Scientific Poster Session III - Original Research

Original Research
  Monday, October 14, 2024
  01:00 PM–02:30 PM

Abstract

Introduction: CenterWell Pharmacy (CWP) aims to reduce medical costs through evidence-based practices. Previous work has shown CWP’s mail-order with 90-day fills is associated with higher Proportion of Days Covered (PDC), reduced hospitalizations and allowed medical spend. This study extends into patients with Heart Failure with Reduced Ejection Fraction (HFrEF). Our findings confirmed patients who take more medications on Guideline-Directed Medical Therapy (GDMT) have better health outcomes, regardless of pharmacy. In addition, those who filled with CWP had higher adherence and fewer admits compared with patients who fill elsewhere.

Research Question or Hypothesis: Does CWP improve outcomes for HFrEF patients?

Study Design: Retrospective study using 6 months of medical claims data nationwide from 2022 examined 200k Humana beneficiaries who were taking at least 1 therapy for HFrEF , in provider groups with 100+ patients.

Methods: Propensity Score Matching (PSM) and Doubly Robust Targeted Maximum Likelihood Estimation (DRTMLE) were used to compare member PDC for those who used CWP to fill HFrEF medication(s) with those who didn’t while controlling for provider group influences, healthcare policy, and environmental factors. We used mixed linear effect (MLE) regression to model the number of ER visits and allowed medical spend against CWP usage, number of HFrEF therapies, and other covariates including comorbidities and demographics. We included a random intercept for provider group and state issued.

Results: PSM and DRTMLE demonstrated within provider groups, CWP usage was associated with a statistically significant 4.8% higher HFrEF therapy PDC. MLE models show that CWP usage was associated with a significant 5.6% fewer ER visits and 3.5% reduced medical spend. This is in addition to the statistically significant effect of 5.6% fewer ER visits and 2.3% reduced medical costs per added GDMT therapy, mirroring clinical findings.

Conclusion: Providers can help HFrEF patients by prescribing more GDMT medications. Filling prescriptions at CWP could increase PDC and reduce costs and hospitalizations.

Presenting Author

Stephen Mattingly PhD
Humana Inc.

Authors

Natalia Quintero Doctor of Pharmacy (PharmD)
Humana Inc.

Melanie Sadler Doctor of Pharmacy (PharmD)
Humana Inc.