Specialty pharmacy interventions benefit patients receiving HIV postexposure prophylaxis

Area of Science:

• Pharmacy Practice
• Infectious Diseases
• Public Health

Background:

• Specialty pharmacies manage complex, high-cost medications for diseases like HIV.
• Human immunodeficiency virus postexposure prophylaxis (PEP) requires prompt initiation and patient education for effectiveness.

Purpose of the Study:

• To analyze PEP referrals at a specialty pharmacy.
• To demonstrate the pharmacy's role in financial assistance, clinical interventions, and patient counseling for PEP.

Main Methods:

• Observational retrospective chart review of 52 patients receiving PEP.
• Data collected from electronic medication records from January 2017 to July 2022.
• Analyzed PEP regimens: raltegravir (RAL) + emtricitabine/tenofovir disoproxil fumarate (FTC/TDF) and dolutegravir (DTG) + FTC/TDF.

Main Results:

• Cost savings varied by insurance status and regimen: RAL+FTC/TDF saved $1692.60 (insured) and $218.40 (uninsured); DTG+FTC/TDF saved $676.20 (insured) and $2725.50 (uninsured).
• Pharmacist counseling was offered to all patients, with 74.5% accepting.
• Clinical interventions were made in 29.4% of PEP referrals.

Conclusions:

• PEP medications are costly and time-sensitive, necessitating interventions and counseling.
• Specialty pharmacies are crucial for ensuring patient access to care through financial aid, counseling, and clinical support for PEP.