Data on Managed Care and Specialty Pharmacy Detailed by Researchers at Nationwide Children’s Hospital (Impact of Pharmacist Alternative Therapy Interventions In a Pediatric Medicaid Population): Drugs and Therapies – Managed Care and Specialty Pharmacy

2023 SEP 11 (NewsRx) -- By a News Reporter-Staff News Editor at Insurance Daily News -- Data detailed on Drugs and Therapies - Managed Care and Specialty Pharmacy have been presented. According to news originating from Columbus, Ohio, by NewsRx correspondents, research stated, “Ambulatory clinical pharma-cists are viewed as the medication experts on the health care team and frequently assist with medication access concerns. However, medication access and insurance naviga-tion are difficult because of wide variations in insurance formularies.”

Financial support for this research came from National Center for Advancing Translational Sciences (CTSA Grant).

Our news journalists obtained a quote from the research from Nationwide Children’s Hospital, “Accountable care organizations (ACOs) incorporate pharma-cists as members of their population health teams to assist with these efforts. These ACO pharmacists are uniquely positioned to assist pediatric ambulatory care pharmacists with medication access concerns. This collabora-tion has the potential to not only improve patient care but also provide cost savings.To estimate cost savings to an ACO derived from alternative therapy interventions made by pharmacists embed-ded in pediatric ambulatory clinics, using resources created by ACO pharmacists, within a pediatric Medicaid population. The secondary objectives were to quantify the frequency of alternative therapy inter-ventions provided by these pharmacists, evaluate the impact on medication access through the avoidance of prior authorizations (PAs), and assess the frequency and cost sav-ings of alternative therapy interventions per treatment category. This was a retrospective review of alternative therapy interventions provid-ed by pediatric ambulatory care pharmacists within a health-system in central Ohio. Interventions were collected within an elec-tronic health record from January 1, 2020, to December 31, 2020. Cost savings were calculated using average wholesale pricing, and PA avoidance was quantified.A total of 278 alternative therapy interventions were made with an estimated cost savings of $133,191.43. Primary care clin-ics (n = 181, 65%) had the most documented interventions. A total of 174 (63%) interven-tions resulted in the avoidance of a PA. The antiallergen (28%) treatment category had the most documented interventions.Alternative therapy interventions were provided by pediatric ambulatory care pharmacists in collabora-tion with pharmacists working for an ACO.”

According to the news editors, the research concluded: “The use of ACO prescribing resources can result in cost savings to an ACO and PA avoidance within a pediatric Medicaid population.”

This research has been peer-reviewed.

For more information on this research see: Impact of Pharmacist Alternative Therapy Interventions In a Pediatric Medicaid Population. Journal of Managed Care & Specialty Pharmacy, 2023;29(7):835-841. Journal of Managed Care & Specialty Pharmacy can be contacted at: Acad Managed Care Pharmacy, 100 N Pitt St, 400, Alexandria, VA 22314-3134, USA.

The news correspondents report that additional information may be obtained from Megan C. McNicol, Nationwide Children’s Hospital, Dept. of Pharmacy, Columbus, OH 43205, United States. Additional authors for this research include Kelin Wheaton, Sonya Sebastian, Mahmoud Abdel-Rasoul and Kathy E. Monangai.

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