(89) Validation of Long-term Savings from a Pharmacist-to-Prescriber Telephonic Intervention

Background: : Managed care pharmacist (MCP) programs to optimize cost-effective drug therapy via a pharmacist-to-prescriber telephonic intervention may result in drug therapy changes and savings. To derive and report annualized intervention savings, programs often assume full adherence and enrollment for a year after intervention for a drug therapy regimen change. As these assumptions may not be accurate, a forensic evaluation of actual savings allows for a more accurate understanding of program impact and can be used to validate initial estimates.

Objective: : To validate savings for a MCP program following all drug therapy optimization change cases for up to 2 years from therapy change date compared to an annualization intervention savings methodology.

Methods: : Drug therapy optimization change cases from Jan. 2021 through Oct. 2022 for the HighTouchRx product, servicing ~6.6 million commercially insured members per month, were tracked for up to 2 years from the claims change date. Initial annualized savings estimates were calculated by a MCP and assumed continuous enrollment and adherence to therapy for 1 year from the claims change date. Forensic evaluation assessed savings from actual claims through the earliest of: a stop, reversion, or change to the drug regimen, disenrollment, or 2 years. Drug regimen stopping was defined as a 60-day gap in supply. Savings from the two methods were compared descriptively.

Results: : All 611 drug regimen change cases over 22 months were reviewed. 120 (19.6%) involved single claim savings and therefore were not annualized, resulting in $1,941,028 savings not included in the savings validation. Of the remaining 491 (80.4%) cases, the initial annualized savings estimate calculated a savings of $16,747,305 and the 2-year forensic evaluation method calculated a savings of $21,423,531. Savings from the forensic method were greater than or equal to the annualized estimates for 287 (58.5%) of 491 cases. Elimination of duplicate drug therapy was the most common savings case category that persisted beyond a year, accounting for 151 (53.0%) of 287 cases with greater or equal savings. The most common reason for lower case savings was disenrollment prior to 1 year, 75 (36.8%) of 204.

Conclusions: : Overall, a forensic review of 611 MCP intervention drug therapy change cases demonstrated $21.4 million savings, a 28% higher savings than $16.7 million savings reported when using an annualized method. These results support using a 1-year annualization savings methodology as a pragmatic and conservative approach for savings calculations resulting from MCP interventions.

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