to prevent unnecessary therapy discontinuations
and medication waste. Pharmacists want to
make sure regimens are being followed by
patients as labeled and that recommendations
for side effect management use evidence-based
protocols. Strategies for intervention and support
should address the management of anemia,
thrombocytopenia, depression, injection site
reactions, improper injection technique and also
address the subset of patients who do not have
positive outcomes. Documentation and patient follow
up after intervention are equally important in the
event additional recommendations need to be made.
* American Association of the Study of Liver Diseases
** Infectious Disease Society of America
***International Antiviral Society-USA
All of the activities required to properly manage
a HCV patient are time sensitive and require
a consistent way to record the data collected.
Technology and pharmacy software investments
are important to ensure the pharmacist can follow
a predetermined pathway schedule, document
interventions and record outcomes based on the
specific HCV regimen prescribed. The application
should also provide enough depth that patient needs
are identified and can be properly managed.
5.
References
1.
2.
3.
4.
6.
Tracy Swan. Hepatitis C Drug Development Catapults Onward.www.
pipelinereport.org. http://www.pipelinereport.org/2013/hcv.Updated
June 2013. Accessed February12, 2014.
Recommendations for Testing, Managing, and Treating Hepatitis
C. Downloaded from http://www.hcvguidelines.org on February
13,2014
URAC Specialty Pharmacy Standards version 2.1. Patient Management 13. https://www.urac.org/resource-center/research-publications/standards-and-measures-at-a-glance/#sp
Britt E, Hudson SM, Blampied NM. Motivational interviewing in
health settings: a review. Patient Educ Couns 2004;53:147-55
Am J Manag Care. 2012 Dec 1; 18(12):e461-7.Association between
different types of social support and medication adherence. Scheurer D, Choudhry N, Swanton KA, Matlin O, Shrank W.
URAC Specialty Pharmacy Standards version 2.1 Customer Service,
Communications, and Disclosure (CSCD) #9. . https://www.urac.org/
resource-center/research-publications/standards-and-measures-ata-glance/#sp
Having an accessible healthcare provider outside
of regular business hours is a critical component
to HCV therapy management. This includes 24/7
access to a pharmacist’s support when patients may
experience treatment hurdles or side effects. While
most specialty pharmacies have built their business
model around this concept those that have URAC
Specialty Pharmacy accreditation have demonstrated
accessibility.6 More recent trends have shown
that health plans and payors are often mandating
specialty pharmacies to ensure consistent patient
management services are being offered to their
members.
Evidence-based guidelines have recently changed
and are expected to continue to evolve over the
next several years as additional new agents come
to market. Payors are sensitive to appropriate
utilization due to the significant costs/unit and
higher prevalence of treating HCV-infected patients.
All providers providing service to this member
population must work together to drive optimal
outcomes while controlling all healthcare-related
costs. Pharmacists at a specialty pharmacy
setting are uniquely positioned to collaborate with
prescribers to support their patients achieve SVR
as well as supporting payors by measuring and
reporting HCV outcomes.
9