Potentially Reducing Costs, Drug-Related Problems With Physician Follow-Up Phone Calls

A retrospective drug utilization program designed to resolve drug-related problems (DRPs) by coordinating physician follow-up phone calls and letters resulted in about $9.5 million in pharmacy cost savings, according to data presented at AMCP 2021.

Taline Jaghasspanian, PharmD, Woodland Hills, CA, and colleagues, explained that DRPs such as inappropriate opioid use, drug interactions, and therapeutic duplication increase a patient’s risk of adverse events. DRPs also have great potential to incur unnecessary costs for health plans in pharmacy spend. The program calls for a review of DRPs and offers recommendations to providers to reduce these risks and spend.

Dr Jaghasspanian and colleagues used the RcXellent Care automated system to identify 184,178 DRPs from Medicaid and Medicare members from July 2019 to October 2020 in the following areas: therapeutic duplications, excessive durations (such as long-term use of a proton pump inhibitor or a benzodiazepine), drug-drug/drug-age interactions, overutilization of opioid medications, and opportunities to reduce cost. Included members took 8 or more medications per quarter.

Letters containing recommendations for each of the identified DRPs were sent to providers and a follow-up phone call was conducted by a pharmacist to discuss the possible discontinuation of medication for approximately 15% of identified DRPs.

“In November 2020, the DRP resolution rate was measured to help determine the impact of the follow-up calls (call group) compared to sending letters only (letter group),” explained the researchers. “A chi-square analysis was used to determine if there was a statistically significant difference in the resolution rates between the two groups.”

Phone calls were made for 25,413 DRPs in one group and letters were sent for the remaining 158,765 DRPs. Per the data, 6 to 12 months post intervention, 40% (10,200) of DRPs in the call group were resolved, compared with 44% (158.765) in the letter group. The letter group showed a 4% higher resolution rate. Therapeutic duplication was the highest resolved DRP in both groups. The combination of follow-up calls and letters saved approximately $9.5 million in pharmacy costs.

“Considering the cost associated with follow-up phone calls and the lack of evidence that overall impact improves, there may be an opportunity for health plans to simplify outreach and invest clinical resources in more impactful interventions,” concluded researchers. “There may also be an opportunity to consider risk stratification of outreach and alternative forms of intervention.”

—Edan Stanley

Reference:
Jaghasspanian T, Kawamata J, Misquitta C. Effectiveness of provider follow-up calls on the resolution of drug-related problems. Poster presented at: AMCP 2021, April 12-16, 2021; Virtual