Financial impact of integrated specialty pharmacy efforts to avoid oral anticancer medication waste.

BACKGROUND: The growing number of oral anticancer medications represents a significant portion of pharmacy spending and can be costly for patients. Patients taking oral anticancer medications may experience frequent treatment changes following necessary safety and effectiveness monitoring, often resulting in medication waste. Strategies to avoid medication waste could alleviate the financial burden of these costly therapies on the payer and the patient. OBJECTIVE: To evaluate the impact on waste and cost avoidance of reviewing the amount of medication patients have on hand and the presence of upcoming follow-up (ie, provider visit, laboratory testing, or imaging) before requesting a prescription refill renewal for patients taking oral anticancer medications through an integrated health system specialty pharmacy. METHODS: We performed a retrospective review of patients filling oral anticancer medications prescribed by a Vanderbilt University Medical Center provider and dispensed by Vanderbilt Specialty Pharmacy between January 1, 2020, and December 31, 2020. Specialty pharmacists received a system-generated refill renewal request for oral anticancer medications when the final prescription refill was dispensed, prompting the pharmacist to review the patient's medical record for continued therapy appropriateness and to request a new prescription. If the patient had a sufficient supply on hand to last until an upcoming follow-up (ie, provider visit, imaging, or laboratory assessment), the pharmacist postponed the renewal until after the scheduled follow-up. Patients were included in the analysis if the refill renewal request was postponed after review of the amount of medication on hand and the presence of an upcoming follow-up. Medication outcomes (ie, continued, dose changed, held, medication changed to a different oral anticancer medication, or discontinued) resulting from the follow-up were collected. Cost avoidance in US dollars was assigned based on the outcome of follow-up by calculating the price per unit times the number of units that would have been unused or in excess of what was needed if the medication had been dispensed before the scheduled follow-up. The average wholesale price minus 20% (AWP-20%) and wholesale acquisition cost (WAC) were used to report a range of costs avoided over 12 months. RESULTS: The total cost avoidance over 12 months associated with postponing refill renewal requests in a large academic health system with an integrated specialty pharmacy ranged from $549,187.03 using WAC pricing to $751,994.99 using AWP-20% pricing, with a median cost avoidance per fill of $366.04 (WAC) to $1,931.18 (AWP-20%). Refill renewal requests were postponed in 159 instances for 135 unique patients. After follow-up, medications were continued unchanged in only 2% of postponed renewals, 56% of follow-ups resulted in medication discontinuations, 32% in dose changes, 5% in medication changes, and 5% in medication holds. CONCLUSIONS: Integrated health system specialty pharmacist postponement of refill requests after review of the amount of medication on hand and upcoming follow-up proved effective in avoiding waste and unnecessary medication costs in patients treated with oral anticancer medications at a large academic health system.

Preparing Pharmacists for the Digital Age: How Pharmacy Courses are Adapting to Challenges and Opportunities.

OBJECTIVE: As the digitalization of health accelerates, the fusion of pharmacy and informatics becomes crucial. Pharmacy education must adapt to equip professionals for this evolving landscape. This study aims to compare pharmacy curricula in Brazil and the United States of America, focusing on health informatics, to uncover challenges and opportunities in training pharmacists for the digital era. METHODS: A cross-sectional, descriptive analysis was conducted on pharmacy curricula from leading Brazilian and American universities in early 2024. Two independent researchers collected data, concentrating on health informatics-related courses. Curriculum analysis used the n-gram technique for linguistic pattern identification in course descriptions. RESULTS: The analysis included curricula from 147 Brazilian and 140 American institutions. American programs had more health informatics courses, with greater integration into pharmacy and higher workloads. Brazilian courses were fewer, less specialized, and less integrated with pharmacy practice. Bi-gram analysis showed that the United States emphasized pharmaceutical practice and technologies, while Brazil focused more broadly on public health. Challenges include Brazil's slower integration of health informatics, impacting competitiveness. The study highlights opportunities to enhance curricula in both countries, emphasizing the importance of health informatics courses. CONCLUSION: US pharmacy programs are further developed by providing specialized, high-quality digital health education with extensive coursework, reflecting a curriculum aligned with digital advancements. This stands in stark contrast to Brazilian programs, which show a need for comprehensive curriculum revision to effectively prepare pharmacists for the digital age. This study underscores the urgency for global pharmacy education reform and its alignment with the rapid evolution of digital health.

Impact of pharmaceutical care for asthma patients on health-related outcomes: An umbrella review.

Recent systematic reviews suggest that pharmacists' interventions in asthma patients have a positive impact on health-related outcomes. Nevertheless, the association is not well established, and the role of clinical pharmacists is poorly represented. The aim of this overview of systematic reviews is to identify published systematic reviews assessing the impact of pharmacists' interventions on health-related outcomes measured in asthma patients. PubMed, Embase, Scopus, and Cochrane Library were searched from inception to December 2022. Systematic reviews of all study designs and settings were included. Methodological quality was assessed using AMSTAR 2. Two investigators performed study selection, quality assessment and data collection independently. Nine systematic reviews met the inclusion criteria. Methodological quality was rated as high in one, low in two, and critically low in six. Reviews included 51 primary studies reporting mainly quality of life, asthma control, lung capacity, and therapeutic adherence. Only four studies were carried out in a hospital setting and only two reviews stated the inclusion of severe asthma patients. The quality of the systematic reviews was generally low, and this was the major limitation of this overview of systematic reviews. However, solid evidence supports that pharmaceutical care improves health-related outcomes in asthma patients.

APPE unreadiness - The other side of the coin.

INTRODUCTION: Student readiness for Advanced Pharmacy Practice Experiences (APPEs) has not been explicitly defined in literature or standards. Readiness for APPEs is a programmatic requirement of all schools and colleges of pharmacy (schools), leaving schools to determine their own assessments of APPE readiness. Current literature provides no consensus on the definition of APPE readiness nor the assessments or benchmarks used to evaluate APPE readiness. Schools have an opportunity to improve efforts to identify students at risk for poor APPE performance and provide early intervention. COMMENTARY: Due to a lack of consensus, it may be easier to describe students who are not ready for APPEs than it is to describe students who are APPE ready. APPE unreadiness is defined by the authors as those who require significant preceptor instruction on foundational competencies such as knowledge, skills, and/or attitudes and therefore are unable to meaningfully engage in application-based patient care activities. By adding focus to APPE unreadiness within APPE readiness programs, pharmacy schools may be able to more readily identify and remediate students who are at risk of failing one or more APPE rotations. IMPLICATIONS: We provide four recommendations for schools to consider. These are focused on assessing APPE readiness to qualify and quantify APPE unready students. By assessing APPE unreadiness, schools can make continuous quality improvement to ensure that preceptors, sites, students, and faculty can have the ongoing confidence that APPE students are all ready to meaningfully engage on rotation.

Análisis 2016-2021 del desarrollo del proyecto de atención farmacéutica al paciente externo MAPEX por Comunidades Autónomas / Analysis 2016-2021 of the development of the MAPEX outpatient pharmaceutical care Project by regions in Spain

Objetivo: analizar la evolución del proyecto «Mapa Estratégico de Atención Farmacéutica al Paciente Externo» (MAPEX) por comunidades autónomas en España, a través del análisis de los resultados de la encuesta de situación comparativa entre los años 2016 y 2021. Métodos: un comité de expertos nacionales pertenecientes a la Sociedad Española de Farmacia Hospitalaria elaboró la Encuesta MAPEX sobre la situación de las unidades de pacientes externos, que constó de 43 preguntas específicas de aspectos relacionados con estructura, contexto, integración, procesos, resultados y formación, docencia e investigación. Se llevó a cabo en 2 periodos, uno en 2016 y otro en 2021 (con 3 preguntas adicionales en 2021, relacionadas con los avances de la iniciativa MAPEX y las líneas prioritarias a seguir). Se realizó un análisis comparativo de resultados a nivel nacional y por comunidad autónoma. Resultados: participaron 141 hospitales en 2016 y 138 en 2021, con representación de las 17 comunidades autónomas. El análisis de los resultados mostró mejoras significativas en todas las dimensiones de la encuesta, con variabilidad entre las diferentes regiones. De entre las mejoras más importantes, destacó el desarrollo y consolidación de la telefarmacia, la mayor especialización del farmacéutico por áreas de conocimiento y su integración en equipos multidisciplinares. La mejora del modelo asistencial se consideró el mayor avance a nivel general (65%) y la atención farmacéutica no presencial a nivel de centro (48,2%). Se consideraron líneas prioritarias de trabajo la expansión y aplicación práctica de la metodología de atención farmacéutica (66,4%), la investigación (58,4%) y la formación en todas las iniciativas MAPEX (53,3%). Conclusiones: la implantación y desarrollo de las iniciativas MAPEX ha supuesto un impacto positivo en la evolución en todos los ámbitos asistenciales de la atención farmacéutica al paciente externo. La encuesta permite identificar...(AU)

Objective: Analyse the evolution of the MAPEX Project (Strategic Map of Pharmaceutical Care for Outpatients) by regions in Spain, through the results of the comparative situation survey between the years 2016 and 2021. Methods: A committee of national experts belonging to the Spanish Society of Hospital Pharmacy prepared the MAPEX Survey on the situation of Outpatient Units, which consisted of 43 specific questions on aspects related to structure, context, integration, processes, results and training, teaching and investigation. It was carried out in two periods, one in 2016 and another in 2021 (with 3 additional questions in 2021, related to the progress of the MAPEX initiative and the priority lines to follow). A comparative analysis of results was carried out at the national level and by regions in Spain. Results: 141 hospitals participated in 2016 and 138 in 2021, with representation from the 17 autonomous communities. The analysis of the results shows significant improvements in all the dimensions of the survey, with variability between the different regions. Among the most important improvements, the development and consolidation of telepharmacy stood out, the greater specialization of pharmacists by areas of knowledge and their integration into multidisciplinary teams. The improvement of the healthcare model was considered the greatest advance at a general level (65%), and remote pharmaceutical care at the hospital level (48.2%). Priority lines of work were considered the expansion and practical application of the pharmaceutical care methodology (66.4%), research (58.4%), and training in all MAPEX initiatives (53.3%). Conclusions: The implementation and development of the MAPEX initiatives has had a positive impact on the evolution in all healthcare areas of pharmaceutical care for outpatients. The situation survey makes it possible to identify by regions the significant points for improvement...(AU)

Analysis 2016-2021 of the development of the MAPEX outpatient pharmaceutical care Project by Regions in Spain / Análisis 2016-2021 del desarrollo del Proyecto de atención farmacéutica al paciente externo MAPEX por Comunidades Autónomas en España

Objetivo: analizar la evolución del proyecto «Mapa Estratégico de Atención Farmacéutica al Paciente Externo» (MAPEX) por comunidades autónomas en España, a través del análisis de los resultados de la encuesta de situación comparativa entre los años 2016 y 2021. Métodos: un comité de expertos nacionales pertenecientes a la Sociedad Española de Farmacia Hospitalaria elaboró la Encuesta MAPEX sobre la situación de las unidades de pacientes externos, que constó de 43 preguntas específicas de aspectos relacionados con estructura, contexto, integración, procesos, resultados y formación, docencia e investigación. Se llevó a cabo en 2 periodos, uno en 2016 y otro en 2021 (con 3 preguntas adicionales en 2021, relacionadas con los avances de la iniciativa MAPEX y las líneas prioritarias a seguir). Se realizó un análisis comparativo de resultados a nivel nacional y por comunidad autónoma. Resultados: participaron 141 hospitales en 2016 y 138 en 2021, con representación de las 17 comunidades autónomas. El análisis de los resultados mostró mejoras significativas en todas las dimensiones de la encuesta, con variabilidad entre las diferentes regiones. De entre las mejoras más importantes, destacó el desarrollo y consolidación de la telefarmacia, la mayor especialización del farmacéutico por áreas de conocimiento y su integración en equipos multidisciplinares. La mejora del modelo asistencial se consideró el mayor avance a nivel general (65%) y la atención farmacéutica no presencial a nivel de centro (48,2%). Se consideraron líneas prioritarias de trabajo la expansión y aplicación práctica de la metodología de atención farmacéutica (66,4%), la investigación (58,4%) y la formación en todas las iniciativas MAPEX (53,3%). Conclusiones: la implantación y desarrollo de las iniciativas MAPEX ha supuesto un impacto positivo en la evolución en todos los ámbitos asistenciales de la atención farmacéutica al paciente externo. La encuesta permite identificar...(AU)

Objective: Analyse the evolution of the MAPEX Project (Strategic Map of Pharmaceutical Care for Outpatients) by regions in Spain, through the results of the comparative situation survey between the years 2016 and 2021. Methods: A committee of national experts belonging to the Spanish Society of Hospital Pharmacy prepared the MAPEX Survey on the situation of Outpatient Units, which consisted of 43 specific questions on aspects related to structure, context, integration, processes, results and training, teaching and investigation. It was carried out in two periods, one in 2016 and another in 2021 (with 3 additional questions in 2021, related to the progress of the MAPEX initiative and the priority lines to follow). A comparative analysis of results was carried out at the national level and by regions in Spain. Results: 141 hospitals participated in 2016 and 138 in 2021, with representation from the 17 autonomous communities. The analysis of the results shows significant improvements in all the dimensions of the survey, with variability between the different regions. Among the most important improvements, the development and consolidation of telepharmacy stood out, the greater specialization of pharmacists by areas of knowledge and their integration into multidisciplinary teams. The improvement of the healthcare model was considered the greatest advance at a general level (65%), and remote pharmaceutical care at the hospital level (48.2%). Priority lines of work were considered the expansion and practical application of the pharmaceutical care methodology (66.4%), research (58.4%), and training in all MAPEX initiatives (53.3%). Conclusions: The implementation and development of the MAPEX initiatives has had a positive impact on the evolution in all healthcare areas of pharmaceutical care for outpatients. The situation survey makes it possible to identify by regions the significant points for improvement...(AU)

Comparación de la calidad de vida en personas que viven con infección por VIH en seguimiento mediante atención farmacéutica según metodología capacidad motivación-oportunidad vs. seguimiento convencional. Proyecto MAS-VIH / Comparison of quality of life in patients living with HIV infection through pharmaceutical care according to CMO methodology vs. conventional follow-up. MAS-VIH project

Objetivo. Comparar la calidad de vida en personas que viven con infección por el Virus de la Inmunodeficiencia Humana según el modelo de Atención Farmacéutica que reciben en los Servicios de Farmacia Hospitalaria: CMO (capacidad, motivación y oportunidad), versus seguimiento convencional. Método. Estudio longitudinal, prospectivo, multicéntrico, realizado entre octubre-2019 y noviembre-2021 en 14 Servicios de Farmacia Hospitalaria de España. Se incluyeron pacientes mayores de 18 años, que recibían tratamiento antirretroviral y acudían a las consultas de Atención Farmacéutica durante ≥1 año. Se excluyeron aquellos pacientes sin autonomía para completar los cuestionarios previstos. Los centros fueron aleatorizados a seguir utilizando la misma sistemática de trabajo (seguimiento tradicional) o implementar el modelo CMO, utilizando la estratificación, establecimiento de objetivos farmacoterapéuticos, uso de entrevista motivacional, así como el seguimientolongitudinal con nuevas tecnologías. La variable principal fue la diferencia en el número de dimensiones afectadas negativamente, en cada rama, a las 24 semanas, según cuestionario MOS-HIV. En el brazo CMO se registraron las intervenciones más frecuentemente realizadas.Resultados. Se incluyeron 151 pacientes. La mediana de edad fue de 51,3 años. Se encontró mejora significativa de la calidad de vida al final del seguimiento en el grupo CMO, reduciéndose el número de pacientes con dimensiones afectadas negativamente (2/11 vs 8/11). Las intervenciones más frecuentes llevadas a cabo, según la taxonomía, fueron: Motivación (51,7%) y Revisión y validación del TAR (49,4%). Conclusiones. La calidad de vida de los pacientes es superior en aquellos centros que desarrollan Atención Farmacéutica basada en metodología CMO en comparación con el seguimiento tradicional. (AU)

Objective. To compare quality of life, in patients livingwith HIV infection with pharmaceutical care according to the CMO methodology: capacity, motivation and opportunity versus conventional follow-up. Method. Longitudinal, prospective, multicenter, health intervention study, conducted between October 2019 and November 2021 in 14 centers throughout Spain. Patients over 18 years of age, receiving antiretroviral treatment and attending the consultations of the participating Pharmacy Services for 1 year were included. Patients who did not have the autonomy to complete the planned questionnaires were excluded. At baseline, participating centers were randomized to continue using the same systematics of work (traditional follow-up) or to implement the CMO model using patient stratification models, goal setting in relation to pharmacotherapy, use of motivational interviewing, as well as longitudinal follow-up enabled by new technologies. The main variable was the difference in the number of dimensions positively affected in each follow-up arm at 24 weeks of follow-up according to the MOS-HIV questionnaire. In the CMO group, the interventions performed the most frequently were recorded. Results. 151 patients were included. The median age was 51.35 years. A significant improvement in quality of life was found at the end of follow-up in the CMO group, reducing the number of patients with negatively affected dimensions (2/11 vs 8/11). The most frequent interventions carried out in the CMO group, according to the taxonomy, were Motivation (51,7%) and review and validation (49,4%) Conclusions. The quality of life of patients is higher in those centers that develop Pharmaceutical Care based on the CMO methodology compared to traditional follow-up. (AU)

Design of a multi-category drug information integration platform for intelligent pharmacy management: A needs analysis study.

A drug store was never just an area to fill personal solution. Patients considered drug specialists to be counsels, somebody who could help them pick an over-the-counter treatment or understanding the portion and directions for a solution. Drug stores, similar to the remainder of the medical services business, are going through changes. Nowadays, one of the main highlights of any structure is the board. The executives give the refinement needed to wrap up any responsibility in a particular way. The executive framework of a drug store can be utilized to deal with most drug store related errands. This report has provided data on the best way to fabricate and execute a Pharmacy Management System. The primary objective of this system is to expand exactness, just as security and proficiency, in the drug shop. This undertaking is focused on the drug store area, determined to offer engaging and reasonable programming answers to assist them with modernizing to rival shops (helping out other equal modules in a similar examination program). This study will clarify the system's thoughts concerning the board issues and arrangements of a drug store. Likewise, this study covers the main parts of the Pharmacy application's investigation, execution, and look.

Intelligent supervision of PIVAS drug dispensing based on image recognition technology.

Pharmacy Intravenous Admixture Services (PIVAS) are places dedicated to the centralized dispensing of intravenous drugs, usually managed and operated by professional pharmacists and pharmacy technicians, and are an integral part of modern healthcare. However, the workflow of PIVAS has some problems, such as low efficiency and error-prone. This study aims to improve the efficiency of drug dispensing, reduce the rate of manual misjudgment, and minimize drug errors by conducting an in-depth study of the entire workflow of PIVAS and applying image recognition technology to the drug checking and dispensing process. Firstly, through experimental comparison, a target detection model suitable for drug category recognition is selected in the drug-checking process of PIVAS, and it is improved to improve the recognition accuracy and speed of intravenous drug categories. Secondly, a corner detection model for drug dosage recognition was studied in the drug dispensing stage to further increase drug dispensing accuracy. Then the PIVAS drug category recognition system and PIVAS drug dosage recognition system were designed and implemented.

Patient satisfaction with pharmaceutical services at primary healthcare centers under the Palestinian Ministry of Health.

BACKGROUND: The measurement of patient satisfaction is a vital metric that enhances stakeholders to take proactive steps in improving the quality of healthcare services within medical care systems. This study assessed patient satisfaction receiving pharmaceutical services from primary health care centers in the Palestinian Ministry of Health (PMoH) governorate directorates in the West Bank. METHODS: A total of 938 patients, all aged 18 years or older, completed a self-administered questionnaire. The assessment of general satisfaction was based on selected questions. Analyses were conducted to explore demographic characteristics. Mean and standard deviation (S.D.) were reported. Likert method was used to average scale satisfaction. To examine statistically significant differences, Chi-square analysis and binary logistic analysis were employed. RESULTS: 56.8% of the survey respondents were women, 57.2% were 40 years or older, and 63.2% had graduated from high school. The general satisfaction score averaged 4.10 ± 0.77 indicating good satisfaction. Patients were satisfied with interpersonal relationships, with a mean score of 4.19 ± 0.70. However, satisfaction with therapy management was lower, with a mean score of 3.99 ± 0.77 indicating moderate satisfaction. A significant factor can affect patient's satisfaction such as the location of the pharmacy (OR = 1.720, P = 0.012), the waiting area (OR = 1.671, P = 0.002) and the cleanness of pharmacy (OR = 2.307, P = 0.001). CONCLUSION: This study underlines the main components of patient satisfaction who receive pharmaceutical services in PMoH. It is highly recommended that PMoH must address patient dissatisfaction points in a total quality management plan.

A primer on brand-name prescription drug contracting.

Prescription drug contracting in the United States has evolved over decades from discounts provided to members of early health maintenance organization plans to rebate contracts to more complex value-based purchasing arrangements. This primer describes the history of contracting between pharmaceutical manufacturers and managed care pharmacy organizations and details the various contracting methods used today.

Intervenciones farmacéuticas en usuarios de benzodiacepinas durante la pandemia COVID-19 / Pharmaceutical interventions in benzodiazepine users during the COVID-19 pandemic

Introducción: la Intervención Farmacéutica busca optimizar y racionalizar el uso, la efectividad y la seguridad de los medicamentos dispensados resolviendo problemas relacionados con el medicamento (PRM) y resultados negativos asociados a la medicación (RNM).Objetivo: evaluar las Intervenciones Farmacéuticas realizadas a usuarios de benzodiacepinas durante la pandemia COVID-19 desde una Farmacia Comunitaria.Método: estudio prospectivo observacional, descriptivo y transversal (código AEMPS: DAA-CLO-2020-01) de las Intervenciones Farmacéuticas llevadas a cabo por una farmacia comunitaria tinerfeña entre agosto 2020 y febrero 2021.Resultados: un total de 306 Intervenciones Farmacéuticas fueron realizadas sobre 127 pacientes. La educación sanitaria y la información personalizada sobre el medicamento fueron las Intervenciones Farmacéuticas mayoritarias tras detectar entre los pacientes un alto grado de desconocimiento sobre las benzodiacepinas usadas. Las Intervenciones Farmacéuticas que se acompañan de derivación al médico alcanzan el 37,8 % tras detectar PRM y/o RNM o identificar al paciente como candidato para deprescripción. Estas derivaciones incluyen a los pacientes con un estado de depresión muy alto según el test Euroqol 5D-3L. La Intervención Farmacéutica con derivación al Servicio de Seguimiento Farmacoterapéutico se realiza en el 3,1 % de los pacientes. El grado de aceptación de la Intervención Farmacéutica por parte de los pacientes alcanza el 98,4 %.Conclusiones: el alto porcentaje de aceptación de las Intervenciones Farmacéuticas refuerza el valor de la Farmacia Comunitaria en la optimización y racionalización del uso de benzodiacepinas y fortalece el vínculo farmacéutico-paciente. La pandemia COVID-19 dificultó la colaboración farmacéutico-médico, a pesar de la existencia de protocolos telemáticos de comunicación entre sanitarios.(AU)

Using the Kirkpatrick model to evaluate a sepsis escape room for advanced pharmacy learners.

BACKGROUND AND PURPOSE: The purpose of this study was to use the first three levels of the Kirkpatrick Model to evaluate the effectiveness of a simulation center-based escape room activity designed to positively influence student learning. EDUCATIONAL ACTIVITY AND SETTING: In this simulation, learners solve puzzles related to care of a critically ill patient. This activity was assessed via an assessment questionnaire (Kirkpatrick level 1), a pre/post learner knowledge quiz and learner self-assessment of skills and attitudes (Kirkpatrick level 2), and unstructured observation of learners upon return to the clinical environment (Kirkpatrick level 3). FINDINGS: Average learner knowledge assessment scores (Kirkpatrick level 2) improved from 80% (pre-) to 90.5% (post-) and learners identified an increased confidence in disease state diagnosis and expression of recommendations (Kirkpatrick level 2). Learner perception of the activity (Kirkpatrick level 1) was positive but also included areas for improvement. Anecdotal reporting supports learners transfer of the knowledge and skills reviewed in the session to practice (Kirkpatrick level 3), but no formal data collection or analysis was completed. SUMMARY: This study provides quantitative and qualitative evidence to support effectiveness of the activity according to Kirkpatrick's Levels 1 and 2, and anecdotal evidence to support effectiveness according to Kirkpatrick's Level 3. Learners had positive perspectives of this activity and demonstrated evidence of increased knowledge and self-reported confidence in skills and attitudes, suggesting this activity has a positive impact on learners in the short-term; however, the data is not robust enough to support conclusions that this activity influences learner practice.

Current scenario and challenges of clinical pharmacists to implement pharmaceutical care in DRG/DIP payment hospitals in China: a qualitative interview study.

Purpose: The Diagnosis-Related Group (DRG) or Diagnosis-Intervention Packet (DIP) payment system, now introduced in China, intends to streamline healthcare billing practices. However, its implications for clinical pharmacists, pivotal stakeholders in the healthcare system, remain inadequately explored. This study sought to assess the perceptions, challenges, and roles of clinical pharmacists in China following the introduction of the DRG or DIP payment system. Methods: Qualitative interviews were conducted among a sample of clinical pharmacists. Ten semi-structured interviews were conducted, either online or face to face. Thematic analysis was employed to identify key insights and concerns related to their professional landscape under the DRG or DIP system. Results: Clinical pharmacists exhibited variable awareness levels about the DRG or DIP system. Their roles have undergone shifts, creating a balance between traditional responsibilities and new obligations dictated by the DRG or DIP system. Professional development, particularly concerning health economics and DRG-based or DIP-based patient care, was highlighted as a key need. There were calls for policy support at both healthcare and national levels and a revised, holistic performance assessment system. The demand for more resources, be it in training platforms or personnel, was a recurrent theme. Conclusion: The DRG or DIP system's introduction in China poses both opportunities and challenges for clinical pharmacists. Addressing awareness gaps, offering robust policy support, ensuring adequate resource allocation, and recognizing the evolving role of pharmacists are crucial for harmoniously integrating the DRG or DIP system into the Chinese healthcare paradigm.

A primer on quality measurement and reporting in pharmacy benefit plans.

Pharmacy benefit plans in the United States are evaluated on quality measures and other requirements of the government and accrediting organizations. This primer describes the roles of key organizations involved in measuring and reporting quality in pharmacy benefit plans and explains the methods that pharmacy benefit plans use to promote quality of medication use.

Comparison of time to treatment initiation of specialty medications between an integrated health system specialty pharmacy and external specialty pharmacies.

BACKGROUND: Specialty medications are commonly dispensed through specialty pharmacies equipped to meet unique monitoring and dispensing requirements. Integrated health system specialty pharmacies (HSSPs) coordinate with health system providers to deliver specialty medications to patients and ameliorate barriers to care. However, payors may restrict specialty medication fills to specialty pharmacies external to the health system, potentially leading to delayed treatment. OBJECTIVE: To compare time to treatment initiation among patients whose specialty medications were transferred to external pharmacies and patients whose medications were filled at an internal HSSP. METHODS: This was a retrospective, propensity-matched cohort study examining time to treatment initiation in patients with a specialty medication referral to the University of Kentucky HealthCare Specialty Pharmacy between July 1, 2021, and July 1, 2022. Patients were classified into cohorts by receipt of dispensing services from the internal HSSP or an external specialty pharmacy. Data collected via chart review included insurance type, reason for prescription transfer, dates of service (including prescription order, transfer, and receipt of medication), and whether a prior authorization or clinical intervention was performed. Subgroup analyses were performed for patients requiring a prior authorization or clinical intervention. The Wilcoxon signed-rank test was used to assess for statistically significant differences in time to treatment initiation between cohorts. RESULTS: A total of 560 patients with external transfers were identified for inclusion into the study, and after exclusion criteria were applied, 408 external transfer patients were propensity matched 1:1 to 408 patients with internal fills (total n = 816). Time to treatment initiation was significantly longer in the external transfer cohort as compared with the internal fill cohort, (18 days vs 12 days; P < 0.0001). The internal fill cohort had a greater mean days from provider order to the medication being ready to fill compared with the external transfer cohort (10 days vs 6 days; P < 0.0001). The internal fill cohort had fewer mean days from the medication being ready to fill to patient receipt of the medication as compared with the external transfer cohort (2 days vs 12 days; P < 0.0001). Similar findings were observed in the subgroup analyses. CONCLUSIONS: Average time to treatment initiation was 6 days shorter for patients whose specialty medications were filled at this HSSP compared with externally transferred patients. Delays in therapy can cause a negative impact on patient care and disease state management, with increased concern for specialty populations. The results of this study highlight the need for continued discussion about policies that limit patient choice to in-network pharmacies.