Specialty Pharmacy Improves Adherence to Imatinib

Dec 1, 2013

Specialty Pharmacy Improves Adherence to Imatinib. Published in American Journal of Pharmacy Benefits.


Background: Adherence to imatinib contributes to treatment success in patients with chronic myeloid leukemia. Specialty pharmacies offering refill reminders, care management, and educational programs may improve adherence to imatinib.

Objectives: To compare adherence to imatinib between patients using a specialty pharmacy (specialty pharmacy group) and patients using other dispensing channels (other pharmacy group).

Study Design: Retrospective, pharmacy claims–based observational study using pharmacy benefits manager data from 2010 to 2012.

Methods: Patients starting a new course of imatinib therapy we followed for 365 days after treatment initiation. Medicare and Medicaid beneficiaries and patients who paid 100% of the cost of imatinib out of pocket were excluded. Optimum imatinib adherence was defined as a proportion of days covered of 90% or higher. Multivariate logistic regression was used to evaluate the impact of dispensing channel on medication adherence, controlling for differences in demographics, medication burden, out-of-pocket spending per 30-day adjusted imatinib prescription, average days of supply per imatinib prescription, and use of a prescription days-of-supply optimization program.

Results: The final study sample consisted of 704 patients, 433 in the specialty pharmacy group and 271 in the other pharmacy group. After multivariate adjustment, patients in the specialty pharmacy group had 1.46 times greater odds of attaining optimum adherence to imatinib compared with patients in the other pharmacy group (95% confidence interval, 1.02-2.09).

Conclusion: Patients who used a specialty pharmacy offering refill reminders, care management, and educational programs achieved higher rates of optimal adherence to imatinib compared with those using other dispensing channels.