This study evaluates health-system specialty pharmacy (HSSP) pharmacists' roles in medication discontinuations, switches, and dose changes, focusing on cost avoidance. HSSP pharmacists intervene to ensure safe and effective use of specialty medications, preventing unnecessary costs. Pharmacists successfully avoided $129,705 - $162,133 in direct costs through their interventions. These findings support the employment and role of pharmacists in HSSPs, extending beyond prescription filling.

This study assessed TB and HBV screening completion rates at the time of immune response mediator initiation and reasons for incomplete screening in health-system specialty pharmacies. Most patients with a health-system specialty pharmacy referral are screened for TB and HBV prior to treatment. Omitted safety screening is commonly driven by the prescribing provider.

This commentary provides practical recommendations for managing VMAT2 inhibitors. With limited clinical trial and real world data on this topic, the case examples and firsthand experience described are useful to clinicians and pharmacists who manage VMAT2 inhibitors.