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A veteran in front of a computer holding a pen device, discussing the medication with a healthcare provider via video call. A tagline at the top reading, "Centralized Specialty Medication Management. Helping Veterans with medication since 2020."

Centralized Specialty Medication Management

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Specialty medications taken at home are expensive, complex to administer, and have unique side effect profiles. Centralized Specialty Medication Management (CSMM) connects specialty pharmacists with Veterans initiating select specialty medications for detailed education and close monitoring. This innovation contains costs (with a positive ROI) and improves medication safety while achieving high satisfaction from both Veterans and providers.

This innovation is emerging and worth watching as it is being assessed in early implementations. See more emerging innovations.

Adoptions:

2 successful, 1 in-progress

Awards and Recognition:

Clinical Pharmacy Practice Office Best Practice

Partners:

Academic Affiliations, Clinical Pharmacy Practice Office, Dermatology, Gastroenterology and Hepatology, Neurology, Rheumatology

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Metrics

  • Veterans were 25% less likely to discontinue their new biologic at one year due to adverse effects. This was attributed to management of injection site reactions (60% CSMM, 13% control; p=0.009). Figure 1
  • CSMM pharmacists make or recommended medication changes for 1 in 5 Veterans and corrected storage requirements in 1 in 10 Veterans. Table 1
  • CSMM clinic conservatively save $787 per patient seen. The cost avoidance related to CPP interventions was 149% compared to the cost of the pharmacist to run the clinic. Cost savings was primarily due to medication adjustments and replacement of defective devices.
  • CSMM service has high Veteran satisfaction with a mean overall satisfaction of 4.92 out of 5 (excellent). All patients said they would choose to use CSMM again if prescribed a new specialty medication.
  • In January 2024, the Milwaukee VA implemented CSMM and corrected injection technique in 40.5% of patients. Figure 2

Diffusion tracker

Does not include Clinical Resource Hubs (CRH)

Statuses

WI: Tomah VA Medical Center (Tomah)
  • Started adoption on 05/2024.

There are no unsuccessful adoptions for this innovation.

Multimedia

Images

A table showing outcomes from the Madison and Milwaukee VA with multiple interventions including injection technique intervention and care coordination among others.
Above:

Table 1: CSMM outcomes following Biologic Medication initiation.

Kaplan Meier survival plots showing the overall time on agents prior to discontinuation, comparing CSMM to regular care
Above:

Figure 1. Kaplan Meier survival plots agents comparing CSMM and usual care for medication discontinuation due to safefy.

A poster presenting information and results about the CSMM expansion to the Milwaukee VA including, background, objectives, service description, results, discussion, limitations, and future directions.
Above:

Figure 2. Poster presentation by PharmD Furley, Margolis, Uildriks, Jablonski, McGill and Koch given at Pharmacy Society of Wisconsin 2024 Educational Conference