. More than half (56%) of follow-up visits prompted medication discontinuations, and nearly one-third (31%) resulted in dose changes. Medication changes and holds occurred in 6% and 5% of visits, respectively.

Only 2% of follow ups resulted in no change in treatment.

Findings showed the total cost avoidance of postponing renewals until after follow-up visits was $967,831.74, or a median of $2417.10 per fill. To determine cost avoidance, researchers multiplied each drug’s Average Wholesale Price per unit by the number of units that would have been wasted had the pharmacist not postponed.

“Specialty pharmacist review of amount of medication on hand and upcoming follow-up proved effective in avoiding waste and unnecessary medication costs,” Dr Whelchel and coinvestigators concluded.

Reference:
Whelchel K, Crumb J, Jones G, et al. Financial impact of integrated specialty pharmacy efforts to avoid oral oncolytic waste. J Manage Care Spec Pharm. 2022;28(10-a suppl):S1-S137. doi:10.18553/jmcp.2022.28.10-a.s1