TRC Case Study: Improving Care for Patients With HIV

Feb 17, 2015
Interventions from specialist pharmacists in the HIV Therapeutic Resource Center® help patients have safer treatment outcomes.
  • HIV

What Happened?

A 58-year-old patient with HIV had a historical regimen of Norvir® (ritonavir) tablets in combination with Prezista® (darunavir).

The prescriber’s office submitted a new prescription of Norvir capsules without Prezista.

Clinical Gaps in Care

Norvir on its own, at the dose prescribed, is not effective for antiretroviral therapy.  The drug is usually used as a boosting agent to increase the levels of other medications.

If the patient were to only take Norvir, his regimen would be inadequate – potentially leading to therapy failure, increased chance of resistance and further limiting the patient’s treatment options in the future.

In addition, the patient had a history of taking Norvir tablets, but the new prescription received was for capsules. Capsules require refrigeration which can be more costly to ship and inconvenient for the patient.

Specialist Pharmacist Intervention

An Express Scripts HIV specialist pharmacist contacted the prescriber’s office to address the concerns about an incomplete regimen and a change in dosage form that would require refrigeration.

Safe HIV Treatment

This a recording of an actual call between an Express Scripts specialist pharmacist and a nurse from the prescriber's office.

The prescriber changed the Norvir capsules to tablets and also sent in a new prescription for Prezista later that day.

Why It Matters

HIV specialty pharmacists have the training and experience necessary to identify causes that may lead to therapy failure and resistance. Specialty pharmacists will interact with the patient and the patient’s healthcare team to address such things as drug interactions, side effects, abnormal doses and therapy omissions. Therapy failure and resistance can lead to increased costs and decreased quality of life due to potential worsening of the condition and hospitalization.

A strong roster of specialist pharmacists focusing on patients with needs in a specific area, like HIV, is one of the unique ways Express Scripts helps patients stay on the right treatment and avoid unnecessary, harmful, adverse events. We call it Health Decision Science: the application of clinical specialization and behavioral sciences combined with actionable data to enable better decisions and healthier outcomes.

Click to download an overview of this conversation.

Author Bio

Lab Staff
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