Journal of managed care & specialty pharmacy最新文献

{"title":"Poster Abstracts - Academy of Managed Care Pharmacy 2026.","authors":"","doi":"10.18553/jmcp.2026.32.4-a.s1","DOIUrl":"https://doi.org/10.18553/jmcp.2026.32.4-a.s1","url":null,"abstract":"<p><p>The AMCP Poster Abstract Program provides a forum for authors to share their research with the managed care pharmacy community. Authors submit their abstracts to AMCP, and each abstract is reviewed by a team of peer reviewers and editors. All accepted abstracts are presented as posters at AMCP's Annual and Nexus meetings. These abstracts are also available through the AMCP meeting app. This JMCP supplement publishes all abstracts that were peer reviewed and accepted for presentation at AMCP 2026. Abstracts submitted in the Student and Encore categories did not undergo peer review; therefore, these abstracts are not included in the supplement.</p>","PeriodicalId":16170,"journal":{"name":"Journal of managed care & specialty pharmacy","volume":"32 4-a Suppl","pages":"S1-S142"},"PeriodicalIF":2.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147592635","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Budget impact of xanomeline and trospium chloride for the treatment of adults with schizophrenia in the United States.","authors":"Annika Bjerke, Tyler Mantaian, Kristin Gillard, Matthew F Sidovar, Jonathan Kowalski, Jeff Lee, Andrew Tunnicliffe","doi":"10.18553/jmcp.2026.25256","DOIUrl":"10.18553/jmcp.2026.25256","url":null,"abstract":"<p><strong>Background: </strong>Schizophrenia is a severe mental health condition affecting up to 1.2% of the US population, resulting in an estimated economic burden of approximately $343 billion in 2019. Traditional treatments primarily target dopamine receptors and include first- and second-generation antipsychotics, which are associated with chronic adverse events (AEs) (eg, severe movement disorders, metabolic syndrome). Management of these AEs entails considerable clinical implications and economic burden, leading to increased health care expenditures for patient care and symptom control. Recently, the US Food and Drug Administration (FDA) approved xanomeline and trospium chloride (X/T), a novel treatment targeting muscarinic rather than dopaminergic receptors. X/T has demonstrated efficacy in reducing both positive and negative symptoms of schizophrenia, with a more tolerable AE profile than traditional standard of care.</p><p><strong>Objective: </strong>To estimate the budget impact of incorporating X/T in a hypothetical 1 million-member US health plan, with Medicare, Medicaid, and commercial coverage, to treat adults with schizophrenia.</p><p><strong>Methods: </strong>A 3-year budget impact model was developed in Microsoft Excel to estimate the number of schizophrenia patients eligible for second-line treatment within a health plan and the total treatment-related costs. The 10 largest first- and second-generation antipsychotic treatments by market share across payer type were the comparators included in the base case analysis. The model captured drug acquisition, administration, and treatment-emergent AE management costs to estimate the budget impact on a total per year and per member per month (PMPM) basis.</p><p><strong>Results: </strong>Introducing X/T as a second-line treatment for adults with schizophrenia to a 1 million-member health plan results in a PMPM budget impact ranging from $0.0177 in year 1 to $0.1006 in year 3. The total annual budget impact is estimated to be between $212,479 and $1,219,085 in year 1 and year 3, respectively. X/T also results in reduced AE management costs over 3 years ($11,336 692 vs $11,276,020) driven by lower rates of tardive dyskinesia and metabolic syndrome associated with X/T use. Sensitivity and scenario analyses demonstrated minimal budget impact sensitivity to parameter variations, with results most sensitive to the cost of X/T and inputs used to estimate the size of the eligible patient population.</p><p><strong>Conclusions: </strong>The safety and tolerability profile of X/T, coupled with its minimal PMPM budget impact of $0.0177 in year 1 up to $0.1006 in year 3, based on market uptake of 1%, 2%, and 3% in years 1, 2, and 3, respectively, supports the inclusion of X/T on the formularies of third-party US health care plans for adults with schizophrenia.</p>","PeriodicalId":16170,"journal":{"name":"Journal of managed care & specialty pharmacy","volume":" ","pages":"458-469"},"PeriodicalIF":3.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13020391/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147355211","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health care cost trajectories among patients with cancer and cardiometabolic comorbidities over a decade including the pandemic period.","authors":"Li-Wei Wu, Ji Haeng Heo, Arianna Fa, Boon Peng Ng, Chanhyun Park","doi":"10.18553/jmcp.2026.32.4.445","DOIUrl":"10.18553/jmcp.2026.32.4.445","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Cardiometabolic comorbidities, including hypertension, hyperlipidemia, and diabetes, are common among patients with cancer. Although the financial burden of cancer is well documented, how the extent to which these comorbidities affect trends in health care costs after a cancer diagnosis remains unknown. Furthermore, the influence of the COVID-19 pandemic on these health care cost trends has yet to be thoroughly examined.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To assess trends in annual health care costs among patients with cancer over a decade, including the pandemic period, and the impact of preexisting cardiometabolic comorbidities on these costs.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This retrospective cohort study used 2011-2021 MarketScan data to identify patients with newly diagnosed cancer annually from 2012 to 2020. The 2019 and 2020 cohorts included patients assessed during the COVID-19 pandemic. The primary predictor was the presence of preexisting comorbidities, including hypertension, hyperlipidemia, and diabetes, in the year before the cancer diagnosis. Outcomes were health care costs incurred within 1 year after the diagnosis, including inpatient, emergency department, outpatient, and pharmacy expenses. Generalized linear models and Joinpoint models estimated mean cost ratios and annual percentage changes (APCs). All costs were inflation-adjusted to 2021 US dollars.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Among 738,414 patients (mean age: 60.5 years, SD: 13.2), 42.4% had hypertension, 41.5% hyperlipidemia, 14.9% diabetes, and 41.2% none of these comorbidities. From the 2012 cohort to the 2018 cohort, average health care costs during the first year after diagnosis increased steadily: from $30,702 to $41,962 (APC: 5.5%) for patients with hypertension, from $29,353 to $40,510 (APC: 5.6%) for hyperlipidemia, and from $28,968 to $42,432 (APC: 6.2%) for diabetes. Among those without these conditions, costs increased from $26,856 to $36,624 (APC: 5.1%), $28,188 to $38,259 (APC: 5.1%), and $28,608 to $38,620 (APC: 5.2%), respectively. Annual health care costs declined in the 2019 and 2020 cohorts, overlapping with the pandemic. Specifically, health care costs dropped to $30,992 (APC: -14.3%) for patients with hypertension, $29,332 (APC: -14.7%) for hyperlipidemia, and $31,301 (APC: -13.3%) for diabetes; corresponding declines were $26,003 (APC: -14.1%), $28,013 (APC: -13.6%), and $27,987 (APC: -14.5%) among patients without these conditions. Patients with hypertension, hyperlipidemia, and diabetes had 14% to 21%, 4% to 8%, and 1% to 12% higher annual health care costs, respectively, than those without these comorbidities.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Health care costs for patients with cancer and preexisting cardiometabolic comorbidities have increased significantly since 2012, with a temporary decline after 2019, potentially due to the COVID-19 pandemic. Patients with cancer who had cardiometabolic comorbidities had sig","PeriodicalId":16170,"journal":{"name":"Journal of managed care & specialty pharmacy","volume":"32 4","pages":"445-457"},"PeriodicalIF":3.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13020394/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147512741","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transparent reporting of group-based trajectory modeling to study medication adherence: Practical considerations and common pitfalls.","authors":"John G Rizk, Danya M Qato","doi":"10.18553/jmcp.2026.32.4.507","DOIUrl":"10.18553/jmcp.2026.32.4.507","url":null,"abstract":"<p><p>Medication adherence is dynamic and varies over time, yet many studies use the proportion of days covered as a static measure summarized across the entire observation period, which can obscure meaningful changes in adherence behavior over time. Group-based trajectory modeling (GBTM) has become an increasingly popular method for examining longitudinal adherence patterns and for identifying distinct subgroups of individuals with similar medication-taking behavior. Although this approach provides important advantages, it also introduces additional methodological complexity that has implications for reproducibility, interpretation, and bias. This Viewpoint article provides practical guidance for researchers, clinicians, editors, and peer reviewers who evaluate or apply GBTM to study medication adherence. We describe common modeling decisions, including selecting the time scale, choosing between binary or continuous adherence measures, determining the number and shape of trajectories, and handling enrollment requirements, while highlighting the benefits and limitations associated with each approach. We also identify major threats to study validity, including selection bias from restrictive continuous enrollment criteria, immortal time bias, and reverse causality. To support transparency and consistency in reporting, we summarize key components that should be documented in manuscripts using GBTM. In sum, we aim to strengthen the quality of evidence informed by medication adherence studies.</p>","PeriodicalId":16170,"journal":{"name":"Journal of managed care & specialty pharmacy","volume":"32 4","pages":"507-516"},"PeriodicalIF":3.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13021367/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147512709","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence of amyloid-related imaging abnormalities and health resource utilization in patients with Alzheimer disease receiving monoclonal antibody treatments: A real-world evidence study.","authors":"Saba Dangpiaei, Khalid M Kamal, Osama A Shoair, Mohammad A Al-Mamun","doi":"10.18553/jmcp.2026.32.4.470","DOIUrl":"10.18553/jmcp.2026.32.4.470","url":null,"abstract":"<p><strong>Background: </strong>All recently approved monoclonal antibodies (eg, aducanumab, lecanemab, and donanemab) for Alzheimer disease (AD) were shown to increase the risks of amyloid-related imaging abnormalities (ARIA) in randomized clinical trials, which can include brain swelling or hemorrhage. Real-world evidence (RWE) studies are critically warranted to evaluate the associated risks of ARIA and health care resource utilization (HRU) with monoclonal treatments compared with existing nonmonoclonal (eg, donepezil, memantine and rivastigmine) treatments.</p><p><strong>Objective: </strong>To evaluate the risk of ARIA in patients receiving monoclonal vs nonmonoclonal treatments. The secondary aim was to investigate the HRUs including emergency department (ED) and inpatient visits between the 2 groups.</p><p><strong>Methods: </strong>We conducted a retrospective study using a large electronic health record dataset. Individuals (aged ≥18 years) diagnosed with AD and receiving monoclonal treatment were matched with a nonmonoclonal treatment group using propensity score matching. An Andersen-Gill survival model was used to estimate the cumulative hazard of ARIA after adjusting for baseline comorbidities. Negative binomial regression was applied to assess the HRUs between the 2 groups.</p><p><strong>Results: </strong>The monoclonal group included 240 patients. Most patients in both groups were aged 70-80 years (47.08% vs 47.29%), female (55.42% vs 56.25%), and White (85.42% vs 85.83%) in the monoclonal and the nonmonoclonal groups, respectively. The monoclonal group had significantly higher cumulative hazard of ARIA (hazard ratio = 4.65, 95% CI = 3.77-5.73; <i>P</i> < 0.001) compared with the nonmonoclonal group. Concurrent antithrombotic use (1.87, 1.48-2.37; <i>P</i> < 0.001), a history of stroke (1.59, 1.21-2.10; <i>P</i> < 0.001), and hyperlipidemia (1.41, 1.09-1.84; <i>P</i> = 0.008) were also associated with increased hazard of ARIA. Among those patients who had at least 180 days of follow-up, the monoclonal group had significantly fewer inpatient visits (β = -2.71, -3.84 to -1.58; <i>P</i> < 0.001) compared with the nonmonoclonal group.</p><p><strong>Conclusions: </strong>Monoclonal treatment was associated with higher cumulative hazard of ARIA but fewer inpatient visits. This study indicated the potential of RWE, despite its distinct observational design and differences from randomized clinical trials, to serve as a credible proof-of-concept in postapproval assessment and to inform personalized treatment guidelines based on patients' risk factors.</p>","PeriodicalId":16170,"journal":{"name":"Journal of managed care & specialty pharmacy","volume":"32 4","pages":"470-484"},"PeriodicalIF":3.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13020393/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147512712","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of a pharmacist-led hepatitis C clinic on hepatitis A and B vaccination rates and treatment outcomes: A retrospective cohort study.","authors":"Lauren Jenkins, Courtney Koogler, Emma Sapp, Andrea Spaulding, Shelbi Adams","doi":"10.18553/jmcp.2026.32.4.485","DOIUrl":"10.18553/jmcp.2026.32.4.485","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Hepatitis C virus (HCV) affects approximately 2.4 million people in the United States, with Kentucky having one of the highest HCV infection rates. The Centers for Disease Control and Prevention (CDC) recommend that all patients diagnosed with HCV be screened and vaccinated as appropriate for hepatitis A virus (HAV) and hepatitis B virus (HBV). Despite these long-standing recommendations, vaccination rates remain below target goals.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To evaluate the impact of a pharmacist-led Medication Management Clinic (MMC) on HAV and HBV vaccination rates and other treatment outcomes in patients diagnosed with HCV compared with a traditional care model.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This retrospective cohort study compared patients diagnosed with HCV treated through a pharmacist-led MMC between August 1, 2022, and February 28, 2024, with those treated through traditional care between August 1, 2016, and February 28, 2018. Primary outcomes included HAV and HBV vaccination initiation rates among eligible patients. Secondary outcomes included screening rates for HAV and HBV, HCV treatment completion, sustained virologic response (SVR), and specialty pharmacy prescription retention. Logistic regression was performed to assess the relationship between vaccination rates and type of care received (traditional care vs MMC), adjusting for baseline demographic and clinical factors, including, age, sex, HCV genotype, and fibrosis stage. Adjusted odds ratios (aORs) with 95% CIs were calculated for HAV and HBV initiation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The study included 330 MMC patients and 250 traditional care patients. Among eligible patients, HAV vaccination rates were higher in the MMC group (33.3% vs 22.6%, &lt;i&gt;P&lt;/i&gt; = 0.02; unadjusted OR = 1.71, 95% CI = 1.11-2.65). After adjusting for age, sex, genotype, and fibrosis stage, patients in the traditional care group were less likely to receive HAV compared with patients in the MMC group (aOR = 0.569, 95% CI = 0.362-0.893; &lt;i&gt;P&lt;/i&gt; = 0.014). Similarly, HBV vaccination rates were higher in the MMC group (36.6% vs 23.7%, &lt;i&gt;P&lt;/i&gt; = 0.01; unadjusted OR = 1.84, 95% CI = 1.15-2.94). In the adjusted analysis, patients in the MMC group were more likely to receive HBV compared with patients in the traditional care group (aOR = 1.85, 95% CI = 1.14-3.00; &lt;i&gt;P&lt;/i&gt; = 0.013). Additionally, older age (OR = 1.03 per year, 95% CI = 1.01-1.05; &lt;i&gt;P&lt;/i&gt; = 0.008) and female sex (OR = 2.29, 95% CI = 1.39-3.754; &lt;i&gt;P&lt;/i&gt; = 0.001) were independent predictors of HBV vaccination. The MMC group also achieved higher screening rates for HAV (97.6% vs 76.4%, &lt;i&gt;P&lt;/i&gt; &lt; 0.001) and HBV (96.1% vs 28.8%, &lt;i&gt;P&lt;/i&gt; &lt; 0.001) and a greater proportion initiated HCV treatment (95.8% vs 24.4%, &lt;i&gt;P&lt;/i&gt; &lt; 0.001), although these treatment initiation differences may be partly attributable to changes in national guidelines and payor restrictions between study periods. A trend toward improved SVR","PeriodicalId":16170,"journal":{"name":"Journal of managed care & specialty pharmacy","volume":"32 4","pages":"485-493"},"PeriodicalIF":3.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13020389/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147512678","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effectiveness and value of brensocatib for the treatment of non-cystic fibrosis bronchiectasis.","authors":"Avery McKenna, Jason H Wasfy, Kibum Kim, Daniel R Touchette, Sodam Kim, Marina Richardson, Daniel A Ollendorf","doi":"10.18553/jmcp.2026.32.3.392","DOIUrl":"10.18553/jmcp.2026.32.3.392","url":null,"abstract":"","PeriodicalId":16170,"journal":{"name":"Journal of managed care & specialty pharmacy","volume":"32 3","pages":"392-397"},"PeriodicalIF":3.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12948755/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147317046","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends in 1-year persistence and adherence among initiators of high-potency, weight loss-indicated glucagon-like peptide 1 receptor agonists.","authors":"Landon Z Marshall, Patrick P Gleason, Nicholas Friedlander, Joel Farley, Benjamin Y Urick","doi":"10.18553/jmcp.2026.32.3.281","DOIUrl":"10.18553/jmcp.2026.32.3.281","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Despite the clinical efficacy of glucagon-like peptide-1 receptor agonists (GLP-1RAs) for weight loss, real-world persistence remains substantially lower than seen in clinical trials. Since 2021, GLP-1RA shortages and changes in product availability have complicated access and persistence.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To describe by calendar year of initiation the 1-year treatment persistence and adherence trends among commercially insured members without diabetes newly initiating high-potency, weight loss-indicated GLP-1RA products, semaglutide (Wegovy) and tirzepatide (Zepbound).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This cohort study used Prime Therapeutics' integrated medical and pharmacy claims data from an average monthly membership of 17.9 million commercially insured individuals to identify members without diabetes who newly initiated high-potency, weight loss-indicated GLP-1RA treatment between January 1, 2021, and June 30, 2024 (index date period), defined in year increments, 2021, 2022, 2023, and the first half of 2024 (1H 2024). Members were included in the study sample if they were continuously enrolled with no more than 15 days total enrollment gap during the 365-day preperiod and the 365-day postperiod after their index GLP-1RA claim with no prior GLP-1RA drug claim 365 days before index. Members were excluded if they had a preperiod diabetes diagnosis medical claim or diabetes drug claim or if they were aged less than 19 years at index. The primary outcome of GLP-1RA persistence was measured as no more than a 60-day gap between the end of a GLP-1RA claim's days supply and the subsequent claim fill date in the 365-day period following index. Adherence was defined as proportion of days covered of at least 80%. Across all measures GLP-1RA product switching was allowed.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Among the 62,650 members without diabetes newly initiating a high-potency, weight loss-indicated GLP-1RA between 2021 and June 30, 2024, 33,607 (53.6%) met the full study criteria. The mean age was 45.7 years, and 75.5% were female. Across the index years, 1-year persistence increased from 33.2% in 2021 to 60.9% in 1H 2024. Semaglutide 1-year persistence rates from 2021 to 1H 2024 were 33.2%, 34.1%, 39.8%, and 58.6%, respectively. For tirzepatide, 1-year persistence rates in 2023 and 1H 2024 (the only years the product was available) were 64.0% and 64.8%, respectively.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;This real-world analysis of high-potency, weight loss-indicated GLP-1RA products among individuals without diabetes found that 1-year treatment persistence has nearly doubled from 33.2% in 2021 to 60.9% in 1H 2024. GLP-1RA product shortage resolution may have improved persistence rates. Other potential influencing factors include improved GLP-1RA dose escalation and side effect management, as well as weight loss lifestyle management programs. Additional research is needed to understand treatment discontinua","PeriodicalId":16170,"journal":{"name":"Journal of managed care & specialty pharmacy","volume":"32 3","pages":"281-291"},"PeriodicalIF":3.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12948759/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147317124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparing rates of primary medication nonadherence and turnaround time among patients at a health system specialty pharmacy compared with external specialty pharmacies.","authors":"Katie R Cruchelow, Sarah Layne, Josh DeClercq, Leena Choi, Autumn D Zuckerman","doi":"10.18553/jmcp.2026.32.3.300","DOIUrl":"10.18553/jmcp.2026.32.3.300","url":null,"abstract":"<p><strong>Background: </strong>Access to specialty medications prescribed for complex and debilitating conditions is often delayed or unsuccessful. Specialty pharmacies can streamline medication access and timely delivery.</p><p><strong>Objective: </strong>To compare primary medication nonadherence (PMN), the rate at which a prescription is written but not obtained by the patient, and turnaround time (TAT) between patients filling specialty medication with an integrated health system specialty pharmacy (HSSP) and those using external specialty pharmacies (non-HSSP).</p><p><strong>Methods: </strong>A retrospective single-center cohort study was performed between June 2021 and May 2022. Patients prescribed specialty medications from the Vanderbilt Health System Oncology, Inflammatory, or Multiple Sclerosis clinics were included if they had a new prescription within the study period and follow-up encounter after the prescription. The primary outcome was PMN, defined as the prescribed medication or therapeutic alternative confirmed to not be filled. TAT was defined as time from a specialty medication prescription to the first filled claim. A logistic regression model was used to test for associations with PMN and the pharmacy the medication was sent to (HSSP vs non-HSSP), controlling for age, sex, clinic, race, and insurance. An ordinal logistic regression model was used to test for associations with TAT and the filling pharmacy (HSSP vs non-HSSP), controlling for age, sex, clinic, race, and insurance.</p><p><strong>Results: </strong>There were 1,466 patients with 1 eligible prescription (67% HSSP and 33% non-HSSP) evaluated for PMN. Of these patients, the median age was 56 (interquartile range [IQR] 41-68) years, 55% of patients were female, and 56% had commercial insurance. PMN was 6.5% for HSSP patients, and 9.9% for non-HSSP patients. Patients who had a prescription sent to non-HSSP pharmacies had 60% higher odds of having PMN (<i>P</i> = 0.027). For the TAT outcome, 1,188 eligible patients were included (66% HSSP and 34% non-HSSP). TAT for patients filling at an HSSP was a median 3 (1-6) days and a median 4 (1-10) days for patients filling at a non-HSSP. Patients who filled at non-HSSP pharmacies had 40% higher odds of having a longer TAT (OR = 1.4, 95% CI = 1.1-1.7, <i>P</i> = 0.004). Patients using commercial insurance (<i>P</i> = 0.018) and Black patients (<i>P</i> = 0.018) had higher odds of a longer TAT.</p><p><strong>Conclusions: </strong>Prescriptions sent to non-HSSP specialty pharmacies are more likely to not be filled or to take longer to fill than those sent to an HSSP.</p>","PeriodicalId":16170,"journal":{"name":"Journal of managed care & specialty pharmacy","volume":"32 3","pages":"300-311"},"PeriodicalIF":3.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12948760/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147317088","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Infusion therapy patient outcomes are similar at reduced costs in alternative sites of care compared with hospital outpatient departments: A matched cohort analysis of infusion therapy across multiple chronic conditions.","authors":"Daniel Cullen, Aliza S Gordon, Sarah Adkins Svoboda, Madison Alvarez, Rebecca Cobb","doi":"10.18553/jmcp.2025.25264","DOIUrl":"10.18553/jmcp.2025.25264","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Infusion therapy, used to administer medications for multiple chronic diseases, can be performed in hospital outpatient departments (HOPDs), patients' homes, ambulatory infusion centers, and physicians' offices. The site for administering infusion therapy can impact the cost of care. However, there is limited evidence on quality associated with the site of care (SOC).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To assess how patient utilization, cost, and adherence outcomes differ between infusions administered in HOPDs compared with alternative SOCs (ambulatory infusion centers, patients' homes, and physicians' offices).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This retrospective cohort study used administrative claims data to construct a sample of infusions administered in January 2022 to December 2023 to commercially insured adults across the United States, with infusions occurring in all 50 states and Washington, District of Columbia. These included 23 infusion agents used to treat 7 chronic conditions. To assess outcomes across SOCs, infusions in HOPDs were 1:1 matched to infusions in alternative SOCs using a combination of exact matching and propensity score matching on the infusion agent, treated disease, infusion sequence number, state of residence, patient demographics, baseline health status, and baseline medical utilization. Infusions were excluded when an HOPD was deemed medically necessary. Using logistic and Poisson regressions, outcomes were observed in two separate postinfusion time frames, including the infusion date: 1-day postinfusion and 7-day postinfusion. Outcomes included all-cause cost and utilization across inpatient, emergency department (ED), outpatient, and pharmacy services; mild adverse events; and severe adverse events. Using linear regressions, infusion therapy adherence outcomes were observed within 12 months of an index infusion for a subset of the study sample treated with 8 infusion agents.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Of 52,760 infusions among 18,988 patients, within 1-day postinfusion, patients administered infusions in HOPDs had no significant differences in ED and inpatient utilization and costs compared with alternative SOCs. However, outpatient costs were 41.9% higher (&lt;i&gt;P&lt;/i&gt; &lt; 0.01) among patients treated in an HOPD compared with those treated in alternative SOCs. There were no significant differences in serious or mild adverse events between the two groups. Within 7 days postinfusion, outcomes were similar, except HOPD-treated patients had 8.6% lower odds of filling any prescription at a pharmacy (&lt;i&gt;P&lt;/i&gt; &lt; 0.01) and 45.2% higher odds of having an inpatient admission (&lt;i&gt;P&lt;/i&gt; &lt; 0.05). Among the 410 patients analyzed for infusion adherence, there were no significant differences in adherence outcomes 12 months after the index infusion.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Patients receiving infusions in HOPDs have higher outpatient costs without a reduction in adverse events, inpatient ","PeriodicalId":16170,"journal":{"name":"Journal of managed care & specialty pharmacy","volume":" ","pages":"312-322"},"PeriodicalIF":3.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12948754/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145794159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}