Managed Care Pharmacy Research Articles

AMCP Partnership Forum: Patient input and payer decision-making.

There has been growing consensus for the health care community to become more patient centered by considering patient needs, preferences, and values in decision-making. To advance partnership between payers and patient representatives to gather patient input and incorporate their perspective on the broad range of managed care pharmacy decisions, the AMCP held a multistakeholder Partnership Forum on December 6 and 7, 2023, in Alexandria, Virginia. Forum participants were asked to (1) identify opportunities for patient representatives to engage with payers and other managed care pharmacy decision-makers, (2) recognize challenges and propose potential solutions to establish patient engagement programs between payers and patient representatives, and (3) review and provide input on draft frameworks created by the 2023-24 AMCP Patient Voice Advisory Group. Key themes that emerged from the participant discussion included to assemble and draw upon successful examples and best practices, recognize different levels of engagement, build trust and relationships proactively, create defined access points and open dialogue channels, incorporate the patient perspective as an element of coverage decision-making, leverage existing patient data and reports, crystallize a key message furthering common goals, and facilitate ongoing education and learning.

Unlocking the potential of digital therapeutics: The need for consistent and granular inclusion in drug compendia for managed care.

The field of digital therapeutics (DTx), software programs that prevent, manage, and treat medical conditions, continues to grow. DTx offers new treatment options and has the potential to close gaps in care caused by unmet patient needs, provider shortages, or socioeconomic or geographical disparities. However, the field of DTx has not seen steady adoption owing to barriers, particularly related to coverage, payer acceptance of the category, provider use, and integration within existing health care delivery tools. One challenge for payers to effectively evaluate and cover DTx products is ensuring that consistent data elements are listed for these products in traditional drug compendia databases. Managed care organizations will need similar information about DTx product features as are available for traditional medications to inform coverage and reimbursement decisions. The Academy of Managed Care Pharmacy DTx Advisory Group developed and distributed a request for information to the 5 top drug compendia companies to assess how compendia products incorporate DTx and prescription DTx. This article summarizes how DTx are listed within different compendia products and offers insights on future data needs to adequately inform payers. As the DTx sector grows and consumer demand rises, compendia listing services will need to evolve to accommodate these new therapies and treatment modalities and facilitate patient access and efficient claims processing. Recommendations for how compendia companies can support managed care in these efforts are outlined.

Biosimilars: What pharmacists should know and a survey

Biosimilars are biologic products that are highly similar to existing reference biologics and provide cost-effective treatment alternatives. As more biologic patents expire, biosimilars are becoming increasingly important in healthcare, requiring healthcare professionals to have a solid understanding of their development, regulatory pathways, and clinical implications. Despite their potential benefits, biosimilars face barriers such as limited awareness, concerns about safety and efficacy, and complex regulatory processes. This study aimed to evaluate the effectiveness of an educational program designed to address these challenges and enhance healthcare professionals’ knowledge and confidence in biosimilar use. Methods: The Howard University College of Pharmacy, in collaboration with the FDA, Academy of Managed Care Pharmacy (AMCP), and Biologics & Biosimilars Collective Intelligence Consortium (BBCIC), conducted a symposium on biosimilars. The program, funded by an unrestricted educational grant from Pfizer, included two primary sessions featuring expert presentations and workshops. Feedback was collected from 114 participants using post-program surveys to assess learning outcomes, program relevance, and its impact on practice. Participants included pharmacists (44.74%), students (44.74%), and other healthcare professionals (10.52%) from various states, with a strong representation from Maryland and Washington, D.C. Results: The program received highly positive feedback, with 86.96% rating the applicability of the program to their practice as "Excellent" and 13.04% as "Good." In terms of knowledge enhancement, 89.13% rated the program as "Excellent," and 10.87% as "Good." Overall, 84.78% rated the program as "Excellent" and 13.04% as "Good," with only 2.17% being "Neutral." No participants rated the program negatively. The program was effective in meeting specific educational objectives, with 89-93% of respondents marking “Strongly Agree” for understanding key biosimilar concepts, such as recognizing their role in practice and understanding development pathways. The objective on using biosimilars in practice received slightly lower ratings, with 73.91% “Strongly Agree” and 19.57% “Agree.” Conclusion: The study demonstrates the effectiveness of structured educational programs in enhancing healthcare professionals’ understanding and confidence in the use of biosimilars. The overwhelmingly positive reception underscores the need for continued education, particularly as more biosimilars enter the market. Future programs should focus on addressing remaining barriers, such as provider hesitancy and practical implementation strategies, to ensure that healthcare professionals are well-prepared to integrate biosimilars into clinical practice. This will ultimately contribute to better patient outcomes, increased adoption of cost-effective therapies, and a more sustainable healthcare system

Poster Abstracts - Academy of Managed Care Pharmacy 2024.

The AMCP Poster Abstract Program provides a forum for authors to share their research with the managed care pharmacy community. Authors submit their abstracts to AMCP, and each abstract is reviewed by a team of peer reviewers and editors. All accepted abstracts are presented as posters at AMCP's Annual and Nexus meetings. These abstracts are also available through the AMCP meeting app. This JMCP supplement publishes all abstracts that were peer reviewed and accepted for presentation at Nexus 2024. Abstracts submitted in the Student and Encore categories did not undergo peer review; therefore, these abstracts are not included in the supplement.

Evolving oncology care management trends in the United States: A survey among health care decision makers.

There is limited knowledge of how US managed care professionals view and prioritize quality metrics/performance measures, care models, alternative payment models, and clinical pathways in oncology settings. To characterize payor perspectives on, and the use of, oncology clinical pathways and performance measures in their reimbursement/access decision-making process. A survey was implemented via SurveyMonkey software and distributed electronically to a national sample of the Academy of Managed Care Pharmacy (AMCP) Market Insights Panel members from July 11 through August 5, 2022. The survey was created by a steering committee based on literature reviews of the current and future oncology care landscapes. The survey consisted of 47 questions, including those to establish respondents' position, responsibilities, and demographics. The results are presented as descriptive statistics for 7 key questions that covered the perceptions and use of quality metrics/performance measures, alternative payment models, and oncology care pathways as prioritized by the steering committee. Among the 695 AMCP panel members who were sent the survey, 73 responded (response rate 10.5%), 54 were eligible to continue, and 31 completed the entire questionnaire; the low response rate may limit generalizability of the survey results. Specific oncology clinical and economic measures of performance were currently used (70%-88%) but generally received less endorsement for future use (39%-49%) except for chemotherapy during end of life, which was considered for future use by 80% of respondents but was only currently used by 31%. Benchmarking was the primary reason for the use of performance measures; only 27% used these to inform value-based agreements. Real-world data tracked by respondents' institutions primarily focused on managed care and pharmacy utilization (39%-85%), with patient-reported and clinical outcomes tracked by only 17%-34%. Almost one-third (31%) did not use clinical oncology pathways, and among those who did, fewer than half (48%) reported that their organization tracks whether treatment decisions agree with the oncology care pathways, and only 26% reported feedback to oncology providers on how often their treatment decisions agree with the pathways. When considering alternative payment models, patient-related components received lower rankings in importance than clinical relevance, actionability, and costs. Variation among payors regarding current trends in oncology care management, including on the importance of patient-centric outcomes and the use of oncology clinical pathways, suggests the need to focus on value-based health care and greater uptake of oncology clinical pathways.

National Recommendations for Pharmacoeconomic Evaluations Reporting for Reimbursement and Procurement of New Pharmaceutical Applications in Egypt.

To improve resource allocation within our healthcare system, the Egyptian Authority for Unified Procurement, Medical Supply and the Management of Medical Technology (UPA) and Universal Health Insurance Authority (UHIA) established a joint economic evaluation process to support UHIA reimbursement decisions and UPA procurement decisions. The main objective of this study is to describe the developed national pharmacoeconomic guidelines in Egypt, especially for reimbursement and procurement for new pharmaceuticals. A focus group was formed as a national initiative activity by governmental authorities in Egypt. The aim of this focus group was to develop national pharmacoeconomic guidelines for the evaluation of innovative and high-budget pharmaceutical products. This group consisted of various stakeholders with experience in health economics, outcomes research, public health, and pharmacy practice. To develop our national pharmacoeconomic guidelines, three steps were taken. First, the focus group reviewed the European Network for Health Technology Assessment (EUnetHTA) methods for health economic evaluations for new pharmaceuticals as well as the Canadian Agency for Drugs and Technologies in Health (CADTH) guidelines and the Academy of Managed Care Pharmacy (AMCP) Format for Formulary Submissions. Second, the focus group used the EUnetHTA guideline as a reference and adapted it to our local context. The focus group added the value assessment component, using the CADTH and AMCP guidelines. Third, the focus group collected input and feedback from key stakeholders through a focus group by using the quasi-Delphi panel approach. The results of the focus group are a main structure of national pharmacoeconomic guidelines for the evaluation of innovative and high-budget pharmaceutical products, consisting of seven main topics. Economic evaluation is a core element of Health Technology Assessment, (HTA); therefore, the UHIA and UPA were encouraged to produce unified joint pharmacoeconomic guidelines for innovative products as an initial step in their commitment to implement the use of HTA in decision-making. This standardization of guidelines not only ensures transparency but also guarantees an accurate and transparent process to support evidence-based decision-making. These guidelines are expected to help decision-makers improve their process and attain better health outcomes for Egyptian patients.

Considerations for US coverage and reimbursement: Which digital health products to evaluate? Findings from a modified Delphi study.

The rapid growth of digital health tools, including digital applications, wearables, sensors, diagnostics, digital therapeutics (DTx), and prescription DTx, offers new ways to treat patients and close gaps in care. Payers need transparent, credible, and efficient processes to differentiate products for potential reimbursement from the larger universe of digital health products. To identify areas of agreement, disagreement, and rationale for payers to determine which digital health products should be evaluated for formulary consideration and to develop generalizable criteria for health care decision-makers developing policies and approaches for digital health products. Experts from the Academy of Managed Care Pharmacy DTx Advisory Group Payer Evaluation subcommittee rated whether a pharmacy and therapeutics committee, health technology assessment group, or an innovation center within a health plan or pharmacy benefit manager should consider 14 hypothetical products for potential formulary coverage. Using a 4-step modified Delphi approach, experts rated whether it was appropriate for a payer to evaluate each product on a scale of 1 (strongly disagree) to 9 (strongly agree). Quantitative agreement was assessed using terciles of responses, medians, and the distribution of appropriateness scores. The corresponding discussions are summarized to identify generalizable criteria for payers to consider as they develop approaches to determine which digital health products to evaluate. Among the 14 hypothetical products, 4 achieved quantitative agreement that payers should evaluate the product. 5 products had quantitative disagreement, and the remaining were indeterminant. Payers were most likely to review a product if it (1) was reviewed by the US Food and Drug Administration, (2) required a prescription, (3) was intended to be paid for using premium dollars, (4) treated rather than diagnosed or monitored a clinical condition, (5) had a low clinical opportunity cost, and (6) could address population health metrics. The rapid availability of digital health and DTx options can be daunting for health care decision-makers when determining which products to evaluate. These generalizable criteria can help payers develop a more efficient process.

Reducing disparities in medication use: Responding to managed care pharmacy's imperatives.

Although disparities and inequities in health status and access to health care services have long existed in our nation, the COVID-19 pandemic cast a bright spotlight on them. Communities of color and socioeconomically disadvantaged populations were disproportionally affected by the pandemic. These same populations suffer from higher prevalences of chronic illnesses, which puts them at greater risk for poor outcomes associated with SARS-CoV-2. At long last, in the wake of the pandemic, the health care community began to acknowledge improving health equity as a public health imperative. In a November 2020 JMCP Viewpoints article, Dr Stephen Kogut of the University of Rhode Island College of Pharmacy presented an insightful analysis of disparities in medication use (DMU) and offered 4 suggestions on how the managed care pharmacy community can help eliminate DMU. This Viewpoints article assesses what progress has been made in addressing those imperatives and proposes further steps that should be taken. Although the managed care pharmacy community has broadly acknowledged the existence of DMU and taken steps to mitigate them, there is much work to do in examining and improving benefit design and coverage policies; collecting and reporting data on race and ethnicity and DMU; incorporating the perspectives of patients, including those representing minority populations, in benefit design and coverage policies; and addressing the challenges associated with traditional cost-sharing models. The entire managed care pharmacy community, including AMCP and other membership organizations, must remain steadfast in its efforts to improve health equity and eliminate DMU.

Clinical and economic evaluation of tralokinumab for atopic dermatitis.

Tralokinumab is the first selective interleukin 13 inhibitor approved for moderate to severe atopic dermatitis. This article reports the findings of a comprehensive literature review and extensive economic analysis to assess tralokinumab's safety, effectiveness, and cost. Evidence synthesis involved evaluating comparative effectiveness and conducting economic sensitivity analyses. This review was prepared by the University of Connecticut School of Pharmacy Academy of Managed Care Pharmacy (AMCP) Student Chapter. The student author group won the AMCP National Pharmacy and Therapeutics competition for their tralokinumab product review in March 2023.

Health care decision-maker perceptions and trends in the utilization of preapproval information for formulary decision-making.

Preapproval information exchange (PIE) has increased between biopharma companies and health care decision-makers (HCDMs) over the last several years. However, there still exists a gap in what HCDMs need and what biopharma companies are providing. To assess trends in the utilization of preapproval information by HCDMs and identify resources that may best support organizations in evaluating product information for formulary coverage prior to US Food and Drug Administration approval. A double-blinded, web-based survey was fielded to a research panel of HCDMs from FormularyDecisions from May 16, 2022, to May 23, 2022. A total of 30 advisors were invited to take the survey and 17 responded to the survey, with representation largely from health plans (41%), pharmacy benefit managers (24%), and integrated delivery networks (12%) across commercial, Medicare, and Medicaid lines of business. Of the respondents, 47% noted that the availability of preapproval information has shortened the time to make a formulary decision. Almost all respondents (90%) ranked the availability of clinical and economic information in a timely manner to evaluate budget impact as a top benefit for PIE. Respondents noted that Academy of Managed Care Pharmacy (AMCP) preapproval dossiers (88%), AMCP PIE webinars (76%), preapproval presentations/videos (65%), and posters and abstracts of clinical trials results (59%) were the main resources used to facilitate PIE. The availability of preapproval information for HCDMs (particularly content related to anticipated place in therapy and product pricing) has an impact on shortening formulary decision-making timelines.

Increasing Naloxone Access and Prescribing for Patients on High-Dose Opioids From a Managed Care Pharmacy Health Plan Perspective

Background: Opioid overdoses decrease when communities have access to naloxone. Clinicians play a key role in offering naloxone to high-risk chronic opioid patients. Managed care pharmacists within our health plan noted disproportionate processing for claims of opioid utilizers compared to claims of naloxone prescriptions. Objective: To increase naloxone access and prescribing to members who classify at a dosage with a higher risk for opioid overdose, defined as over 90 morphine milligram equivalents (MME). Methods: Multiple system-wide initiatives were implemented to improve naloxone access. A claims file was pulled monthly to identify members on opioids meeting MME criteria >90 MME per day excluding members with cancer, sickle cell disease, or on hospice. A separate report was then matched to naloxone claims and prescribing percentages calculated. Results: 12 444 utilizing members on opioids were identified from June 2019 prescription claims data. Of these, 131 were on opioids exceeding 90 MME per day, or 1.05% of utilizers, and the percentage of members exceeding 90 MME per day prescribed naloxone was 6.87%. By May 2023, the percentage of opioid utilizers exceeding 90 MME per day decreased to 0.58%. Naloxone prescribing increased to 41.18%. Conclusion: A multi-pronged approach to improve access to naloxone and continued educational efforts by our health plan increased naloxone prescribing in members on opioids exceeding 90 MME per day.

A primer on brand-name prescription drug contracting.

Prescription drug contracting in the United States has evolved over decades from discounts provided to members of early health maintenance organization plans to rebate contracts to more complex value-based purchasing arrangements. This primer describes the history of contracting between pharmaceutical manufacturers and managed care pharmacy organizations and details the various contracting methods used today.

Poster Abstracts - Academy of Managed Care Pharmacy 2024.

The AMCP Poster Abstract Program provides a forum for authors to share their research with the managed care pharmacy community. Authors submit their abstracts to AMCP, and each abstract is reviewed by a team of peer reviewers and editors. All accepted abstracts are presented as posters at AMCP's Annual and Nexus meetings. These abstracts are also available through the AMCP meeting app. This JMCP supplement publishes all abstracts that were peer reviewed and accepted for presentation at AMCP 2024. Abstracts submitted in the Student and Encore categories did not undergo peer review; therefore, these abstracts are not included in the supplement.

A primer on formulary structures and strategies.

Formularies are a tool for managing costs, optimizing patient access, and improving overall health outcomes. The general goal of formularies is to provide access to appropriate therapy while promoting effective resource utilization, which allows the managed care pharmacy organization to operate sustainably. Traditional formulary strategies have included open and closed formularies as well as tiered formularies. However, other formulary structures have emerged in support of the focus on product value. The formulary development process is primarily driven by the pharmacy and therapeutics (P&T) committee and value committee within an organization. Key considerations such as member population, regional differences, regulatory/compliance implications, and benefit design strategies may influence payers to create a customized formulary to provide additional value to their members while managing costs. With the rise of high-cost and specialty products, formularies continue to serve as an important tool for managed care pharmacy organizations. Ongoing trends, such as biosimilars, prescription digital therapeutics, and addressing health equity, will shape future strategy and management of formularies.

A primer on managed care pharmacy.

This primer defines the practice of managed care pharmacy and introduces key competencies of managed care pharmacy organizations, including pharmacy benefit design and implementation, formulary and medication utilization management, clinical program development and implementation, quality and safety program management, and promotion of affordability.

Opportunities and challenges surrounding financial models for high-investment medications: A survey of access decision-makers and employers.

BACKGROUND: As an increasing number of cell and gene therapies are US Food and Drug Administration approved, health care stakeholders are attempting to strike a balance between patient access to innovative treatments and overall affordability. Access decision-makers and employers are evaluating how implementation of innovative financial models can support coverage of high-investment medications. OBJECTIVE: To understand how access decision-makers and employers are using innovative financial models for highinvestment medications. METHODS: A survey was conducted with access and employer decision-makers recruited from a proprietary database of market access decision-makers from April 1 to August 29, 2022. Respondents were asked about their experiences using innovative financing models for high-investment medications. RESULTS: Across both stakeholder segments, stop-loss/reinsurance was the most utilized financial model, with 65% of access decision-makers and 50% of employers currently using this financial model. More than half (55%) of access decision-makers and nearly one-third of employers (30%) currently use a provider contract negotiation strategy, with similar percentages of access decision-makers (20%) and employers (25%) planning to implement this strategy in the future. Aside from stop-loss/reinsurance and provider contract negotiation, no other financial models exceeded 25% penetration in the employer market. Subscription models and warranties were the least common models currently used by access decision-makers (10% and 5%, respectively). The greatest growth for access decision-makers is expected for annuities, amortization or installment strategies, outcomes-based annuities, and warranties, with 55% of access decision-makers planning to implement each. Few employers are seeking to implement new financial models in the next 18 months. Both segments prioritized financial models that can address the actuarial or financial risk arising from uncertainty in the number of patients likely to be treated with a durable cell or gene therapy. Many access decision-makers cited a lack of opportunities from manufacturers as a reason for not using a model, whereas employers also identified lack of information and financial viability as reasons for not using a model. In most cases, both stakeholder segments prefer to work with current partners as opposed to a third party when executing an innovative model. CONCLUSIONS: Access decision-makers and employers are adopting innovative financial models as traditional management techniques are insufficient to manage the financial risk associated with highinvestment medications. Although both stakeholder segments see a need for alternative payment models, they also recognize the challenges and complexity associated with their implementation and execution of these types of partnerships. DISCLOSURES: This research was sponsored by the Academy of Managed Care Pharmacy and PRECISIONvalue. Dr Lopata, Mr Terrone, and Dr Gopalan are employees of PRECISIONvalue.

HTA184 Investigating How Orphan Drug Manufacturers Can Optimize Clinical Trial Design so Patients across Geographies Can Access Life-Saving Innovations

Orphan drugs offer significant clinical benefit, however their cost leads to potentially unsustainable budget impact. US Managed Care Organizations (MCOs) and Pharmacy Benefit Managers (PBMs) often provide coverage, regardless of price and limitations of data at launch, while European payers review data more critically before providing coverage. This poses a challenge to manufacturers of how to design clinical trials that ensure their product will be reimbursed across geographies.

Collaborative approach to harm reduction by managed care pharmacy team for populations with substance use disorder

BackgroundOregon has one of the highest rates of substance use and substance use disorders (SUDs) in the nation. To improve access to SUD treatment in Oregon, CareOregon clinical pharmacists in collaboration with the behavioral health team have implemented these best practices to support members with SUD. ObjectiveThe primary objective of this article is to describe the various harm reduction programs and interventions implemented by managed care clinical pharmacists at CareOregon to prevent overdose and ensure improved health outcomes for populations with SUD. Practice descriptionThe CareOregon team of managed care clinical pharmacists acts as a liaison with provider networks by providing pharmacy benefit knowledge and implementing several interventions and best practices to improve health outcomes for populations with SUD. Practice innovationThe managed care clinical pharmacist team implemented a medication education (MEDS Ed) program to provide educational support to the CareOregon provider network on harm reduction, supported medication for opioid use disorder (MOUD) program initiatives to increase buprenorphine prescribing, and used programs to increase naloxone access for populations at high risk of overdose. Evaluation methodsA mixed-method approach was applied to evaluate the impact of the practice innovations implemented. A qualitative self-assessment questionnaire was used to evaluate the impact of the harm reduction MEDS Ed. Quantitative data accessed via CareOregon’s claims data were used to evaluate the effect of initiatives to expand naloxone access and increase buprenorphine prescribing. ResultsThe CareOregon provider network reported an increase in knowledge about harm reduction by attending the MEDS Ed training. From the first quarter of 2019 to the second quarter of 2022, the number of naloxone prescriptions filled increased by 346%. From the third quarter of 2017 to the first quarter of 2022, the number of Drug Addiction Treatment Act–waivered providers prescribing buprenorphine increased by 331%. As a result, the number of prescriptions for MOUD doubled during this period. ConclusionThe harm reduction interventions implemented by the managed care clinical pharmacist team at CareOregon were successful in improving knowledge on harm reduction and increasing naloxone access and buprenorphine prescribing for populations at risk of opioid use disorder.

Predictors of Erythropoiesis-Stimulating Agent Failure in Lower-Risk Myelodysplastic Syndromes: Systematic Literature Review

Introduction: Patients with lower-risk myelodysplastic syndromes (LR-MDS) commonly experience chronic progressive anemia, which is initially treated with erythropoiesis-stimulating agents (ESAs). However, many patients do not respond to ESAs, thereby putting them at risk of earlier disease progression, which can require invasive and/or costly treatments, including blood transfusions or hypomethylating agents. A systematic literature review (SLR) was conducted to assess quantitative associations between prognostic factors and response to treatment with ESAs in patients with LR-MDS. Methods: An electronic search for relevant literature was conducted on February 25, 2022, across Embase and MEDLINE via OvidSP. Also, proceedings from the American Society of Hematology, European Hematology Association, American Society of Clinical Oncology, Academy of Managed Care Pharmacy, and European Society for Medical Oncology meetings from 2019 to 2022 were searched via OvidSP or manually if not indexed in databases. Articles written in languages other than English were excluded. Adult patients with LR-MDS were included in the analysis. Studies reporting measures of effect between prognostic factors and ESA response were included, as were studies reporting quantitative data pertaining to differences in patient characteristics between ESA responders and non-responders. Studies reporting both univariate and multivariate analyses were included. No geographic or temporal limits were applied to the search strategy, except for congress proceedings, which were limited to 2019 onwards. Results: In total, 38 studies were eligible for inclusion in this SLR, and 8 prognostic factors of interest were most frequently reported: baseline serum erythropoietin (EPO), hemoglobin (Hb), transfusion independence, bone marrow blast count, ferritin levels, International Prognostic Scoring System (IPSS) risk status, age, and karyotype status. Regarding study design, most were retrospective cohort studies (N = 15) or single-arm trials (N = 12), and were conducted in Europe (N = 24). Within the identified publications, ESA response was often assessed using the International Working Group (IWG) MDS 2000 or 2006 criteria in publications after 2000. Studies published prior to 2000 did not use a standardized method of refining response, but still classified patients according to changes in Hb levels or transfusion requirements. The literature available in LR-MDS demonstrated statistically significant relationships suggesting that patients with low serum EPO levels (vs higher EPO levels), high Hb levels (vs lower levels), and transfusion independence (vs transfusion dependent) are more likely to respond to ESA treatment (Table). This relationship was consistent across both univariate and multivariate analyses. The evidence for bone marrow blasts and ferritin levels was inconclusive, but could potentially be influenced in the future by the publication of studies with larger patient populations. There was no published evidence that ESA response was related to IPSS risk status, age, and karyotype status. The associated data for these prognostic factors in responders versus non-responders showed similar patterns. Conclusion: All studies assessing quantitative associations between ESA response and prognostic factors were published after 2000, hence ESA response was assessed according to IWG 2000 or 2006 criteria. The studies demonstrate a clear link between response to ESA treatment and lower serum EPO levels, higher Hb levels, and transfusion independence. The other prognostic factors were either not significant or inconclusive, and more research is needed to clarify whether they have a prognostic impact on ESA response in patients with LR-MDS. Some of the studies comparing prognostic factors for responders versus non-responders to ESA treatment were published before 2000 and did not use standardized methods to describe response. Due to changes in ESA treatment response definitions over time, some patients in the included studies may be classified differently with a more recent version of the IWG MDS criteria. Figure 1View largeDownload PPTFigure 1View largeDownload PPT Close modal

Poster Abstracts - Academy of Managed Care Pharmacy 2022.

NEXUS 2022 will be held October 11-14, 2022 in National Harbor, Maryland. The AMCP abstracts program provides a forum through which authors can share their insights and outcomes of advanced managed care practice. Podium presentations for the Platinum award-winning abstracts are Wednesday, October 12, from 1:00 pm to 2:15 pm. Poster presentations are scheduled for Thursday, October 13, from 11:00 am to 2:30 pm. Posters will be on display on Wednesday October 12, from 4:00 pm to 7:00 pm at the Opening Reception, located in the Exchange.