Harnessing the Electronic Health Record to Improve Workflow & Reporting in a Hepatitis C Clinic

This quality improvement project implemented the use of tools in the electronic health record that allowed specialty pharmacist to discretely document clinical data for Hepatitis C as part of their normal workflow. Post-implementation, the documentation burden for pharmacists was reduced and documented data was used to create a near real-time dashboard for reporting and tracking patient outcomes.

Cost analysis of once daily extended-release tacrolimus (LCPT) and twice daily immediate-release tacrolimus (IR-Tac) for Kidney Transplant Patients

This study evaluated the out-of-pocket (OOP) costs of LCPT vs IR-Tac in kidney transplant patients, including the use of financial assistance, and found that at an institution with patient assistance grants, patients are less likely to have high out of pocket costs with LCPT compared to those prescribed IR-Tac.

Health Insurer Strategies to Reduce Specialty Drug Spending: Copayment Adjustment and Alternative Funding Programs

This Viewpoint paper describes programs that employers, health plans, and other payers are using to reduce their own spending on specialty drugs including copay accumulator and maximizer programs and alternative funding programs.
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Cost Avoidance from Pharmacist Interventions in MS

This study found that health system specialty pharmacist interventions in MS can lead to substantial direct and indirect cost avoidance-up to $156,265 within a 6-month time frame. Most costs were avoided directly by preventing the dispensing of inappropriate therapies and indirectly by preventing additional health care utilization.
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New Onset Lymphopenia in Patients with Relapsing Multiple Sclerosis Switching from Longstanding Dimethyl Fumarate Treatment to Diroximel Fumarate

This case series identified patients with multiple sclerosis whose lymphocyte counts were stable on dimethyl fumarate, and then subsequently developed lymphopenia after switching to diroximel fumarate, prompting its discontinuation.
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Comparing rates of primary medication nonadherence, turnaround time, adherence, and persistence among patients at Vanderbilt Specialty Pharmacy to external specialty pharmacies

We compared rates of PMN, TAT, PDC, and persistence between an HSSP and external specialty pharmacies. Prescriptions sent to non-HSSP specialty pharmacies 60% more likely to experience PMN than prescriptions sent to an HSSP. Patients filling with an HSSP had higher adherence. Patients with inflammatory conditions filling with the HSSP had shorter turnaround time and higher persistence. Patients with MS who filled with the HSSP had higher PDC.

Deprescribing 5-Aminosalicytes in patients with inflammatory bowel disease on concomitant advanced therapy: A qualitative analysis

This study assessed patients' satisfaction and barriers to their current UC or IBD treatment, their perceived quality of life, and pill burden associated with their current treatment. Patients are open to deprescribing their 5-ASA but would have several questions for their prescribing physician including assurance of continued symptom management or ease of returning to the 5-ASA if needed.

Switching MS Fumarates

It is unexpected that patients with stable lymphocytes on one fumarate would experience significant changes when switching to another fumarate; however, this was being observed in clinical practice. We wanted to identify the frequency and severity of lymphopenia after switching from dimethyl fumarate to either diroximel fumarate (DRF) or monomethyl fumarate (MMF). Our study determined that patients switching to DRF were more likely to have decreased lymphocyte counts post switch compared to MMF.

DAA Treatment Failure And Retreatment Strategies Following NAT+ HCV Solid Organ Transplantation In HCV-Negative Recipients: A Case Series

Given the high efficacy rates of DAA treatment in patients following NAT+ HCT SOT in HCV-recipients, little data is available to guide retreatment selection. This study aims to fill this gap by polling data from multiple treatment sites, assessing the retreatment strategies and SVC rates of said strategies.

Implementation of EHR Flowsheet to track patients taking specialty medications with complex dosing regimens

The purpose of this quality improvement project was to implement a transparent, streamlined process of managing patients with IBD receiving specialty medications that have complex dosing regimens with IV to SubQ routes of administration. This was achieved by implementing an EHR flowsheet for patient management and care coordination between infusion and specialty pharmacy staff.