A “split-fill” pharmacy option, which dispenses medications at half-quantity intervals, seeks to reduce pharmacy costs and medication wastage due to early treatment discontinuation.
In a study of oncology patients, researchers compared patients with pharmacy benefit designs that included a split-fill option to those who did not and found that, in the first three months, split-fill management resulted in lower discontinuation rates, significantly reduced pharmacy costs, and reduced potential waste. The results of the study were presented at the AMCP Annual Meeting during a poster session titled “Cost and Wastage Estimates for an Oral Oncology Medication Split-Fill Option in a Patient Management Program.”
This retrospective cohort study assessed patients who were new to treatment with one of the 11 split-fill oral oncologic medications between September 2015 and August 2017. Researchers used a 1:1 greedy match algorithm to match split-fill and nonsplit-fill patients by age, sex, state census areas, index medication, start date, and switching to another medication. They assessed per-month discontinuation rates for each group.
The study included 2,363 patients within the managed program, and 671 patients from each group were matched. For the split-fill cohort, monthly utilization trends indicated a significantly higher persistency rate in the first two months (P<0.0001) and lower copays (by $132.50) in the first month (P<0.007).
Payers participating in a split-fill program had a mean average wholesale price (AWP) savings of $2,724.97 per month on medications (P<0.0001). Based on modeled wastage for the first three months, payers without a split-fill program could expect to save $2,782.29 AWP if the moved to the split-fill method.
All patients were clinically managed through the same management program. There were no between-group differences for rates of adverse events (AEs) or time to first reported AE.
The study was sponsored by AllianceRx Walgreens Prime.
Staskon F, Kirkham H, Pfeifer A, Miller R. Cost and Wastage Estimates for an Oral Oncology Medication Split-Fill Option in a Patient Management Program. Abstract C21. Presented at the AMCP Managed Care & Specialty Pharmacy Annual Meeting, March 25-28; San Diego, CA.