Specialty Pharmacy Literature Review

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Impact of Specialty Pharmacists A literature review conducted by Anderson and Philbrick attempts to answer how medication therapy management (MTM) provided by pharmacists may help increase patient adherence with medications, especially DMTs. Adherence with MS medications are known to be problematic, with 17 – 40% of MS patients discontinuing DMTs within one year of therapy initiation. Nonadherence, defined as failing to fill prescriptions, missing doses, or reducing the dose or frequency of the medication, is known to lead to more frequent relapses and overall worsening health. Known barriers to adherence include high financial burden, issues with insurance, troublesome adverse drug reactions (ADRs), fear of administering injectable medications, and comorbid conditions. The authors note that there is a great shortage of pharmacists providing MTM services to MS patients. These services include …show more content…

described the specialty pharmacy model at Vanderbilt University Medical Center, Vanderbilt Specialty Pharmacy (VSP). Two dedicated pharmacists and two technicians were integrated into the MS clinic. They manage the prior authorization (PA) process, patient education of self-injectables and other medications, access to patient financial assistance programs, and overall coordination of care. After the medication is started, the pharmacist performs regular patient assessments for ADRs and adherence. The authors noted that specialty pharmacists opened clinic time to allow practitioners to see more new patients (0.36 down to 0.1 clinic visits per day) with 38% increase in new prescriptions and increased access to medication by following up and getting more PAs approved through insurance appeals or enrollment in manufacturer assistance programs. Patients had much lower than average out-of-pocket costs because pharmacists sought out grants, copay or patient assistance. Also, patient adherence, assessed through medication possession ratio, was very high, at

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