PMID- 30020742
OWN - NLM
STAT- MEDLINE
DCOM- 20200214
LR  - 20200214
IS  - 1936-2692 (Electronic)
IS  - 1088-0224 (Linking)
VI  - 24
IP  - 8 Spec No.
DP  - 2018 Jul
TI  - 5-ASA to sulfasalazine drug switch program in patients with ulcerative colitis.
PG  - SP303-SP308
AB  - OBJECTIVES: To switch patients with ulcerative colitis (UC) from costlier 
      5-aminosalicylic acid compounds to sulfasalazine and assess (1) the cost savings, 
      (2) the barriers to switching, and (3) adverse events (AEs) and adherence at 3 
      months after the drug switch. STUDY DESIGN: An open-label, 
      pharmacist-administered drug switch program coordinated at an academic 
      inflammatory bowel disease center. METHODS: A clinical pharmacist contacted 
      patients with UC who were prescreened by physicians and covered by specific 
      insurers to enroll them in the drug switch program. Enrolled patients were 
      followed for 3 months to assess AEs and medication adherence. Reasons for 
      declining to participate were recorded. RESULTS: A total of 205 eligible patients 
      were identified; only 14 enrolled, and 10 remained on sulfasalazine for the 
      entire 3-month follow-up period. The enrollment rate was only 4.9%, yet a net 
      cost savings of $22,828/3-month to the insurer was achieved (including program 
      administration costs but excluding AE costs), with co-pays reduced by 
      approximately $25 per month per patient. The rate of AEs on sulfasalazine (28.6%) 
      was similar to that found in previous reports. Significant unanticipated barriers 
      to switching were encountered, namely patient desire to not alter an existing 
      effective drug regimen. CONCLUSIONS: A pharmacist-administered drug switch 
      program in patients with UC was significantly more difficult than anticipated, 
      with questionable achievement of cost savings. This experience suggests that 
      future drug switches and studies should focus on patient preferences for drug 
      switching, as this may have implications for switching from brand name to 
      biosimilar drugs.
FAU - Goldsmith, Jason R
AU  - Goldsmith JR
AD  - Department of Pathology and Lab Medicine, University of Pennsylvania Perelman 
      School of Medicine, 713 Stellar-Chance Labs, 422 Curie Blvd, Philadelphia, PA 
      19104-6160. Email: goldsj@pennmedicine.upenn.edu.
FAU - Waljee, Akbar K
AU  - Waljee AK
FAU - George, Tom
AU  - George T
FAU - Brown, Alexandra
AU  - Brown A
FAU - Choe, Hae Mi
AU  - Choe HM
FAU - Noureldin, Mohamed
AU  - Noureldin M
FAU - Bernstein, Steven J
AU  - Bernstein SJ
FAU - Higgins, Peter D R
AU  - Higgins PDR
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PT  - Research Support, U.S. Gov't, Non-P.H.S.
PL  - United States
TA  - Am J Manag Care
JT  - The American journal of managed care
JID - 9613960
RN  - 0 (Aminosalicylic Acids)
RN  - 3XC8GUZ6CB (Sulfasalazine)
MH  - Administration, Oral
MH  - Adolescent
MH  - Adult
MH  - Aminosalicylic Acids/*economics/therapeutic use
MH  - Cohort Studies
MH  - Colitis, Ulcerative/diagnosis/*drug therapy/economics
MH  - *Cost Savings
MH  - Drug Substitution/*economics
MH  - Female
MH  - Humans
MH  - Male
MH  - Program Evaluation
MH  - Retrospective Studies
MH  - Sulfasalazine/*economics/*therapeutic use
MH  - United States
MH  - Young Adult
EDAT- 2018/07/19 06:00
MHDA- 2020/02/15 06:00
CRDT- 2018/07/19 06:00
PHST- 2018/07/19 06:00 [entrez]
PHST- 2018/07/19 06:00 [pubmed]
PHST- 2020/02/15 06:00 [medline]
AID - 87619 [pii]
PST - ppublish
SO  - Am J Manag Care. 2018 Jul;24(8 Spec No.):SP303-SP308.