Integrating Clinical Pharmacy Services Into Comprehensive Multiple Sclerosis Care Teams: A Narrative Review of 4 Models.

BACKGROUND: Over the past 30 years, the treatment landscape for multiple sclerosis (MS) has become increasingly complex. All MS disease-modifying therapies (DMTs) and several symptomatic medications are designated specialty medications, and their financial coverage is subject to complicated insurance processes and a wide array of patient support programs. Many patients receiving MS DMTs need ongoing monitoring or enrollment in a Risk Evaluation and Mitigation Strategy program. Integrated pharmacy services can facilitate financial, technical, and educational aspects of providing specialty medications. Although pharmacy services are often part of the care team for patients with complex chronic medical conditions, MS clinics may not have the benefit of full pharmacy services. We present 4 models of MS health care delivery and discuss how integrating pharmacy services into an MS multidisciplinary team can potentially increase the efficiency and quality of health care delivery. Clinical pharmacists, working with other providers, can optimize and accelerate access to medications requiring prior authorization, improve patient outcomes by promoting medication adherence and persistence, enhance safety by monitoring laboratory findings and potential drug-drug interactions, and minimize clinical workflow burden by improving process efficiency, which may be cost-effective for the MS health care delivery system.