P-1843. Real-world experience and outcomes implementing an electronic pharmacy care coordination queue for treatment of hepatitis C virus

TL;DR

A pharmacy care coordination queue improved access to hepatitis C treatment by reducing delays and helping patients complete therapy.

Contribution

A new pharmacy-coordinated workflow was implemented to address structural barriers in HCV treatment.

Findings

The PCCQ reduced the time from prescription to DAA dispensing to an average of 3 days.

Pharmacists facilitated patient assistance programs, securing $55,272 in support.

33% of patients completed treatment and achieved sustained virologic response.

Abstract

To date, only 37% of Americans have been cured of chronic hepatitis C virus (HCV). Yet, the CDC’s strategic plan for HCV elimination includes the goal of viral clearance for 80% of people - a goal often stymied by structural barriers such as medical provider capacity and insurance restrictions. We hypothesized implementation of a pharmacy care coordination queue (PCCQ) would reduce barriers to HCV treatment success via co-management between medicine and pharmacy disciplines in a hospital-based infectious disease outpatient program.Figure 1.HCV PCCQ WorkflowTablet 1.Patient baseline characteristics and HCV treatment outcomes

HCV PCCQ Workflow

Patient baseline characteristics and HCV treatment outcomes

People with chronic HCV were evaluated and prescribed direct acting antivirals (DAAs) by ID physicians and referred for co-management with the hospital-based specialty pharmacy program. The PCCQ (Figure 1) utilized pharmacy technicians and ID/HIV-trained clinical pharmacists. Pharmacy technicians managed tasks related to DAA acquisition including prior authorizations, appeals, and patient assistance programs (PAPs). Clinical pharmacists provided initial patient education, on-treatment follow-up of DAA tolerability, DAA and lab adherence, adverse reaction management, and facilitated engagement with the care team.

During the first 6 months of program implementation (Oct 2024-Apr 2025), 12 patients were co-managed through the PCCQ (Table 1). Patients were 75% male with a mean age of 45 (SD = 12) years. Genotype 1 HCV was most common (58%), followed by genotype 2 (17%) and genotype 3 (17%). HIV co-infection was present in 17% of patients, 25% of patients had F3-F4 liver fibrosis and 25% of patients were DAA treatment-experienced. DAA regimens prescribed were SOF/VEL (67%), SOF/VEL/VOX (25%), and GLE/PIB (8%). Turnaround time from writing the DAA prescription to DAA dispensing was mean 3 (SD = 1) days. The PCCQ obtained $55,272 in PAPs. Pharmacists made interventions on all 12 patients (Table 1). Of 12 patients, 4 (33%) completed treatment and achieved SVR, 5 (42%) completed treatment and are pending SVR, and 3 (25%) are still receiving treatment.

Implementation of a PCCQ can expand medical provider capacity and positively affect patient access to and shorten time to DAA initiation, facilitate engagement in care and successful completion of therapy, and mitigate structural barriers and gaps in the HCV care cascade.

All Authors: No reported disclosures

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