Specialty Pharmacy Patients More Adherent to Imatinib

Medication adherence was higher among patients who received their medication from a specialty pharmacy than from other dispensing channels.

Medication adherence was higher among patients who received their medication from a specialty pharmacy than from other dispensing channels.

Patients with chronic myeloid leukemia who received their medications from a specialty pharmacy were nearly 50% more likely to adhere to their complex regimens than those who received their drugs from other dispensing channels, new research finds. The specialty pharmacy offered refill reminders, care management, and educational programs to the oncology patients.

Medication adherence is particularly important for patients with chronic myeloid leukemia. However, there are many barriers that prevent patients from taking their medications correctly. Previous research has found that just 54% of patients taking imatinib achieve the optimum adherence level of 90% or higher. The current study, published online on December 5, 2013, in the American Journal of Pharmacy Benefits, evaluated the role of the specialty pharmacy in improving adherence to the therapy.

Pharmacy claims data for patients starting imatinib therapy were collected from a pharmacy benefits manager with an in-house specialty pharmacy from July 2010 to August 2012. Patients could receive their medications from the in-house specialty pharmacy, other specialty pharmacies, retail pharmacies, home delivery pharmacies, or from a combination of these sources. The specialty pharmacy offered education and care management provided by pharmacists and nurses trained in oncology, as well as prescription refill reminders via telephone. Specialty pharmacists monitored adherence, addressed patients’ specific medication problems, and helped to detect side effects, medication errors, and discontinuation of therapy. All patients were followed for 1 year and the researchers analyzed differences in adherence levels, controlling for demographics, medication burden, cost, and other factors.

A total of 704 patients were included in the study: 433 used the specialty pharmacy and 271 used other dispensing channels. Specialty pharmacy patients were 1.46 times more likely to reach optimum adherence when compared with those who received the drug from other suppliers. Patients who used the specialty pharmacy also had their medication on hand more often than those who used other channels. Patients who used the specialty pharmacy also paid less out-of-pocket and had a lower medication burden than other patients.

Although the study could not account for disease severity and was limited by the scope of the data collected, the results indicate that specialty pharmacies can help to improve adherence among cancer patients, potentially lowering medication costs.

“With an increasing number of oral medications for cancer entering the marketplace, patient adherence is an increasingly important determinant of treatment success,” the authors of the study conclude. “Plan sponsors, payers, and patients may benefit from a pharmacy model used by the specialty pharmacy evaluated in this study for the dispensing and use of oral oncology medications.”

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