AmerisourceBergen Integrated Health Systems Outcomes Coalition (IHOC), Conshohocken, PA, USA.
Xcenda LLC, Conshohocken, PA, USA.
J Oncol Pharm Pract. 2024 Jul;30(5):884-892. doi: 10.1177/10781552231190016. Epub 2023 Aug 30.
Integrated delivery networks can use medically integrated dispensing of oral oncolytics on site through health system specialty pharmacies. There is little published research examining cost savings. Our objective was to demonstrate the financial value of health system specialty pharmacies among patients receiving oral oncolytics dispensed through fully, partially, and non-integrated dispensing strategies.
This was a retrospective cohort study of adult patients from Symphony Health's Integrated Dataverse repository who filled a prescription for an agent of interest from 7/1/16-6/30/20 that was written within 25 US health systems. Outcomes included costs, healthcare resource utilization, and duration of therapy.
In total, 36,816 patients were included; 986 patients (2.7%) integrated, 1,822 (4.9%) partially integrated, and 34,008 (92.4%) non-integrated. Mean 6-month medical charge and oncolytic prescription costs were lower for the integrated group ($36,831; $55,786) than the partially integrated ($46,304, = 0.053; $63,295, = 0.071) and non-integrated groups ($54,261, < 0.001; $65,005, = 0.004). In most healthcare resource utilization categories, the integrated group had the lowest patient percentage utilizing medical care. Duration of therapy was lower on average by ∼3 months in the integrated vs non-integrated group, which may represent closer monitoring of patient medical records and need for fills vs autoship practices.
Patients receiving oral oncolytics through medically integrated dispensing at health system specialty pharmacies may have lower medical and pharmacy costs and decreased healthcare resource utilization. This study adds to the growing body of literature supporting integrated delivery networks and integrated dispensing. Further research is needed to demonstrate the value of medically integrated dispensing through health system specialty pharmacies in the delivery of treatment to patients with cancer and other high-cost diseases.
综合交付网络可以通过卫生系统专科药房在现场进行医学整合的口服肿瘤药物配药。几乎没有发表的研究探讨成本节约。我们的目的是展示通过完全、部分和非整合配药策略接受口服肿瘤药物配药的患者中，卫生系统专科药房的经济价值。
这是一项回顾性队列研究，来自 Symphony Health 的综合数据仓库中的成年患者，他们在 2016 年 7 月 1 日至 2020 年 6 月 30 日期间从 25 个美国卫生系统中的一个卫生系统开具了处方。结果包括成本、医疗资源利用和治疗持续时间。
共有 36816 名患者被纳入研究；986 名患者（2.7%）整合，1822 名（4.9%）部分整合，34008 名（92.4%）非整合。整合组的 6 个月平均医疗费用和肿瘤药物处方费用低于部分整合组（36831 美元；55786 美元）和非整合组（46304 美元；0.053；63295 美元；0.071）。在大多数医疗资源利用类别中，整合组的患者医疗利用率最低。与非整合组相比，整合组的治疗平均持续时间约缩短了 3 个月，这可能代表了对患者病历和需求的更密切监测，而不是自动配药。
通过卫生系统专科药房进行医学整合的患者接受口服肿瘤药物配药，可能具有更低的医疗和药物成本以及更少的医疗资源利用。这项研究增加了支持综合交付网络和整合配药的不断增长的文献。需要进一步研究以证明卫生系统专科药房通过医学整合配药在为癌症和其他高成本疾病患者提供治疗方面的价值。
