A “split-fill” pharmacy option, which dispenses medications at half-quantity intervals, seeks to reduce pharmacy costs and medication wastage due to early treatment discontinuation.
In a study of oncology patients, researchers compared patients with pharmacy benefit designs that included a split-fill option to those who did not and found that, in the first three months, split-fill management resulted in lower discontinuation rates, significantly reduced pharmacy costs, and reduced potential waste. The results of the study were presented at the AMCP Annual Meeting during a poster session titled “Cost and Wastage Estimates for an Oral Oncology Medication Split-Fill Option in a Patient Management Program.”
This retrospective cohort study assessed patients who were new to treatment with one of the 11 split-fill oral oncologic medications between September 2015 and August 2017. Researchers used a 1:1 greedy match algorithm to match split-fill and nonsplit-fill patients by age, sex, state census areas, index medication, start date, and switching to another medication. They assessed per-month discontinuation rates for each group.
The study included 2,363 patients within the managed program, and 671 patients from each group were matched. For the split-fill cohort, monthly utilization trends indicated a significantly higher persistency rate in the first two months (P<0.0001) and lower copays (by $132.50) in the first month (P<0.007).
Payers participating in a split-fill program had a mean average wholesale price (AWP) savings of $2,724.97 per month on medications (P<0.0001). Based on modeled wastage for the first three months, payers without a split-fill program could expect to save $2,782.29 AWP if the moved to the split-fill method.
All patients were clinically managed through the same management program. There were no between-group differences for rates of adverse events (AEs) or time to first reported AE.