Evaluation of a Hepatitis C Patient Management Program at a University Specialty Pharmacy

Ann Pharmacother. 2017 Apr;51(4):307-314. doi: 10.1177/1060028016683495. Epub 2016 Dec 16.


Background: The University of Rochester (UR) Specialty Pharmacy hepatitis C patient management program offers a unique advantage of being integrated within the same health system as the University of Rochester Medical Center (URMC) Gastroenterology and Hepatology division.

Objective: The primary purpose of this study was to assess treatment success through the incidence of achieving a sustained virological response (SVR) in patients served by the UR Specialty Pharmacy versus other nonintegrated pharmacies.

Methods: This was a single-center retrospective cohort study in adult patients of URMC Gastroenterology and Hepatology prescribed hepatitis C treatment between January 1, 2014, and July 15, 2015. The incidence of SVR, adherence, delay in therapy initiation, early treatment discontinuation, rate of attainment of viral load measurement post-therapy completion, and predictors associated with treatment outcome were assessed.

Results: A total of 414 patients were prescribed hepatitis C virus treatment during the study period; 137 did not initiate therapy. The rate of SVR was 93% among patients at the UR Specialty Pharmacy and 89% at nonintegrated pharmacies ( P = 0.357). Adherence to therapy was 100% and 97% at the UR Specialty Pharmacy and nonintegrated pharmacies, respectively ( P = 0.046).

Conclusions: The UR Specialty Pharmacy was associated with a 93% SVR rate and significantly greater adherence compared with nonintegrated pharmacies. Larger studies are needed to determine if a significant difference in SVR exists between integrated and nonintegrated pharmacies. This study provides a framework for other institutions to justify developing integrated hepatitis C specialty pharmacy services and evaluate their success.

Keywords: adherence; hepatitis C; integrated care; patient management program; predictors of treatment outcome; specialty pharmacy; sustained virological response.

MeSH terms

  • Adult
  • Aged
  • Female
  • Hepacivirus / drug effects*
  • Hepatitis C / drug therapy*
  • Humans
  • Male
  • Medication Adherence / statistics & numerical data
  • Medication Therapy Management / organization & administration*
  • Medication Therapy Management / standards
  • Medication Therapy Management / statistics & numerical data
  • Middle Aged
  • Pharmacy Service, Hospital / methods
  • Pharmacy Service, Hospital / organization & administration*
  • Pharmacy Service, Hospital / standards
  • Program Evaluation*
  • Retrospective Studies
  • Treatment Outcome
  • Universities