Study Shows Health Outcome in HCV Tied to Specialty Pharmacy Channel

Improvements in adherence levels and outcomes for patients with hepatitis C were recently linked to the pharmacy channel through which the patients received their specialty medications.

A study published in the January/February 2013 edition of The American Journal of Pharmacy Benefits utilizing data from Express Scripts demonstrated that patients with hepatitis C who exclusively used a specialty pharmacy to fill their medications had a 60% higher likelihood of realizing optimum adherence levels than those who used a retail pharmacy. The improvement in regimen adherence, according to study researchers, was influenced by the additional support services offered by the specialty pharmacy.

Investigators analyzed hepatitis C patients from the Express Scripts database from 2007 to 2009 and determined the channel through which these patients received their medications based on adjudication claims. They compared adherence levels of patients who received a 2-drug regimen of ribavirin plus interferon from the company’s in-house specialty pharmacy with patients who got the same medications from either an external specialty pharmacy or a retail pharmacy. Patients using an amalgamation of channels during this period were excluded from the study. Patients who also showed claims for antiretroviral or hepatitis B medications were also omitted, as these patients were determined to be at a higher risk of treatment discontinuation.

Nearly 41% of retail patients (n=741) had adherence levels of 80% or better, compared with nearly 54% of patients receiving their medications from a specialty pharmacy (N=1489) (either in-house or external). The difference in likelihood of reaching 80% adherence was determined to be statistically significant. Moreover, patients who only used a specialty pharmacy were found on average to have nearly 9% higher adherence and 2 fewer weeks of gap days. Most notably, the investigators concluded that patients using a specialty pharmacy had nearly 60% higher odds of realizing a sustained virologic response than those using a retail channel.

“Hepatitis C therapy comes with a unique set of challenges and many barriers to adherence for HCV patients,” Sharon Frazee, PhD, MPH, vice president of research and analysis at Express Scripts, and a coauthor of the study, told Specialty Pharmacy Times in an email. “Overcoming these barriers is essential to patients being adherent to therapy and improving their chances of achieving a sustained viral response—or cure—and avoiding serious long-term complications such as cirrhosis or the need for a liver transplant.”