Real-World Impact of Switching to Biosimilars

his study evaluated biosimilar switches and patient outcomes (adverse events, worsening symptoms or flares, and dose escalations) in rheumatology or IBD patients who switched to an adalimumab biosimilar. Biosimilars were well-tolerated during the first 3 months of therapy with a low number of patients experiencing worsening of symptoms or flares. Many patients stable on adalimumab originator who switched to an adalimumab biosimilar required subsequent switches within 3 months.
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Pharmacist Intervention Cost Avoidance

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.

Pre-Treatment Safety Screening for Biologic Medications at Health System Specialty Pharmacies

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 modified Delphi study engaged a large, multidisciplinary panel of specialty pharmacy stakeholders to identify meaningful, standardized reporting measures for managing rheumatoid arthritis (RA) within specialty pharmacy practice. The panel ultimately reached consensus on 13 measures, 7 core (including adherence, serious adverse events, patient response to therapy, discontinuations, medication

This multisite national effort aims to identify measures deemed important and usable by specialty stakeholders that can be standardized and implemented in specialty pharmacy practice to ensure the safe, appropriate, and effective use of specialty medications in patients with RA. This poster describes the study methodology and response rate.
View presentation. November 2025

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.
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Primary medication nonadherence rates to specialty disease-modifying antirheumatic drugs for rheumatoid arthritis within a health system specialty pharmacy

This study evaluated reasons for and rates of primary medication nonadherence to specialty DMARDs in patients with RA referred to an integrated health systems specialty pharmacy
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Evaluating Patient-Reported Adherence and Outcomes in Specialty Disease States: A Dual Site Initiative

This study examined the association between patient characteristics and patient-reported outcomes for patients prescribed specialty medications from rheumatology or multiple sclerosis clinics in two HSSPs for 3,677 patients over 30 months. Patients reporting tolerability issues or lower perceived effectiveness were more likely to report a missed dose.
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Assessing Patient-Reported Outcomes and Pharmacist Interventions in Rheumatology Specialty Disease States within an Integrated Care Center

Patient reported outcomes (PROs) are used to assess response to medication and the need for therapeutic adjustments in patients with rheumatologic disease states. Vanderbilt Specialty Pharmacy, an integrated health-system specialty pharmacy, assesses PROs through monthly refill questionnaires to guide specialty pharmacist interventions and improve patient care.

Implementing a Specialty Pharmacist Led Vaccine Screening and Assessment Program for Biologic Disease Modifying Anti-Rheumatic Drugs (bDMARDS) in an Integrated Outpatient Rheumatology Clinic

Patients are recommend to receive all necessary vaccines prior to starting immunosuppressive specialty DMARD therapy. This quality improvement project developed a vaccine screening protocol for patients initiating new specialty medications at an outpatient rheumatology clinic. This protocol was effective in delivering patient-specific vaccine recommendations and was rated as efficient by specialty pharmacists.

Adherence to Disease-Modifying Anti-Rheumatic Drugs in Patients in an Integrated Clinic and Specialty Pharmacy

This study demonstrated high medication adherence rates and low patient out-of-pocket costs for patients in an integrated clinic and specialty pharmacy. Adherence measured using mean proportion of days covered was 0.89 and 80% of patients were adherent (PDC≥0.80). Rates of financial assistance were high and low out-of-pocket costs were associated with higher adherence.
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