Impact of a pharmacist-led adalimumab biosimilar interchange protocol on order processing time

The transition to biosimilars poses challenges for health systems, due to diverse options and insurance-specific preferences. Implementing a pharmacist-driven adalimumab interchange protocol could improve the efficiency of specialty prescription processing and address a significant gap in health-system specialty clinic workflows. This study evaluated the impact of an adalimumab interchange protocol on order processing times across specialties and payor types.

This retrospective, multicenter cohort study evaluated the impact of a pharmacist-led adalimumab interchange protocol, implemented on May 20, 2024, by clinic-embedded pharmacists at CHRISTUS Specialty Pharmacy. Eligible patients were those prescribed adalimumab for inflammatory conditions. Data retrieved included baseline characteristics such as the reason for switching, payor type, duration on adalimumab, and biosimilar ordered. The primary outcome was order processing time, measured from the date of notification to switch to the date the order was released to the pharmacy. The study also assessed biosimilar discontinuation rates and reasons.

Of the adalimumab orders requiring a switch (n = 178), 28% were handled utilizing the interchange protocol. The mean order processing time with the protocol was 2.08 days compared to 4.60 days without the protocol (P = 0.000106). Medicare orders had the highest mean processing time (8.22 days). Of the discontinued biosimilar orders (n = 18), 67% had loss of efficacy reported as the reason for discontinuation.

This study indicates that utilization of a pharmacist-led interchange protocol may improve the order processing time for biosimilars. Focused efforts could prioritize comparison of the rates of discontinuation for adalimumab products.