Predicting Time to Medication Access for Hematologic Malignancies: The Impact of an Integrated Specialty Pharmacy and Limited Distribution Drug Networks

This study found that integrating a pharmacist into clinic significantly shortened time from treatment decision to shipment for LDD drugs, partially overcoming access barriers. Additionally, access to LDDs was still slower than non-LDDs as they cannot be fully integrated into clinic workflow. The integrated specialty pharmacy program adds value to patient access and outperforms LDDs, challenging the value of LDD networks beyond medical economics.
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Apixaban for primary prevention of venous thromboembolism in patients with Multiple Myeloma

This is a phase IV single-arm study prospectively evaluating the safety and efficacy of apixaban for primary prevention of VTE in patients with MM. The study found that during the 6 month evaluation no patients experienced major hemorrhagic events, MI, stroke, or death. Three patients did have non-major events that were medically managed and one patient discontinued therapy because of an allergic reaction to apixaban.
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Ivosidenib: IDH1 Inhibitor for the Treatment of Acute Myeloid Leukemia

Ivosidenib is the first approved oral, targeted, small molecule inhibitor of the isocitrate dehydrogenase 1 (IDH1) mutation seen in acute myeloid leukemia. This review article discusses the clinical trials and dose escalation studies conducted to secure the U.S. Food and Drug Administration approval.
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Venetoclax-Based Salvage Therapy for Post-Hematopoietic Cell Transplantation Relapse in Acute Myeloid Leukemia

This study looked at 21 acute myeloid leukemia patients who had received a hematopoietic cell transplant and experienced relapsed disease. Each patient underwent salvage therapy with a venetoclax- based treatment regimen. Nineteen patients were assessed for treatment response and 12 of the 19 patients responded to venetoclax-based salvage therapy, leading to a 63.2% response rate.
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Primary Prevention of Venous Thromboembolism with Apixaban for Multiple Myeloma Patients Receiving Immunomodulatory Agents

Immunomodulatory therapies for multiple myeloma can increase patient risk for venous thromboembolism (VTE). This phase IV single-arm study assessed the rate of symptomatic VTE over 6 months in 50 patients with multiple myeloma receiving immunomodulatory therapy and apixaban for primary prevention. No patients experienced symptomatic VTE or a major hemorrhage and 3 patients experienced clinically relevant non-major hemorrhage but were able to resume apixaban after medical management.
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Evaluating Prescription Outcomes for Specialty Agents used to Treat Dermatologic Conditions: A Quality Improvement Initiative

In this initiative, we evaluated outcomes following prescription of specialty dermatology medications in biologic-naïve patients. Of the 28 prescriptions evaluated, median time to approval was 9 days, with delays resulting from the need for a pharmacist to ascertain clinical data such as disease severity and treatment history.

Implementing a Medication Reconciliation Protocol for Adult Cystic Fibrosis Patients in an Integrated Outpatient Clinic

In this study, we conducted a quality improvement initiative to increase the number of patients taking standard of care maintenance therapies, including cystic fibrosis transmembrane receptor (CFTR) modulators. With implementation of a specialty pharmacist directed protocol, rate of standard of care medication use increased for all therapies. The highest rate of increase was in CFTR modulator use.

Testicular Pain Following Initiation of Elexacaftor / Tezacaftor / Ivacaftor in Males with Cystic Fibrosis

In this case series, we discuss 7 males between 17 and 39 years of age who reported testicular pain or discomfort within the first two weeks of starting therapy. The precise mechanism of this side effect is unknown, but it may be related to restoration of CFTR function in the male reproductive tract. All patients experienced resolution of this side effect within a week after onset, regardless of the management, exception for one patient.
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Navigating the Wild West of Medication Adherence Reporting in Specialty Pharmacy

This article highlights the challenges in standardizing adherence methodologies as well as the key elements to consider when interpreting adherence results. Specialty pharmacies should consider using adherence measures to identify and intervene on patients with adherence challenges. In addition, integrated specialty pharmacies should work to link adherence to clinical outcomes and healthcare cost savings.
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Development and Outcomes of a Student Research Program within a Health-System Specialty Pharmacy

Because of the growing focus on outcomes research within Vanderbilt Specialty Pharmacy (VSP) and the need for more student research opportunities, VSP developed a longitudinal student research training program. This report describes the development and outcomes of that program as of June 2021.