Clinical Therapy Management Boosts Patient Outcomes

With the escalating cost of specialty drugs and the emerging prominence of value-based contracting, there is a growing need for programs that address the need for improved outcomes for patients on these therapies.

One such program is the Clinical Therapy Management (CTM) patient management software application developed by Managed Health Care Associates, Inc (MHA). The benefits of a comprehensive patient management system were presented by MHA Senior Director of Specialty Clinical Services Stacey Ness, PharmD, RPh, CSP, MSCS, AAHIVP, during the company’s Annual Business Summit last week in Las Vegas, NV.

“We were hearing from our pharmacy constituents, as well as from manufacturers we work with, that a resource was needed in the marketplace,” Ness said during the session. “Pharmacies were in need of additional reporting to meet manufacturer requirements, prescribers were asking for additional reporting elements, payers were asking for additional reporting elements not captured by traditional dispensing systems, and accrediting bodies were asking for clinical-based reporting and outcomes-based reporting.”

Ness noted that pharmacies focus on adherence and persistence and subsequently needed a comprehensive clinical program to better manage their patients. With manufacturers also zeroed in on adherence and persistency as well, there was a need to aggregate clinical and dispensing data together.

“MHA sits in the middle of those organizations and, as such, developed the CTM software application a number of years ago in response to those stakeholder needs,” Ness said.

The CTM software application addresses several therapeutic areas, including modules for hepatitis C virus (HCV), immune globulin (IG) therapy, HIV, inflammatory conditions, multiple sclerosis, universal specialty module, bleeding disorders, and oncology. Ness discussed several of the disease-specific goals for each module, such as getting viral levels as low as possible in HIV, eliminating HCV from the body, and extending survival and managing side effects in oncology.

“With the continual feedback of patients and how patients are doing in that patient assessment for each of these different disease states, the pharmacies are able to identify any issues—or if the medication isn’t working as it should be in that particular patient a lot sooner—and get those patients referred back to the physician for either an adjusted dosing interval or a more appropriate dose of their medication,” Ness said.

The software also allows for enhanced reporting that is useful for accreditation, that satisfies prescriber and payer requirements, and allows for internal analysis, Ness said. Among the chief benefits for pharmacies are the benefits for adherence that clinical management systems offer.

Ness noted that CTM can track when and why patients missed a dose in order to implement quality improvement initiatives to reduce missed doses.

“One of the ways you can interact with patients is through the adherence journey,” Ness said.

To illustrate the efficacy of CTM, Ness presented results from a study in a patient population undergoing IG therapy.

The study, originally presented at the 2016 Immune Globulin National Society conference, included 178 patients on immune globulin therapy and looked at total fills prior to CTM, compared with 1 to 6 months after CTM was initiated, and 12 to 18 months long-term after CTM. There were a total of 696 fills in the study population prior to the pharmacy initiating CTM, compared with 943 fills in the six months post-CTM, and 843 fills long-term post-CTM. Average number of fills during each 6 month study time period were 3.91 pre-CTM, 5.3 post-CTM, and 4.76 long-term, both of which were statistically significantly different than the pre-CTM population. Average grams per patient were 168.54 pre-CTM, 246.29 post-CTM, and 235.77 long-term, both of which were statistically significantly different than the pre-CTM population.

“The bottom line is not only can CTM help pharmacies impact adherence from a positive perspective, but also can use the data to create meaningful outcomes studies you can use for poster presentations, you can use for marketing resources, and really understand how your pharmacy is able to positively impact patients and quantify them in that manner,” Ness concluded.