Clinical and economic benefits of pharmacist interventions in a non-multiple sclerosis neurology clinic

To examine interventions, recommendations, and direct cost avoidance from integrated outpatient specialty neurology pharmacists in the non-multiple sclerosis (MS) setting.

A single-center, retrospective cohort study was performed, including patients prescribed specialty medications from non-MS neurology clinics with at least one pharmacist intervention from January to March 2023. Outcomes included pharmacist intervention types, intervention recommendations to patients and providers, and direct cost avoidance from interventions. Cost avoidance was calculated by summing the total costs (average wholesale price minus 20%) of one fill of medications that were discontinued or had a dose change as a result of an intervention or refill deferral. Patients who used excess supply on hand from a previous fill were accounted for during the calculation. The cost per unit of each medication/dosage was multiplied by the quantity of the last medication fill to calculate the cost avoided.

The study included 741 patients with a median age of 60 (interquartile range, 22-72) years; 83% were White; 55% were male; and 69% used the integrated health-system specialty pharmacy (IHSSP) for medication fulfillment. Pharmacists performed 2,244 interventions, generating 392 recommendations, with a 98% acceptance rate. The most common recommendation outcomes were medication changes (34%, n = 129) and financial assistance referrals (17%, n = 64). During the 3-month study period, discontinuations and dose changes resulted in $172,757 in direct cost avoidance for IHSSP patients.

IHSSP neurology pharmacists in the non-MS setting frequently perform interventions that result in therapy changes and direct cost avoidance. IHSSP pharmacist interventions benefit patients, providers, the healthcare system, and insurers.