Objectives: To compare adherence to hepatitis C regimens between patients using specialty pharmacy and those using retail pharmacy.
Study Design: Retrospective, observational, pharmacy claims– based study using pharmacy benefit manager data from 2007 to 2009.
Methods: Patients starting a new ribavirin-interferon regimen who exclusively used a single dispensing channel were followed for up to 52 weeks after treatment initiation. Regimen adherence was defined as days of supply of both interferon and ribavirin, divided by the expected regimen duration. Regimen adherence of 80% or better was considered optimum. Multivariate statistical models were used to evaluate differences in regimen adherence between dispensing channels.
Results: Most (82.5%) patients exclusively used a single dispensing channel. These included 1489 patients who used specialty pharmacy and 741 who used retail pharmacy. Mean regimen adherence was 69.5% (95% confidence interval [CI] 66.7%-72.4%) and 78.1% (95% CI 75.7%-80.5%) in the retail and specialty groups, respectively. Patients using specialty pharmacy had a significantly higher likelihood of achieving optimum adherence (adjusted odds ratio 1.59; 95% CI 1.32-1.91) compared with retail pharmacy users.
Conclusions: In practice settings, use of specialty pharmacy was associated with significantly higher regimen adherence and likelihood of achieving optimum adherence to hepatitis C regimens compared with use of retail pharmacy.
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