Pharmacists’ Involvement with Gene Therapies, Potential Candidates, Forecasting Effectively

Landon Marshall, PharmD, PhD is the Principal Health Outcomes Researcher at Prime Therapeutics, LLC. Marshall joins Pharmacy Times at the Academy of Managed Care Pharmacy (AMCP) Nexus 2023 Conference (October 16 through October 19) in Orlando, Florida, to discuss costs associated with gene therapies and how they can vary depending on the technology used and the administration setting. He notes the key considerations when identifying potential gene therapy candidates and highlights the important role pharmacists can play in this space.

Pharmacy Times: What are the associated costs with gene therapies and why are they so significant?

Landon Marshall: So, gene therapies really represent this unique kind of class of medications that we're seeing market entry with now and expected more therapies that enter the market in the future. Right now, really, depending on the technology that is being used with the gene therapy can really impact the ancillary cost that's associated with it beyond the 1-time administration, or the actual cost of the drug. So, we do see gene therapies that have significant kind of inpatient costs associated with it. We also have current gene therapies that are really kind of in an outpatient-administered setting that don't necessarily have as much ancillary cost associated with those.

Pharmacy Times: What are some key considerations when discussing gene therapy candidates and what data resources are necessary or useful to identify potential candidates?

Marshall: So, in-house, the data resources that we utilize are our integrated medical and pharmacy claims data, we do leverage information from the medical benefit and the pharmacy benefit to really understand or identify these candidates. Outside of that we leverage any publicly available information, leveraging clinical trial, inclusion and exclusion criteria, understanding potentially [the] standard of care that they're using in those trials, as well as investor reports, manufacturer reports, or really any insights that we can gather externally, and then [we] kind of wrap that into our integrated medical and pharmacy claims data. [That] is the data resources where we're currently using.

Pharmacy Times: What roles can pharmacists play in this space?

Marshall: I think pharmacists can make a significant impact. When we are building the forecast, building the analytics, we leverage our clinical pharmacists in-house to help us understand these conditions and the typical care that's associated with these conditions and members with these conditions. And then also, beyond our internal forecast, managed care pharmacists can provide services that help clients and plans identify and manage these members before they get to gene therapy, or kind of optimize therapy prior to being a candidate for gene therapy.

Pharmacy Times: What training and educational initiatives are in place to ensure that managed care pharmacists and health care professionals have the necessary skills to perform gene therapy forecasting effectively?

Marshall: I think it comes from a variety of different sources. I don't think there's one track that is—that I know of—designed specifically for this because we're talking [about] the intersection of analytics, clinical pharmacist, epidemiology, and those 3 categories really represent the background of individuals within our team at Prime [and Magellan RX Management] to develop this forecast, and then maintain it and update it to keep it current and to keep it relevant.