The adherence impact of a program offering specialty pharmacy services to patients using retail pharmacies

BackgroundA new service model integrates the specialty pharmacy's comprehensive service with the retail pharmacy's patient contact, giving patients options for medication delivery to home, pharmacy, or doctor's office.ObjectiveEvaluate the impact of the new service model on medication adherence.DesignRetrospective cohort studySettingsOne hundred fifteen CVS retail stores in Philadelphia participated in a pilot from May 2012 to October 2013, and 115 matched CVS retail stores from around the nation served as controls.PatientsAll eligible patients from the intervention and control stores received specialty medications through CVS retail pharmacies prior to implementation of the new service model.InterventionThe intervention patients were transitioned from retail pharmacy service to the specialty pharmacy with delivery options. The control patients received standard retail pharmacy services.Main outcome measuresProportion of days covered and first fill persistence were tracked for 12 months before and after program implementation.ResultsUnder the new service model, 228 patients new to therapy in the post period had a 17.5% increase in the rate of obtaining a second fill as compared to matched controls. Patients on therapy in both the pre- and the post-periods had a pre-post increase of 6.6% in average adherence rates and a pre-post increase of 10.8% in optimal adherence rates as compared to 326 matched controls.ConclusionThe study demonstrated significant improvement in both adherence to therapy and first-fill persistence among patients in the new service model integrating specialty pharmacy's comprehensive services with the retail pharmacy's patient contact and medication delivery choices.