At Express Scripts, we have clinical experts in the most complex disease states, including pulmonary arterial hypertension (PAH) – high blood pressure in the pulmonary arteries of the lungs. Many patients are prescribed a prostacyclin therapy, which involves frequent dosing adjustments to balance efficacy and adverse events. Prostacyclin therapies are delivered via inhalation or as continuous infusion – either case requires the use of complex equipment. As a result, many patients experience increased burdens, including increased risk of life-threatening infection.
Prostacyclins are available in an oral form – treprostinil, but transition from one route of administration to another requires specialized care from professionals who have a deep understanding of this complex and rare disease state.
Accredo specialist pharmacists evaluated the success of patients who transitioned from infused to oral treatment using a specialty pharmacy for outpatient care. While the package insert states patients typically transition in five days or less, our analysis found successful transitions to oral therapy require more time due to the complex nature of the disease and limited experience in managing transitions on the part of the prescriber.
Leveraging electronic medical record (EMR) data, we evaluated 119 patients who had both the infused prostacyclin and oral treprostinil dispensed by Accredo. All patients received infused treatment for at least 30 days prior to the transition.
Therapy transition takes longer than clinical guidelines
Our research found the average time to transition from infused to oral therapy to be 47 days. Only 18% of patients transitioned in five days or less – 82% longer than clinical guidance offered in the package insert. Fifty-nine percent of patients took longer than 20 days.
Transition from infused to oral prostacyclin therapy can be achieved, yet the transition is complex and needs to be done in collaboration with a specialist clinician and an experienced specialty pharmacy.
Specialized support for physicians, patients, caregivers
At Accredo, we offer insights and data to support prescribers in creating a transition plan tailored to each patient.
Our PAH Therapeutic Resource Center (TRC) gives patients 24/7 access to pharmacists and nurses who are specifically trained in this life-threatening, incurable disease. These clinicians are with PAH patients every step of the way.
Additionally, Accredo has more than 550 field nurses across the U.S., who perform in-home nursing services. Our PAH nursing team offers disease-specific education, regular coordination with Accredo PAH pharmacists and prescribers, and training for patients, caregivers, and schools. Combined, all of these resources are designed to help patients better manage their conditions and drugs, while offering a more personalized pharmacy experience.
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