Health-system Pharmacy Research Articles

Evaluation of potential cost savings through chemotherapy and biotherapy dose-rounding at a pediatric institution.

Rapidly increasing costs of medication acquisition can pose a challenge for health-system pharmacy budgets. The impact of dose-rounding in a pediatric oncology population has not previously been well documented and a retrospective review was undertaken to quantify the potential cost benefits. A retrospective chart review of patients with an oncologic diagnosis was performed for cytotoxic agents, asparaginase products, and biotherapy administered between January 1, 2014, and December 31, 2017. In the analysis, orders that could be rounded down to the nearest vial size by 5 or 10% were included. Medication pricing information was based on wholesale acquisition cost (WAC) and was provided by the Department of Pharmacy. Cost savings per medication were determined by multiplying the WAC of the medication by the number of vials saved. Over a 4-year span, 347 patients were evaluated and 552 out of a possible 3110 orders (17.7%) met criteria for a theoretical cost savings of approximately $1,126,000 (∼$3200 per patient). Rounding down doses by up to 5% resulted in a potential savings of about $529,000. When rounding was extended to 5-10% of the originally ordered dose, an additional $597,000 of approximate cost savings could have been realized. The medications with the largest impact on cost savings were rituximab, pegaspargase, and erwinia asparaginase. For pediatric oncology patients, there exists a unique potential cost savings opportunity if doses are rounded down within 5 or 10% of the originally ordered weight-based or body surface area-calculated dose.

Informatics technicians fill a growing need at hospitals.

Journal Article Corrected proof Informatics technicians fill a growing need at hospitals Get access Kate Traynor Kate Traynor ktraynor@ashp.org Search for other works by this author on: Oxford Academic Google Scholar American Journal of Health-System Pharmacy, zxad105, https://doi.org/10.1093/ajhp/zxad105 Published: 03 June 2023 Article history Corrected and typeset: 03 June 2023 Published: 03 June 2023

CSHP cofounder and Past President Peter Solyom Jr. dies at 96.

Journal Article Corrected proof CSHP cofounder and Past President Peter Solyom Jr. dies at 96 Get access Kate Traynor Kate Traynor Search for other works by this author on: Oxford Academic Google Scholar American Journal of Health-System Pharmacy, zxad107, https://doi.org/10.1093/ajhp/zxad107 Published: 30 May 2023 Article history Corrected and typeset: 30 May 2023 Published: 30 May 2023

Global research trends and hotspots in pharmaceutical care: a bibliometric analysis and visualisation using CiteSpace and VOSviewer

ObjectivePharmaceutical care is closely related to the outcome and prognosis of disease treatment. This study analyses the research status, hotspots, frontiers and development trends of pharmaceutical care from the perspective...

ASHP Past President R. David Anderson dies at 97.

Journal Article Corrected proof ASHP Past President R. David Anderson dies at 97 Get access —Kate Traynor —Kate Traynor ktraynor@ashp.org Search for other works by this author on: Oxford Academic Google Scholar American Journal of Health-System Pharmacy, zxad123, https://doi.org/10.1093/ajhp/zxad123 Published: 13 June 2023 Article history Corrected and typeset: 13 June 2023 Published: 13 June 2023

ASHP National Survey of Pharmacy Practice in Hospital Settings: Workforce - 2022.

Results of the 2022 ASHP National Survey of Pharmacy Practice in Hospital Settings are presented. Pharmacy directors at 1,498 general and children's medical/surgical hospitals in the United States were surveyed using a mixed-mode method of contact by email and mail. Survey completion was online. IQVIA supplied data on hospital characteristics; the survey sample was drawn from IQVIA's hospital database. The response rate was 23.7%. Inpatient pharmacists independently prescribe in 27.1% of hospitals. Advanced analytics are used in 8.7% of hospitals. Pharmacists work in ambulatory or primary care clinics in 51.6% of hospitals operating outpatient clinics. Some level of pharmacy service integration is reported in 53.6% of hospitals. More advanced pharmacy technician roles are emerging. For health systems offering hospital at home services, 65.9% of pharmacy departments are involved. Shortages of pharmacists and technicians were reported but are more acute for pharmacy technicians. Aspects of burnout are being measured in 34.0% of hospitals, and 83.7% are attempting to prevent and mitigate burnout. The average number of full-time equivalents per 100 occupied beds is 16.9 for pharmacists and 16.1 for pharmacy technicians. Health-system pharmacies are experiencing workforce shortages; however, these shortages have had limited impact on budgeted positions. Workforce challenges are influencing the work of pharmacists and pharmacy technicians. Adoption of practice advancement initiatives has continued the positive trend from past years despite workforce issues.

A hospital within a hospital: An innovative pharmacy model to improve the continuum of care.

To describe the implementation of a contracted pharmacy service model for a co-located long-term acute care hospital (LTAC). Historically, most LTACs have been free-standing healthcare facilities, but there is an increased trend towards the co-located LTAC ("hospital within a hospital") model. Co-located LTACs represent a solution for the management of patient throughput within a health system, with optimized bed capacity at the host hospital, increased revenue under a prospective payment system, and reduced readmission rates. A co-located LTAC will likely share resources with the host hospital, including ancillary departments such as pharmacy services, through a contractual model. Operationalization of pharmacy services in a co-located LTAC presents unique challenges in the integration of pharmacy services. Pharmacy leaders at Houston Methodist collaborated with executive leadership and other healthcare disciplines to expand services from a free-standing LTAC to a co-located LTAC at the academic medical center location. The contracted pharmacy service operationalization processes in the co-located LTAC comprised licensure and regulations, accreditation, information technology enhancements, a staffing model, operations/distribution services, clinical services, and a defined quality reporting structure. Admissions from the host hospital to the LTAC consisted of patients requiring long-term antibiotic administrations, pre- and post-organ transplant care, complex wound care, oncologic-related treatment, and neurological rehabilitation for strengthening and continued care. The framework described here offers guidance to health-system pharmacy departments to support establishment of a co-located LTAC. The case study outlines challenges, considerations, and processes for implementation of a successful contracted pharmacy service model.

Retifanlimab-dlwr.

Journal Article Corrected proof Retifanlimab-dlwr Get access American Journal of Health-System Pharmacy, zxad096, https://doi.org/10.1093/ajhp/zxad096 Published: 31 May 2023 Article history Corrected and typeset: 31 May 2023 Published: 31 May 2023

Leniolisib Phosphate.

Journal Article Corrected proof Leniolisib Phosphate Get access American Journal of Health-System Pharmacy, zxad095, https://doi.org/10.1093/ajhp/zxad095 Published: 31 May 2023 Article history Corrected and typeset: 31 May 2023 Published: 31 May 2023

Improving quality of drug manufacturing is critical to stemming shortages.

Journal Article Corrected proof Improving quality of drug manufacturing is critical to stemming shortages Get access Jodie Tillman Jodie Tillman Search for other works by this author on: Oxford Academic Google Scholar American Journal of Health-System Pharmacy, zxad106, https://doi.org/10.1093/ajhp/zxad106 Published: 30 May 2023 Article history Corrected and typeset: 30 May 2023 Published: 30 May 2023

News briefs.

Journal Article Corrected proof News briefs Get access American Journal of Health-System Pharmacy, zxad104, https://doi.org/10.1093/ajhp/zxad104 Published: 16 May 2023 Article history Corrected and typeset: 16 May 2023 Published: 16 May 2023

Summaries of safety labeling changes approved by FDA-Boxed warnings highlights, January-March 2023.

Journal Article Corrected proof Summaries of safety labeling changes approved by FDA—Boxed warnings highlights, January–March 2023 Get access American Journal of Health-System Pharmacy, zxad085, https://doi.org/10.1093/ajhp/zxad085 Published: 10 May 2023 Article history Corrected and typeset: 10 May 2023 Published: 10 May 2023

Welcome to the 2023 Ashp Summer Meetings

Journal Article Welcome to the 2023 Ashp Summer Meetings Get access American Journal of Health-System Pharmacy, Volume 80, Issue 10, 15 May 2023, Pages 558–640, https://doi.org/10.1093/ajhp/zxad075 Published: 05 May 2023 Article history Corrected and typeset: 05 May 2023 Published: 05 May 2023

Sparsentan.

Journal Article Corrected proof Sparsentan Get access American Journal of Health-System Pharmacy, zxad073, https://doi.org/10.1093/ajhp/zxad073 Published: 04 May 2023 Article history Corrected and typeset: 04 May 2023 Published: 04 May 2023

Velmanase Alfa-tycv.

Journal Article Corrected proof Velmanase Alfa-tycv Get access American Journal of Health-System Pharmacy, zxad074, https://doi.org/10.1093/ajhp/zxad074 Published: 04 May 2023 Article history Corrected and typeset: 04 May 2023 Published: 04 May 2023

Summaries of safety labeling changes approved by FDA-Boxed warnings highlights, January-March 2023.

Journal Article Corrected proof Summaries of safety labeling changes approved by FDA—Boxed warnings highlights, January–March 2023 Get access American Journal of Health-System Pharmacy, zxad083, https://doi.org/10.1093/ajhp/zxad083 Published: 03 May 2023 Article history Corrected and typeset: 03 May 2023 Published: 03 May 2023

Omaveloxolone.

Journal Article Corrected proof Omaveloxolone Get access American Journal of Health-System Pharmacy, zxad072, https://doi.org/10.1093/ajhp/zxad072 Published: 03 May 2023 Article history Corrected and typeset: 03 May 2023 Published: 03 May 2023

Pegcetacoplan.

Journal Article Corrected proof Pegcetacoplan Get access American Journal of Health-System Pharmacy, zxad076, https://doi.org/10.1093/ajhp/zxad076 Published: 03 May 2023 Article history Corrected and typeset: 03 May 2023 Published: 03 May 2023

Daprodustat.

Journal Article Corrected proof Daprodustat Get access American Journal of Health-System Pharmacy, zxad049, https://doi.org/10.1093/ajhp/zxad049 Published: 07 April 2023 Article history Corrected and typeset: 07 April 2023 Published: 07 April 2023

Establishing a pharmacy revenue integrity team: A blueprint for increasing pharmacy's role in health-system revenue cycle.

An increasing focus on driving margin has pushed health-system pharmacy departments to find new ways of generating new or protecting existing revenue. At UNC Health, a dedicated pharmacy revenue integrity (PRI) team has been operating since 2017. This team has been able to significantly reduce revenue loss from denials, increase billing compliance, and improve revenue capture. This article provides a framework for establishing a PRI program and reports results generated from it. The activities of a PRI program can be grouped into 3 main pillars: minimizing revenue loss, optimizing revenue capture, and ensuring billing compliance. Minimizing revenue loss is accomplished primarily through management of pharmacy charge denials and can be an ideal first step in establishing a PRI program due to the tangible value generated. Optimizing revenue capture involves a combination of clinical expertise and understanding of billing operations to ensure medications are being billed and reimbursed appropriately. Finally, ensuring billing compliance, including ownership of the pharmacy charge description master and maintenance of electronic health record medication lists, is vital in preventing charge and reimbursement errors. Successfully bringing traditional revenue cycle functions into the department of pharmacy can be a daunting task but provides significant opportunities to create value for a health system. Key factors to the success of a PRI program include robust data access, hiring individuals with financial and pharmacy expertise into PRI positions, strong relationships with the existing revenue cycle teams, and a progressive model that allows for incremental expansion of services.