Taking CARE of Patients with PAH

Oct 10, 2017
New research from Accredo confirms a high-touch clinical care model for patients with pulmonary arterial hypertension helps to keep them on the most appropriate therapy.
  • Pulmonary Hypertension
Katie Article

Patients with pulmonary arterial hypertension (PAH) live with an incurable disease and have one of the most complex therapy regimens to manage it. Patients often transition from oral to inhaled or infused treatments (or vice versa), which requires frequent dosing adjustments and deep clinical understanding of the disease.

At Accredo, Express Scripts’ specialty pharmacy, we believe pharmacy and nursing support goes beyond filling a PAH prescription.

Our proprietary patient support program – Clinical Assessment and Risk Evaluation (or, CARE) – screens patients receiving oral monotherapy with endothelin receptor antagonists (ETRA) for potential health challenges and clinical worsening, and alerts their prescribing physician to any complications.

Close monitoring paired with physician collaboration improves outcomes for patients with PAH. In fact, of the 6,169 patients enrolled in the CARE program, 28% were more likely to escalate to new therapy at the appropriate time, compared to those not enrolled in the program. Patients also stayed on oral therapy for one month longer, on average, than patients without this clinical support. Oral treatment decreases the risk of life-threatening infection and lessens the burden for patients. Finally, our study identified a statistically significant increase in medication adherence for patients enrolled in the CARE program, which can slow the disease progression and increase quality of life for the patient.

While clinical care is always our primary goal and most important aspect of this program, our study also found a financial benefit. An average of $5,500 can be saved for every patient who is managed on oral monotherapy for 30 days compared to other treatments.

More about the CARE Program

Through the CARE program protocol, patients taking an ETRA are screened monthly to identify signs of clinical worsening and any related health challenges they may be facing. If clinical worsening is suspected, patients are triaged to a PAH-trained nurse for further evaluation. The specialized nurse takes action, which can include:

  • Notifying the prescribing physician that the patient is experiencing health challenges
  • Providing strategies to manage side effects of the ETRA
  • Offering ongoing disease education
  • Re-educating the patient on the use and need for compliance with supplemental oxygen therapy
  • Referring the patient to a PAH support group
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