A collaborative effort involving seven remote clinical pharmacists has yielded considerable savings in cancer care costs.The team helped five practices within The US Oncology Network reduce their total cost of care (TCOC) by $8.98 million over an 18-month period, as part of the Centers for Medicare & Medicaid Services (CMS) Enhancing Oncology Model (EOM).
These breakthrough results, initially presented in June at the American society of Clinical Oncology (ASCO) annual meeting and subsequently published in the Journal of Oncology Practice, highlight the growing impact of pharmacist-led interventions in oncology. The EOM,a successor to the Oncology Care Model (OCM),aims to reward practices for achieving cost savings beyond predetermined benchmarks.
The Power of Remote Clinical Pharmacy Review
Table of Contents
- 1. The Power of Remote Clinical Pharmacy Review
- 2. Significant Savings and Performance-Based Payments
- 3. Implementation and Adoption
- 4. The Future of Oncology Pharmacy
- 5. Frequently asked Questions
- 6. What specific strategies do remote clinical pharmacists employ to optimize prior authorization management and reduce associated costs?
- 7. Remote Clinical Pharmacists Deliver $9M Savings and Enable End-of-Month Targets Achievement for Practices
- 8. The Rising Demand for Telepharmacy & Clinical Pharmacy services
- 9. How Remote Clinical Pharmacists Generate savings
- 10. Achieving End-of-Month Targets: A Direct Correlation
- 11. The Technology Enabling Remote Pharmacy Success
- 12. Case study: Rural Healthcare System Sees Significant Gains
Recognizing the significant proportion of patient costs attributed to medication, The US Oncology Network deployed a remote clinical review pharmacist (CRP) team to support its practices participating in the EOM. Led author Daniel C. Kendzierski, a Pharmacist, explained that the CRPs provided focused reviews of each order, identifying opportunities for savings through six key strategies.
these strategies included optimizing doses of monoclonal antibodies, implementing dose banding for pembrolizumab, encouraging the use of biosimilar alternatives, promoting a preferred PD-1 agent for a specific lung cancer treatment, reducing the upfront use of long-acting growth factors, and favoring zoledronic acid over more expensive bone-modifying agents. These interventions were designed to reduce costs without compromising patient outcomes.
Significant Savings and Performance-Based Payments
From July 1, 2023, to December 31, 2024, the CRPs evaluated 5,600 patients, leading to the adoption of 1,180 interventions. This resulted in projected savings of $1,604 per patient. Moreover, the team identified an additional $1.2 million in savings related to optimal drug selection.
Preliminary data reveal that three practices are poised to earn performance-based payments (PBPs) as a result of these efforts. These practices demonstrated savings percentages of 5.7%, 8.1%, and 23.6% against the established benchmark during the first performance period (July 1 to December 31, 2023).Drug costs accounted for a substantial 72% to 75% of the total cost of care in these instances.
| Initiative | Average Savings Per Intervention | Total Savings |
|---|---|---|
| Pembrolizumab Dose Banding | $18,510 | $2,000,000 |
| Zoledronic Acid Substitution | $11,992 | $2,100,000 |
| Monoclonal Antibody Dose Rounding | $3,470 | $N/A |
| biosimilar Therapeutic Interchange | $4,244 | $N/A |
Did You Know? Pembrolizumab dose banding,despite being applied in a smaller percentage of cases,delivered the highest average savings per intervention.
Implementation and Adoption
The success of the initiative hinged on strong buy-in from participating practices.A remarkable 93% of the 1,271 interventions proposed by the CRPs were accepted and implemented by oncologists. Practices retained autonomy in selecting which initiatives to adopt, with all five participating sites implementing at least four of the six core strategies.
The Future of Oncology Pharmacy
This study underscores the increasing importance of pharmacists in value-based cancer care. As healthcare systems strive to optimize resource allocation and improve patient outcomes, pharmacist-led initiatives will likely become even more prevalent. The trend towards remote pharmacy services, accelerated by technological advancements and the need for cost-efficient solutions, is expected to continue. According to a 2024 report by the American Society of Health-System Pharmacists (ASHP), demand for oncology pharmacists has risen by 15% in the past five years.
Pro Tip: practices considering similar initiatives should prioritize clear communication,establish robust data tracking systems,and actively solicit feedback from oncologists to ensure successful adoption.
Frequently asked Questions
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Remote Clinical Pharmacists Deliver $9M Savings and Enable End-of-Month Targets Achievement for Practices
The Rising Demand for Telepharmacy & Clinical Pharmacy services
The healthcare landscape is rapidly evolving, and with it, the role of the clinical pharmacist. Increasingly, practices are turning to remote clinical pharmacist services to optimize medication management, improve patient outcomes, and crucially, achieve meaningful cost savings. Recent data demonstrates a compelling trend: leveraging remote pharmacy professionals has resulted in over $9 million in documented savings and consistently enabled practices to meet their end-of-month financial targets. This isn’t just about efficiency; it’s about a fundamental shift in how healthcare organizations approach pharmaceutical care.Key terms driving this shift include telepharmacy, remote patient monitoring, medication therapy management (MTM), and pharmaceutical cost reduction.
How Remote Clinical Pharmacists Generate savings
The $9 million in savings isn’t a fluke. It’s a direct result of several key areas where remote clinical pharmacists excel:
Prior Authorization management: A significant portion of pharmaceutical spend is tied up in prior authorizations. Remote pharmacists are adept at navigating these complex processes, reducing delays in care and preventing costly denials. This streamlined process directly impacts pharmacy benefit management (PBM) costs.
Formulary Optimization: Analyzing a practice’s formulary and identifying opportunities for more cost-effective alternatives is a core competency.Remote pharmacists can proactively suggest therapeutic substitutions, leading to substantial savings without compromising patient care. This involves understanding drug utilization review (DUR) processes.
Medication Reconciliation: Accurate medication reconciliation is vital for patient safety and preventing adverse drug events. Remote pharmacists can efficiently review patient medication lists, identify discrepancies, and ensure accurate prescribing, reducing hospital readmissions and associated costs.
Waste Reduction: Identifying and addressing medication waste – expired drugs, unused prescriptions – contributes to overall cost savings. Remote monitoring and analysis can pinpoint areas of waste and implement strategies for betterment.
Chronic Disease Management: Proactive management of chronic conditions like diabetes, hypertension, and heart failure through medication synchronization and adherence programs reduces complications and costly emergency room visits.
Achieving End-of-Month Targets: A Direct Correlation
Beyond cost savings, remote clinical pharmacists play a critical role in helping practices consistently achieve their end-of-month financial targets. This is achieved through:
- Increased Revenue Capture: Identifying and resolving billing discrepancies related to pharmaceutical services.
- Improved Patient Adherence: Better adherence translates to fewer complications and reduced need for expensive interventions.
- optimized Workflow Efficiency: Freeing up physician and nursing time by handling complex medication-related tasks.
- Reduced Readmission Rates: Effective medication management minimizes hospital readmissions,a key metric for value-based care.
- Proactive Intervention: Identifying patients at risk of non-adherence or adverse events allows for timely intervention, preventing costly complications.
The Technology Enabling Remote Pharmacy Success
Several technological advancements are making remote clinical pharmacy services more effective and accessible:
HIPAA-Compliant Video Conferencing: Enables secure and direct interaction with patients and providers.
Electronic health Record (EHR) Integration: Seamless access to patient data for extensive medication reviews.
Remote Monitoring Platforms: Allow for real-time tracking of patient medication adherence and vital signs.
Secure Messaging Systems: facilitate efficient communication and collaboration.
Cloud-Based Pharmacy Software: Enables remote access to pharmacy systems and data.
These technologies are crucial for maintaining patient privacy and ensuring the highest standards of care,adhering to HIPAA regulations and data security protocols.
Case study: Rural Healthcare System Sees Significant Gains
A rural healthcare system in Iowa implemented a remote clinical pharmacist programme to support its network of primary care clinics. Within the first year, they reported:
A 15% reduction in medication errors.
A 10% increase in patient medication adherence.
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