Impact of a Hospital-Based Specialty Pharmacy in Partnership With a Care Coordination Organization on Time to Delivery and Receipt of Oral Anticancer Drugs

Abstract

Oral anticancer drug (OACD) prescriptions require extensive coordination between providers and payers, which can delay drug receipt. Specialty pharmacies facilitate communication between multiple entities. In 2018, our cancer center partnered with a freestanding organization to implement a hospital-based specialty pharmacy (HB-SP). We evaluated the time to drug receipt (TTR) before and after HB-SP implementation.

Data were prospectively collected on all new OACD prescriptions for adult oncology patients from January 1, 2018, to December 31, 2019. In fall 2018, a HB-SP was initiated. We collected patient sociodemographic, clinical, and prescription data. TTR was the number of days from OACD prescription to drug receipt. We used multivariable logistic regression to examine factors associated with TTR ≤ 7 days before and after HB-SP implementation.

In total, 954 patients were included, representing 1,102 new OACDs. The majority of prescribed drugs were targeted OACDs (56%, n = 617), and 71% (n = 779) required prior authorization. Of all prescriptions, 84% (n = 960) were successfully received with an overall median TTR of 7 days. In unadjusted analysis, HB-SP implementation, drug class, race and ethnicity, and prior authorization requirement were significantly associated with TTR. Adjusted analyses found that patients were more likely to receive their drugs ≤ 7 days after HB-SP implementation (53% v 47%; adjusted odds ratio [aOR], 1.29; 95% CI, 1.00 to 1.68; P = .05).

The implementation of a HB-SP in partnership with a collaborative care model contributed to a decrease in TTR for OACDs. This difference is in part attributable to improved care coordination and communication. A centralized approach may improve overall efficiency due to fewer practice disruptions.

© 2022 by American Society of Clinical OncologySUPPORT

Supported by the National Cancer Institute at the National Institutes of Health (R21CA242044 to D.L.H., T32CA094061 to M.P.B. and M.R.L.L.); and the American Cancer Society (ACS Clinical Research Professorship to D.L.H.).

Data are available from the authors upon reasonable request.

The codes utilized during the current study are available from the corresponding author on reasonable request.

Conception and design: Melissa P. Beauchemin, Morgan R.L. Lichtenstein, Rohit Raghunathan, Sahil D. Doshi, Cynthia Law, Melissa K. Accordino, Dawn L. Hershman

Financial support: Dawn L. Hershman

Administrative support: Cynthia Law, Melissa K. Accordino, Dawn L. Hershman

Provision of study materials or patients: Cynthia Law, Melissa K. Accordino

Collection and assembly of data: Melissa P. Beauchemin, Morgan R.L. Lichtenstein, Rohit Raghunathan, Sahil D. Doshi, Cynthia Law, Melissa K. Accordino, Dawn L. Hershman

Data analysis and interpretation: Melissa P. Beauchemin, Morgan R.L. Lichtenstein, Rohit Raghunathan, Shing Lee, Cynthia Law, Melissa K. Accordino, Elena B. Elkin, Jason D. Wright, Dawn L. Hershman

Manuscript writing: All authors

Final approval of manuscript: All authors

Accountable for all aspects of the work: All authors

AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST

Impact of a Hospital-Based Specialty Pharmacy in Partnership with a Care Coordination Organization on Time to Delivery and Receipt of Oral Anticancer Drugs

The following represents disclosure information provided by authors of this manuscript. All relationships are considered compensated unless otherwise noted. Relationships are self-held unless noted. I = Immediate Family Member, Inst = My Institution. Relationships may not relate to the subject matter of this manuscript. For more information about ASCO's conflict of interest policy, please refer to www.asco.org/rwc or ascopubs.org/op/authors/author-center.

Open Payments is a public database containing information reported by companies about payments made to US-licensed physicians (Open Payments).

Shing Lee

Consulting or Advisory Role: PTC Therapeutics

Research Funding: Merck (Inst), Karyopharm Therapeutics (Inst), AstraZeneca (Inst), Genentech/Roche (Inst)

Melissa Accordino

Honoraria: Sermo, M3, Incrowd, Massive Bio

Other Relationship: Onclive

Elena B. Elkin

Research Funding: Pfizer

Jason D. Wright

Consulting or Advisory Role: UpToDate

Research Funding: Merck (Inst)

Patents, Royalties, Other Intellectual Property: UpToDate

Dawn L. Hershman

Consulting or Advisory Role: AIM Specialty Health

No other potential conflicts of interest were reported.

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