Pharmacy-Level Stewardship Can Save on Immune Checkpoint Inhibitors

TUESDAY, July 11, 2023 (HealthDay News) -- Adoption of pharmacy-level stewardship strategies for immune checkpoint inhibitors could generate sizable reductions in spending for these drugs, according to a study published in the July issue of Health Affairs.

Alex K. Bryant, M.D., from the University of Michigan in Ann Arbor, and colleagues conducted a simulation study to assess whether personalized weight-based dosing along with common stewardship efforts at the pharmacy level, such as dose rounding and vial sharing, would lead to reductions in immune checkpoint inhibitor use and lower spending. Data from the Veterans Health Administration (VHA) and Medicare drug prices were used to estimate reductions in immune checkpoint inhibitor use and spending associated with these strategies.

The researchers found baseline annual VHA spending for these drugs to be approximately $537 million. The VHA system could realize an estimated savings of $74 million (13.7 percent) by combining weight-based dosing, dose rounding, and pharmacy-level vial sharing.

"Achieving high-quality, financially sustainable cancer care will require stakeholders to acknowledge that the right dose is likely to be a personalized one and that adoption of operational, regulatory, and methodologic innovations is a necessity," the authors write. "For such innovations to thrive, however, the value-based pharmacy ecosystem must be shaped by collaborative relationships among payers, clinicians, pharmacies, drug makers, and regulators."

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