Scientific Poster Session I - Original Research

Original Research
  Saturday, November 11, 2023
  11:30 AM–01:00 PM

Abstract

Introduction: A specialty pharmacy mandate (SPM) is a rule made by insurance companies requiring patients to obtain “specialty” medications from specific pharmacies (often out-of-state or mail-order pharmacies).

Research Question or Hypothesis: What impact, if any, do SPMs have on patient care and team member experiences post-transplant?

Study Design: Two similar surveys were distributed to transplant providers. One survey was sent to multiple American Society of Transplantation Communities of Practice (ASTCOPs) to capture transplant providers/pharmacists and the other was distributed to the International Transplant Nurses Society (ITNS) to gather nurse/coordinator experiences.

Methods: An email was sent out via ASTCOP and ITNS listservs to participate in an IRB-approved Qualtrics Survey (24 questions). The survey remained open for 8 weeks.

Results: A total of 167 respondents were included (n=105 ASTCOPs, n=62 ITNS) and 12 excluded for incomplete data. The majority of the ITNS cohort identified their role as Nurse/Coordinator (97%), while the majority of the ASTCOPs cohort as Pharmacists (76%) and Physicians (13%). At the end of the survey, over 70% reported that they agree or strongly agree that SPMs affect day to day activities and a majority (74% ASTCOP, 64% ITNS) agreed or strongly agreed that SPMs affect the ability to provide patient care. Table 1 reports the impact of SPMs on discharge and medication access. Approximately 70% reported attempting a one-time fill of specialty medications at a local pharmacy to allow discharge, however, the majority reported numerous barriers, with approximately 50% reporting it required more than 60 minutes.

Table 1.	ASTCOPs (n=105)	ITNS (n=62)
SPM delayed discharge in last 12-months	62%	48%
SPM delayed initiation of therapy in last 12-months	65%	63%
In a setting of delay how has the cost of medication been covered: Institution covers Patient pays cash	43% 58%	40% 53%

Conclusion: SPMs impact care and result in delayed discharges with a significant financial impact on the patient.

Presenting Author

Matt Harris PharmD, MHS
Duke University Hospital

Authors

Marissa Brokhof PharmD
Rush University Medical Center

Ann Kataria PharmD
Baylor University Medical Center at Dallas

Nicole Kenyon PharmD
Rush University Medical Center

Karen Khalil PharmD
University of Illinois Hospital & Health Sciences System

Vineeta Kumar MD
University of Alabama at Birmingham

Renu Nathan PharmD
UMass Memorial Health

Elijah Velasquez PharmD
Fairview Pharmacy

Jeffrey Stern MD
NYU Langone Health