Impact of Comprehensive Pharmacy Services on Inflammatory Bowel Disease Patient Care at Ochsner Health

Background:
The increasing prevalence of inflammatory bowel disease (IBD) and advancements in treatment options, such as biologics and targeted small molecules, have significantly improved patient outcomes. However, these advancements have also introduced complexities in care, compounded by barriers to medication access and adherence due to high costs and intricate insurance processes. The goal of the project was to evaluate the impact of an integrated care model at an academic medical center.
Methods:
Ochsner Health (Ochsner), a nonprofit healthcare provider in the Gulf South with a network of 46 hospitals and over 370 health and urgent care centers, developed a dedicated outpatient pharmacy, Specialty Pharmacy (OSP), in 2015 to support specialty patients. In September 2021, Ochsner created a dedicated IBD clinic-based pharmacist position. The OSP and IBD clinic-based pharmacists provide comprehensive services to patients with IBD, including medication evaluation for clinical appropriateness, patient education, benefits investigation, financial assistance, and monitoring of therapy once treatment is started. To evaluate the impact of this integrated care model, data on medication interventions, prior authorization (PA), patient communication, and adherence were collected.
Results:
The OSP team handles approximately 1,300 interventions and 1,700 PAs monthly. A high approval rate is achieved, with 88% of PAs approved on the first submission and 90% approved after second-level appeals. The average time from prescription to patient treatment initiation is notably quick, ranging from 1.5 to 2 days. The service also maintains strong patient communication, receiving around 7,000 incoming calls per month and managing 10 calls through an on-call service. Furthermore, an analysis of OSP data from August 2018 to January 2022 indicated a link between OSP services and improved medication adherence in patients undergoing subcutaneous (SC) biologic therapy. The overall proportion of days covered during this period was 84.6%, with only 4.5% of patients discontinuing their SC biologic therapy. Since the integration of a clinic-based pharmacist, the IBD clinic has expanded its capacity, adding around 200 new patients annually. This addition has enabled 2 physicians to manage nearly 1,200 unique patients each year. The success of this model has led to the introduction of a second clinic-based pharmacist in the IBD clinic and the extension of pharmacist services to other specialty clinics within Ochsner, including rheumatology, neurology, dermatology, pulmonary, infectious diseases, and endocrinology.
Conclusions:
Ochsner ‘s integrated care model, which includes collaboration between clinic-based and specialty pharmacists, has demonstrated success in enhancing patient education, optimizing medication adherence, and improving access to advanced IBD therapies. This multidisciplinary approach not only improves patient-centered outcomes but also supports healthcare systems by streamlining therapy management and reducing gaps in care. The report underscores the critical role of pharmacists in IBD care and advocates for their expanded integration into healthcare teams, highlighting the need for specialized education and training to support this evolving best practice.