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Pharmacy Technician Impact on Access to High-Cost Heart Failure Pharmacotherapy

Morgan S Augustine1, Erika Nicolsen1, Alexander Reed2

  • 1Duke University Hospital, Durham, NC, USA.

The Annals of Pharmacotherapy
|February 19, 2026
PubMed

Insights

Pharmacy technicians improved access to high-cost heart failure medications, sacubitril-valsartan and sodium-glucose cotransporter 2 inhibitors (SGLT2i). This intervention increased medication prescription and fulfillment rates in heart failure patients.

Area of Science:

  • Cardiology
  • Pharmacology
  • Health Services Research

Background:

  • Guideline-directed medical therapy (GDMT) for heart failure is challenging to access, particularly sacubitril-valsartan and sodium-glucose cotransporter 2 inhibitors (SGLT2i) due to cost.
  • Pharmacy technicians can play a crucial role in improving medication access for heart failure patients.

Purpose of the Study:

  • To assess the impact of integrating a pharmacy technician into an outpatient heart failure clinic on patient access to high-cost GDMT.
  • Specifically evaluating access to sacubitril-valsartan and SGLT2i.

Main Methods:

  • A retrospective, pre-post cohort study design was employed.
  • Adult heart failure patients eligible for sacubitril-valsartan and SGLT2i were analyzed before and after pharmacy technician implementation.
  • Primary outcome was prescription and fill rates of sacubitril-valsartan and/or SGLT2i, controlling for prescription drug coverage.

Main Results:

  • Access to sacubitril-valsartan and/or SGLT2i significantly increased from 71.9% to 86.5% post-implementation (OR = 2.46, P = 0.02).
  • No significant differences were observed in secondary outcomes, including access to other heart failure medications or hospitalization rates.
  • Pharmacy technicians spent an average of 66.4 minutes per assisted patient.

Conclusions:

  • Implementation of a pharmacy technician in a heart failure clinic significantly enhanced patient access to sacubitril-valsartan and SGLT2i.
  • Further prospective research is warranted to explore the effect of pharmacy technicians on clinical outcomes in heart failure management.
Abstract

Keywords:
ambulatory careheart failuremedication accesspharmacypharmacy technicians

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