AlixaRx Therapeutic Interchange Program

AlixaRx is pleased to announce that we have expanded our Therapeutic Interchange (TI) program. This program allows prescribers to preauthorize therapeutic substitution by drug class for all of their nursing home patients. Over the coming weeks, the new TI program will begin to roll out to the majority of our customers and will continue until the program is fully updated in each permitted facility.  Due to regulatory constraints, we are not currently able to rollout an automatic TI program in VA, NE or MO.

The TI program is used to promote medication management that is therapeutically equivalent to the prescribed medication.  The TI program benefits may include, but are not limited to, the following:

• Provide reduction in cost of the medication from a therapeutic category
• Minimize delay in initiating therapy while managing costs to the facility or payer
• Standardization of products used within a therapeutic category with similar or better therapeutic efficacy and similar or lower side effect profiles
• Optimize utilization of the Automated Dispensing Unit (ADU) and Electronic Medication Cabinet (EMC) dispensing system
• Reduce the number of requests to the prescriber for order changes to a preferred medication

A study reported in JAMA Internal Medicine on May 9, 2016 highlights the benefits of TI programs to health care organizations.  In this study the drug classes where the greatest savings were realized included statins (Crestor, Lipitor), proton pump inhibitors (Prilosec, Prevacid, Protonix), SSRIs (Zoloft, Prozac, Lexapro), and angiotensin receptor blockers (Cozaar, Diovan).

Other advantages include decreased facility drug spend for Medicare and Managed Care patients and a reduction in the number of drug claim rejections due to step therapy and prior authorization requests for patients covered by Medicare D or private insurance.  Also, improved therapeutic and regulatory outcomes are achieved by limiting the use of potentially inappropriate medications in older adults.

As the enhancements to the existing program are implemented, your AlixaRx Clinical Pharmacist will continue to provide guidance on the overall process. Please contact your clinical pharmacist for more information on the program, and the full TI medication list.

References: 1. AlixaRx Updated Therapeutic Interchange Program May 2016 2. Johansen ME, Richardson C Estimation of Potential Savings Through Therapeutic Substitution JAMA Intern Med. Published online May 09, 2016. doi:10.1001/jamainternmed.2016.1704

This article was originally published in our monthly issue of From the Front Lines – a monthly publication that shares best practices and medication-related challenges faced by “front line” staff in long-term care and post-acute (LTCPAC) facilities.

>>> From the Front Lines – June 2016 <<<