EFFECTIVENESS OF A CENTRALIZED COMMUNITY PHARMACY-BASED PATIENT ACCESS AND THERAPY MANAGEMENT PROGRAM FOR SPECIALTY-LITE MEDICATIONS: A NATIONAL REAL-WORLD STUDY
Author(s)
Xiaomo (Shawn) Xiong, MS, PhD1, Chase Dye, MBA, MHA2, Kristen Proctor, PharmD2;
1James L Winkle College of Pharmacy, University of Cincinnati, Assistant Professor, Blue Ash, OH, USA, 2Kroger Health, Kroger Co., Cincinnati, OH, USA
1James L Winkle College of Pharmacy, University of Cincinnati, Assistant Professor, Blue Ash, OH, USA, 2Kroger Health, Kroger Co., Cincinnati, OH, USA
OBJECTIVES: Specialty-lite medications are higher-cost therapies dispensed through open distribution community pharmacies that do not meet traditional specialty pharmacy criteria, but often require enhanced, manufacturer-supported patient access services and ongoing therapy management. Centralized, pharmacist-led patient support models may help reduce access barriers, yet real-world evidence remains limited. Therefore, this study assessed the impact of intervention-driven patient access support on medication adherence and dispensing completeness.
METHODS: Using Kroger Health’s national pharmacy dispensing and patient service records (2023-2024), we identified adults initiating a specialty-lite medication through community pharmacies. Enhanced patient services, including onboarding, benefits investigation, therapy education, and adherence outreach, were delivered by a centralized team, while dispensing occurred at local pharmacies. Adherence was measured using proportion of days covered (PDC), allowing gaps ≤14 days, defined as PDC ≥0.8. Enhanced services exposure and dispensing completeness were identified using a pharmacy care index. Outcomes included mean PDC and prescription cancellation measuring dispensing completion. T-tests and chi-square tests compared patients with and without enhanced services; propensity score matching addressed potential confounding.
RESULTS: In the unmatched cohort, we have identified 12,847 patients that did not receive enhanced patient services and 1,652 receiving the centralized support. Patients receiving enhanced services had significantly higher mean PDC (0.75 vs. 0.53; p<0.001). Prescription cancellation rates were significantly lower among patients receiving care coordination (13.4% vs. 22.2%; p<0.001). After matching (1,652 patients per group), care coordination remained associated with significantly higher mean PDC (0.75 vs. 0.71; p=0.015), and significantly lower cancellation rates (13.4% vs. 20.4%; p<0.001).
CONCLUSIONS: A centralized, community pharmacy-based patient access and therapy management program was associated with improved adherence and reduced prescription cancellation for specialty-lite medications. These findings support the effectiveness of centralized, pharmacist-led patient support services in improving treatment continuity for higher-cost therapies dispensed through open distribution channels.
METHODS: Using Kroger Health’s national pharmacy dispensing and patient service records (2023-2024), we identified adults initiating a specialty-lite medication through community pharmacies. Enhanced patient services, including onboarding, benefits investigation, therapy education, and adherence outreach, were delivered by a centralized team, while dispensing occurred at local pharmacies. Adherence was measured using proportion of days covered (PDC), allowing gaps ≤14 days, defined as PDC ≥0.8. Enhanced services exposure and dispensing completeness were identified using a pharmacy care index. Outcomes included mean PDC and prescription cancellation measuring dispensing completion. T-tests and chi-square tests compared patients with and without enhanced services; propensity score matching addressed potential confounding.
RESULTS: In the unmatched cohort, we have identified 12,847 patients that did not receive enhanced patient services and 1,652 receiving the centralized support. Patients receiving enhanced services had significantly higher mean PDC (0.75 vs. 0.53; p<0.001). Prescription cancellation rates were significantly lower among patients receiving care coordination (13.4% vs. 22.2%; p<0.001). After matching (1,652 patients per group), care coordination remained associated with significantly higher mean PDC (0.75 vs. 0.71; p=0.015), and significantly lower cancellation rates (13.4% vs. 20.4%; p<0.001).
CONCLUSIONS: A centralized, community pharmacy-based patient access and therapy management program was associated with improved adherence and reduced prescription cancellation for specialty-lite medications. These findings support the effectiveness of centralized, pharmacist-led patient support services in improving treatment continuity for higher-cost therapies dispensed through open distribution channels.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
HSD85
Topic
Health Service Delivery & Process of Care
Disease
SDC: Neurological Disorders