Journal of the American Pharmacists Association最新文献

{"title":"Projecting financial sustainability for clinical pharmacy services: An implementation science brief report","authors":"Ashley W. Ellis,&nbsp;Cori C. Grant,&nbsp;Christopher K. Finch,&nbsp;Reginald F. Frye,&nbsp;Todd D. Sorensen","doi":"10.1016/j.japh.2025.102988","DOIUrl":"10.1016/j.japh.2025.102988","url":null,"abstract":"<div><h3>Background</h3><div>The United States faces a projected shortage of 86,000 physicians by 2036, disproportionately affecting rural areas. Meanwhile, 90% of Americans live within 5 miles of a pharmacy, positioning pharmacists to help address care gaps. Despite demonstrated clinical value, pharmacist integration into primary care is hindered by unclear compensation pathways.</div></div><div><h3>Objectives</h3><div>This study developed and piloted the Pharmacist Revenue and Integration Modeling Engine (PRIME), a novel tool to support financial decision-making for pharmacist integration. Objectives included (1) developing PRIME, (2) exploring implementation strategies, and (3) modeling financial viability.</div></div><div><h3>Methods</h3><div>The University of Tennessee Health Science Center partnered with an academic family medicine clinic in Memphis, TN, to re-establish clinical pharmacy services. PRIME used the 2025 Medicare Physician Fee Schedule, adjusted for Medicaid, private insurance, and self-pay, to model revenue across 4 service delivery scenarios. A full-time pharmacist (40 h/wk, 46 wk/y) was assumed, and projected revenue was compared to personnel costs.</div></div><div><h3>Results</h3><div>Financial viability varied by service type and volume. Preventive care and collaborative physician-pharmacist visits (e.g., annual wellness visits and 99,214 E/M codes) were key revenue drivers. The most successful model (approach 1.5) blended preventive and collaborative services, generating $286,700 in annual revenue and a net surplus of $105,500 (ROI 1.58:1). This led to a clinic-academic partnership placing 2 pharmacists (1 full-time equivalent) in the clinic.</div></div><div><h3>Conclusion</h3><div>Strategic use of billing codes can make clinical pharmacy services financially self-sustaining in primary care. PRIME offers a customizable roadmap for clinics to evaluate and implement pharmacist integration. This model supports workforce expansion, training opportunities, and improved access to care.</div></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"66 1","pages":"Article 102988"},"PeriodicalIF":2.5,"publicationDate":"2025-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145477373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bridging the gap between expanded pharmacy services and payment models: A jurisdictional scan","authors":"Amarildo Ceka,&nbsp;Bhuvi Juneja,&nbsp;Olivia Tseng,&nbsp;Wei Zhang,&nbsp;I Fan Kuo,&nbsp;Nick Bansback,&nbsp;Michael R. Law,&nbsp;Larry D. Lynd,&nbsp;Peter J. Zed,&nbsp;Craig Mitton","doi":"10.1016/j.japh.2025.102989","DOIUrl":"10.1016/j.japh.2025.102989","url":null,"abstract":"<div><h3>Background</h3><div>Over the past few decades, pharmacists' roles have expanded beyond dispensing to include medication reviews, minor ailment prescribing, and vaccinations. In British Columbia, Canada, the fee-for-service model has been recognized as a barrier to service uptake. To design future payment models that support uptake, it is important to examine the impacts of models used in other jurisdictions.</div></div><div><h3>Objectives</h3><div>To examine pharmacy remuneration models minor ailments provided by pharmacists across Organization for Economic Co-operation and Development (OECD) countries. The objectives of this study were to (1) identify the structure, funding mechanisms, and provider-level incentives for these models and (2) to assess the reported impacts of these models on service uptake, cost-effectiveness, health care access, and associated barriers and facilitators within community pharmacy settings.</div></div><div><h3>Methods</h3><div>We conducted a literature review to investigate the payment structures for pharmacists providing expanded services for minor ailments. Guided by Preferred Reporting Items for Systematic Reviews and Meta-Analyses, we searched MEDLINE and EMBASE databases from January 1, 2003, to September 20, 2023, focusing on pharmacy services, remuneration, and minor ailments in OECD countries such as the United Kingdom, Australia, New Zealand, the United States, etc.</div></div><div><h3>Results</h3><div>The search yielded 1662 records, of which 11 primary studies and 5 systematic reviews met the inclusion criteria, which examined 3 payment models for pharmacies providing minor ailment services: fee-for-service, performance-based payment models (PBPM) and capitation models. Fee-for-service models were found to encourage dispensing based on volume but provided little incentive for quality care. PBPM models were effective in promoting quality care but were noted to lack flexibility. Evidence on capitation models was minimal.</div></div><div><h3>Conclusion</h3><div>This overview of remuneration models explored alternative payment models to encourage expanded pharmacist services. The review highlights that various payment models come with their own unique benefits, such as cost savings and improved patient care. When designing a payment model, it is essential to prioritize stakeholder engagement and address equity concerns.</div></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"66 1","pages":"Article 102989"},"PeriodicalIF":2.5,"publicationDate":"2025-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145472631","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of a community-focused emergency response tool for medication-related preparedness","authors":"Sarah Schneider,&nbsp;Sharon Connor,&nbsp;Kiran Barik,&nbsp;Lauren J. Jonkman,&nbsp;Hoai-An Truong,&nbsp;Joni C. Carroll","doi":"10.1016/j.japh.2025.102987","DOIUrl":"10.1016/j.japh.2025.102987","url":null,"abstract":"<div><h3>Background</h3><div>Pharmacists are among the first health care providers to respond after a disaster. They serve a vital role through mass medication dispensing or vaccination and triaging the medication needs of the community. Their role during the COVID-19 pandemic and other disasters have highlighted a need to engage pharmacists in local emergency preparation and community planning efforts.</div></div><div><h3>Objective</h3><div>The objective of this project was to develop an expert-informed medication-related emergency response readiness tool for community-based pharmacists.</div></div><div><h3>Methods</h3><div>Pharmacists with expertise in the different phases of disaster management informed revisions of an existing emergency response readiness checklist for short-term humanitarian response. The checklist was chosen to adapt because it focuses on pharmacist medication expertise while guiding users through all phases of the disaster management cycle. A variation of nominal group technique was used to gather expert feedback on the checklist and gain consensus on the adapted tool.</div></div><div><h3>Results</h3><div>The expert panel included 9 pharmacists with collective experience in over 50 emergencies in more than 20 countries. The panel recommended adapting the checklist to a comprehensive tool format to represent the continuousness of disaster management cycle. The panel recommended keeping the tool line items focused on medication access and prompting pharmacists to think about how they can use their medication expertise to ensure equitable access to care during and after an emergency. Most revisions were in the prevention and preparedness phases of the tool and build up capacity for a local response effort through community partnerships.</div></div><div><h3>Conclusion</h3><div>To our knowledge, this emergency response readiness tool is the first to guide community-based pharmacists through the critical steps required for disaster and emergency medication-related preparation. Medication-related disaster management requires a multiple-step process that is ongoing as the needs of communities change over time.</div></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"66 1","pages":"Article 102987"},"PeriodicalIF":2.5,"publicationDate":"2025-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145472623","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Misinformation is eroding the foundation of public health","authors":"Benjamin P. Lewis","doi":"10.1016/j.japh.2025.102492","DOIUrl":"10.1016/j.japh.2025.102492","url":null,"abstract":"<div><div>Robert M. Califf, MD, Commissioner of the Food and Drug Administration (FDA), noted at the end of his term that misinformation was a priority during his tenure; however, COVID-19 vaccines have dissuaded people from getting the vaccine and contributed to preventable deaths. The Incoming Secretary of the Department of Health and Human Services, Robert F. Kennedy, Jr (RFK Jr), which includes the FDA, has now stated that there are not sufficient vaccine safety studies, falsely asserted the government doesn't have good vaccine safety monitoring, and that we don't have good science on almost everything, including vaccines. Additionally, he refused to acknowledge the scientific consensus that childhood vaccines (e.g., measles, mumps, and rubella vaccine) do not cause autism.</div><div>Pharmaceutical sponsors study vaccines in clinical trials under an Investigational New Drug Application, which extensively tests vaccines, analyzing thousands of subjects' data for safety and efficacy. Many vaccines have been available for years without reported safety concerns. Conducting comprehensive clinical trials, monitoring, and reporting vaccine safety data are considered good science.</div><div>Effective communication about vaccines is crucial as we become increasingly interconnected through world travel, social media, and the internet. Providing accurate information and fostering trust that supports good clinical and scientific knowledge prevents confusion from unsupported statements, such as social media, that can create misinformation. The FDA approves the official prescribing information and fact sheet for vaccines, ensuring they are accurate and well-documented to prevent misinformation. Responsible health science communication must be correct, transparent, and inclusive to the public. Vaccination is a fundamental principle of public health, and clear communication is the basis of mitigating vaccine hesitancy, misinformation, and disinformation. Without this, misinformation will erode the foundation of public health.</div></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"65 6","pages":"Article 102492"},"PeriodicalIF":2.5,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144777683","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cover","authors":"","doi":"10.1016/S1544-3191(25)00670-3","DOIUrl":"10.1016/S1544-3191(25)00670-3","url":null,"abstract":"","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"65 6","pages":"Article 102991"},"PeriodicalIF":2.5,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145568280","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The use profile of antimicrobial drugs in neonatal intensive care units: a scoping review protocol","authors":"Francisco Clébison Chaves Lope ,&nbsp;Tayssa Figueiredo Moura ,&nbsp;Lucas Amaral-Machado ,&nbsp;Gentil Gomes da Fonseca Filho ,&nbsp;Klayton Galante Sousa","doi":"10.1016/j.japh.2025.102910","DOIUrl":"10.1016/j.japh.2025.102910","url":null,"abstract":"<div><h3>Background</h3><div>Newborns are particularly susceptible to infections due to their immature immune systems. This condition is also exacerbated by the following factors (i) invasive procedures, (ii) length of hospital stay, and (iii) low birth weight.</div></div><div><h3>Objective</h3><div>This study aims to characterize the utilization profile of antimicrobial drugs in neonatal intensive care units (NICUs) through a scoping review.</div></div><div><h3>Methods</h3><div>The protocol, developed in accordance with the methodology outlined by the Joanna Briggs Institute, has been registered on the Open Science Framework (OSF) platform (DOI 10.17605/OSF.IO/YB4AG). The search will encompass databases including LILACS, EMBASE, MEDLINE/PubMed, Scientific Electronic Library Online (SciELO), as well as Web of Science and Scopus. Gray literature will be accessed through digital repositories. Search terms will be combined using Boolean operators 'OR' and 'AND,' aligned with the PCC framework (Population, Concept, Context). Identified studies will be managed using the Rayyan app, with duplicates removed. Two independent reviewers will handle study selection and data extraction. Studies will be included if they are available in full and contain at least one of the following pieces of information: data on antimicrobial consumption rates, the most prescribed antimicrobials, the most common indications for antimicrobial use, or off-label prescription of antimicrobials. Studies must have been conducted in NICUs with neonates hospitalized in this setting; if the study involves other settings or populations, the data must be stratifiable for neonates hospitalized in NICUs. The extracted data will be presented schematically or in tables, with a narrative description accompanying the results.</div></div><div><h3>Conclusion</h3><div>The outcomes will contribute to understanding global variations in antimicrobial utilization, offering evidence to support health care professionals in making informed decisions regarding antimicrobial usage and promoting safer and more effective clinical practices.</div></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"65 6","pages":"Article 102910"},"PeriodicalIF":2.5,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144986479","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Utilization of an electronic health record dashboard report to monitor unreconciled controlled substance dispenses","authors":"Christopher Le,&nbsp;John Mellett,&nbsp;Janinah Barreto,&nbsp;Ben Lopez","doi":"10.1016/j.japh.2025.102968","DOIUrl":"10.1016/j.japh.2025.102968","url":null,"abstract":"<div><h3>Background</h3><div>A medication is considered unreconciled when there is no documented administration or the dispensed amount does not match the amount administered, wasted, or returned. Unreconciled dispenses pose several issues, including inaccurate accounting of controlled substances, potential financial discrepancies, possible masking of controlled substance diversion, and patient safety concerns. Utilization of an electronic health record (EHR) report of unreconciled dispenses is one of several possible surveillance methods to track unreconciled dispenses and detect potential controlled substance diversion.</div></div><div><h3>Objectives</h3><div>The objective of this study is to determine the extent to which the utilization of an EHR reporting dashboard by nursing leaders decreases the number of unreconciled controlled substance dispenses.</div></div><div><h3>Methods</h3><div>An existing report available through the EHR will be used to identify a baseline of unreconciled dispenses. A dashboard was built to include the unreconciled dispenses report that provided real-time data as well as a visualization of historical data. This dashboard was integrated into the nursing leadership workflow on several pilot units covering different levels of care and reviewed regularly for potential intervention. Nurse managers were expected to communicate directly with nurses that had unreconciled controlled substance dispenses and re-educate on appropriate documentation procedures.</div></div><div><h3>Results</h3><div>During the preintervention period, there were a total of 26,101 controlled substance dispenses with 256 unreconciled dispenses (0.98%). Following implementation of the dashboard report, there was a nonsignificant decrease of 0.13% (<em>P</em> = 0.14) with a total of 24,731 controlled substance dispenses and 211 unreconciled dispenses (0.85%).</div></div><div><h3>Conclusion</h3><div>The use of an EHR dashboard report has the potential to improve the documentation of controlled substances by identifying opportunities to correct unreconciled dispenses. However, workflow barriers can impact the utility of and engagement with the dashboard report.</div></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"66 1","pages":"Article 102968"},"PeriodicalIF":2.5,"publicationDate":"2025-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145427145","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Consumer data insights on pharmacy utilization: Comparative study of 2015 and 2021 surveys","authors":"Pranitha Presingu,&nbsp;Suhila Sawesi,&nbsp;Michael Irungu,&nbsp;Kyle Kane,&nbsp;Mohamed Rashrash,&nbsp;Jon Schommer,&nbsp;Lawrence Brown","doi":"10.1016/j.japh.2025.102964","DOIUrl":"10.1016/j.japh.2025.102964","url":null,"abstract":"<div><h3>Background</h3><div>Understanding the evolution of consumer behavior in pharmacy selection is crucial for delivering patient-centered and technology-driven health care.</div></div><div><h3>Objective</h3><div>To identify factors influencing consumer pharmacy choice using 2021 National Consumer Survey on the Medication Experience and Pharmacists' Roles and to examine how these factors have evolved over time using 2015 data as a baseline.</div></div><div><h3>Methods</h3><div>All variables were harmonized with the 2015 dataset to ensure comparability. Guided by the Andersen Behavioral Model, descriptive analyses and logistic regression were performed on 2021 survey data (N = 1521) to evaluate factors influencing pharmacy selection, and results were compared with 2015 findings to assess evolving trends.</div></div><div><h3>Results</h3><div>Younger adults (18–33) increasingly favored prescription-only pharmacies (odds ratios [OR] = 3.523), while older adults (70+) preferred mail-order pharmacies. Use of mail prescriptions rose by 11.7% and remained a strong predictor of mail pharmacy use (OR = 30.29). Vaccination (+20%) and drive-thru utilization (+7.8%) increased substantially and were associated with chain pharmacies (OR = 1.404; OR = 2.500). In contrast, traditional predictors such as education, financial hardship, over-the-counter/herbal use, and medication side effects declined in relevance.</div></div><div><h3>Conclusion</h3><div>Consumer preferences have shifted toward convenience-based and contactless pharmacy models, a trend that has continued beyond 2021. These changes highlight the need for pharmacists to adapt service delivery approaches and for health informatics professionals to strengthen digital infrastructure supporting patient-centered care.</div></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"66 1","pages":"Article 102964"},"PeriodicalIF":2.5,"publicationDate":"2025-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145427189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of digital health technology literacy among community pharmacists in Serbia","authors":"Dušan Vukmirović,&nbsp;Dušanka Krajnović,&nbsp;Marina Odalović","doi":"10.1016/j.japh.2025.102958","DOIUrl":"10.1016/j.japh.2025.102958","url":null,"abstract":"<div><h3>Background</h3><div>Community pharmacists' roles are expanding beyond traditional tasks to include digital health interventions. Despite the growing integration of digital health technologies, gaps remain in understanding pharmacists' digital health technology literacy (DHTL). Adequate DHTL is essential for supporting patients and ensuring the effective implementation of digital tools in pharmacy practice.</div></div><div><h3>Objectives</h3><div>To assess general digital literacy (gDL) and identify specific levels of DHTL among community pharmacists.</div></div><div><h3>Methods</h3><div>A version of the DHTL Assessment Questionnaire (DHTL-AQ), specifically validated for use by community pharmacists, was distributed via online and paper-based formats. In addition to the DHTL-AQ, the questionnaire also included supplementary items assessing gDL. The sample size was calculated on the basis of the targeted pharmacist population. The data were analysed via SPSS. Receiver operating characteristic curves were used to determine cut-off scores, whereas chi-square and Kruskal-Wallis tests were used to assess group differences and associations.</div></div><div><h3>Results</h3><div>A total of 368 valid responses were collected. Among the respondents, 15.2% had low, 68.8% had medium, and 16.0% had high gDL. On the basis of these findings, DHTL cut-off scores were defined as low (35.9%), medium (19.6%), and high (44.5%). Significant differences in DHTL levels were associated with years of working experience. While 41.3% did not use social media professionally, Facebook, YouTube, Instagram, and Viber were the most commonly used platforms among pharmacists.</div></div><div><h3>Conclusion</h3><div>This study provides the first comprehensive assessment of DHTL among Serbian community pharmacists, revealing high gDL but highlighting the need for targeted DHTL training. Future research should focus on expanding the sample size and addressing specific DHTL gaps. The approach used in this study offers a practical framework for assessing DHTL that can be applied internationally to inform the development of relevant, tailored training programs and support the expansion of pharmacist-led services in an increasingly digital health environment.</div></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"66 1","pages":"Article 102958"},"PeriodicalIF":2.5,"publicationDate":"2025-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145403714","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The three-fer: How biosimilars reduce cost, expand access, and improve margin","authors":"Tina M. Seekamp,&nbsp;Michael Hamacher,&nbsp;Jason A. Kemper,&nbsp;Richard W. Toner,&nbsp;Joshua K. Sigrist,&nbsp;Kara Suter,&nbsp;James S. Newman,&nbsp;Chelsee J. Jensen","doi":"10.1016/j.japh.2025.102953","DOIUrl":"10.1016/j.japh.2025.102953","url":null,"abstract":"<div><h3>Background</h3><div>Traditional Medicare Fee for Service (FFS) covers both reference biologics and biosimilars without requiring prior authorization. Biosimilars offer a safe and effective alternative to reference biologics at a lower cost.</div></div><div><h3>Objective</h3><div>This study aimed to reduce Medicare FFS patient use of reference biologics in oncology and oncology-supportive care by 50%, lower Mayo Clinic Community Accountable Care Organization (MCC ACO) spending, achieve institutional cost savings, and improve revenue by increasing biosimilar use.</div></div><div><h3>Practice description</h3><div>Using the quality improvement (QI) framework, we expanded upon Mayo Clinic’s biosimilar-first strategy through the use of targeted electronic health record (EHR) reports to identify Medicare patients using reference biologics when biosimilars were available. We requested pharmacists or physicians to convert these patients to less costly, formulary-preferred biosimilars.</div></div><div><h3>Practice innovation</h3><div>We developed custom EHR reports to pinpoint Medicare patients still on reference biologics despite biosimilar availability and leveraged cost and margin data to promote change. Providers and pharmacists received targeted outreach and education, and pharmacists facilitated transitions to lower-cost biosimilars.</div></div><div><h3>Evaluation methods</h3><div>EHR reports tracked Medicare patients treated with reference biologics (trastuzumab, rituximab, bevacizumab, pegfilgrastim prefilled syringe, filgrastim) and their biosimilars during baseline and postintervention periods using the QI framework. MCC ACO spend impacts were analyzed using EHR data for Medicare beneficiaries treated at a MCC ACO location. Medication margin impact was extrapolated from internal data using the average sales price minus the contracted acquisition cost for each medication.</div></div><div><h3>Results</h3><div>Reference biologic use among Medicare patients dropped 47%. MCC ACO spending decreased by $2.62 million, patient count rose by 4.3%, and per-utilizer-per-month spending fell by 13.9% from fiscal year 2022-2023. Medication margin improved by more than $2.2 million for a modeled patient volume of 1000 per drug category.</div></div><div><h3>Conclusion</h3><div>QI efforts largely reduced reference biologic use in Medicare patients, lowered spending, increased patient access, and improved margins by shifting to biosimilars.</div></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"66 1","pages":"Article 102953"},"PeriodicalIF":2.5,"publicationDate":"2025-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145403733","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}