This article was originally published by Specialty Pharmacy Continuum
GRAPEVINE, Texas—Integrating pharmacy technicians into endocrinology clinics to help manage administrative burdens such as prior authorizations and medication refills for patients with type 2 diabetes can lead to faster access to diabetes medications, better medication adherence and lowered hemoglobin A1C rates, according to new research.
Among 591 patients participating in a pharmacy liaison-managed care model at Berkshire Health Systems, in Pittsfield, Mass., since 2018, the average turnaround time to receive medications was less than a day. The average proportion of days covered was 92% and the average copay was $10 per script.
Evaluating a subset of 325 patients seen between April 2022 and March 2023, investigators found average reductions in hemoglobin A1C (HbA1C) levels of 0.8% from up to 60 days before their onboarding date through six months after enrollment in the program. Patients participated in the program for at least six months. The study, presented in a poster (abstract 14) at the NASP 2023 Annual Meeting & Expo, received an award for the best poster highlighting specialty pharmacy products, services or programs.
Although type 2 diabetes is not typically considered to be a specialty pharmacy disease state, it presents challenges and barriers that have similar demands as traditional specialty pharmacy, said study co-author Lillian Piz, MS, a manager of population health for Shields Health Solutions, a specialty pharmacy consulting agency.
“[Patients] really struggle with self-management,” Lillian Piz, MS of Shields Health Solutions told Specialty Pharmacy Continuum. “There are lots of barriers to access and adherence challenges, and it’s really a complex condition. Patients are managing multiple things; often there’s comorbidities involved, too. We really saw that the core liaison care model can be applied to the diabetes population having more high-touch pharmacy care.”
The liaison-managed diabetes pharmacy care model involves several elements:
- All patients requiring a diabetes medication prescription are directed to the liaison, who investigates pharmacy and medical benefits and completes any needed prior authorizations (PAs).
The liaison looks into any needed financial assistance for patients and helps them apply. - The liaison then provides education to the patient on their pharmacy options, copays and delivery options.
- The liaison documents approved PAs and alerts the prescriber of the patient’s preferred pharmacy. Prescribers send the electronic script to the health system-owned specialty pharmacy whenever possible.
- The prescription is delivered directly to the patient’s home or picked up at the pharmacy if that is preferred.
- For people able to fill their medications at the in-house specialty pharmacy, the liaison reaches out every month to coordinate medication and durable medical equipment refills.
“This model can be replicated across other health systems,” said Ms. Piz, who noted that patients have appreciated the service. “So many endocrinology clinics are places where there’s a high volume of patients with diabetes [who] could benefit from having someone there to be a proactive voice and help remove any barriers they might be facing.”
Studies have documented that lowering HbA1C levels can reduce total medical expenditures (Appl Health Econ Health Policy 2018;16[5]:675-684), she added. “Patients living with diabetes really need this level of care … Having a liaison can be transformative for a lot of patients.”
To learn more about how the Shields model improves outcomes for patients with diabetes, read our white paper.
