Research Projects Page

Since our inception as an outcome committee in 2015, we have consistently and considerably expanded our ability to produce rigorous outcomes research. In 2018, we established a more formal program and leadership, including full time outcomes research staff. The result of these allocated resources has been a productive output across multiple specialty disease states. Below are highlighted outcomes from studies completed in recent years.

Research Project List

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VSP vs. Non-VSP: Comparing rate so primary medication nonadherence and turnaround time

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.

Getting To Specialty Treatment In Dermatologic Inflammatory Conditions: Treatment Requirements And Patient Journey

This single-center, retrospective review evaluated medication outcomes and time to access therapy in patients using step therapy or formulary alternatives after being prescribed specialty medications for psoriasis or atopic dermatitis. Most patients denied specialty medications due to insurance requirements eventually needed them or were lost to follow-up (n=37; 60%). Only 5 patients (8%) benefited from and remained on step therapy.

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.

Meeting the challenges of ultra-complex specialty medications through an integrated specialty pharmacy model

There is a growing number of specialty medications with requirements that exceed standard characteristics, newly defined as "ultra-complex." This article details ultra-complex specialty medications, and strategies implemented by VSP to maintain an optimal patient journey. Ultra-complex specialty medications provide unprecedented therapeutic advancements but demand multidisciplinary resources to reach the desired therapeutic goals, which make health systems an ideal management setting.

Persistence to HIV pre-exposure prophylaxis filled through an integrated health-system specialty pharmacy compared with external pharmacies

This study compares persistence to HIV PrEP in patients filling their medication through an integrated health-system specialty pharmacy (HSSP) compared to those filling at external pharmacies. These findings demonstrate that patients were better maintained on PrEP therapy when their prescriptions were filled with the HSSP compared to external pharmacies, thus highlighting the role HSSPs can have in ending the HIV epidemic.

Management of Patients with Multiple Sclerosis within Health-System Specialty Pharmacies: A Multisite Analysis of Patient outcomes, Pharmacist Actions, Adherence, and Persistence

This multisite, prospective, cohort study of patients with MS evaluated patient-reported outcomes, pharmacists' actions, and DMT adherence/persistence. Patients reported low rates of impacted productivity, hospitalization, and relapse due to MS. Pharmacists commonly provided medication education and actions to ensure DMT safety and adherence. Patients had a high rate of adherence (median PDC 88%) and persistence (86% at 12 months). Findings support positive outcomes for HSSP patients.

2022 ASHP Survey of Health-System Specialty Pharmacy Practice: Clinical Services

This multi-phased survey aggregated data to describe clinical services provided by health-system specialty pharmacies (HSSPs). Results demonstrate that HSSPs are a clinical and educational resource for specialty clinics and have developed robust patient care services that encompass the patient journey from before specialty medication selection through treatment monitoring and optimization.

Exploring healthcare providers' experiences with specialty medication and Limited Distribution Networks

The goal of this study was to explore healthcare providers’ experiences with specialty medications distributed via Limited Distribution Networks (LDN) that do not include IHSSPs. Participants reported barriers to navigating LDNs that can interfere with clinic workflow and patient care. IHSSPs may reduce clinic burden by helping patients access, afford, and remain on therapy.

Comparison of provider satisfaction with specialty pharmacy services in integrated health-system and external practice models: A multisite survey

This online survey study of specialty clinic providers at 10 health-systems evaluated quality of services of integrated and external specialty pharmacies. The mean (SD) score for overall satisfaction with integrated specialty pharmacies was significantly higher than the score for satisfaction with external specialty pharmacies: 4.72 (0.58) vs 2.97 (1.20) out of 5; P 0.001. Findings demonstrate high rates of provider satisfaction with HSSP services and perceived benefits.

Transitions of Care: A Focus on Specialty Medication Challenges and Specialty Pharmacist Opportunities

Adherence and persistence to specialty medications can be challenging during transitions in sites of care, provider types, specialty medications, and financial coverage changes. In this report, we review obstacles encountered within these transitions and the role of the specialty pharmacist in overcoming 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.