Mr. Fast: Assessing the impact of health system specialty pharmacy (HSSP) services on helping patients achieve Migraine Relief Fast through CGRP modulator (CGRPm) stewardship

Migraine creates a significant economic burden for patients and society through direct healthcare costs as well as disability and lost productivity. CPS partners with health systems to offer high-touch pharmacy services to migraine patients. Working onsite at health systems, specialty pharmacists use an efficacy protocol to proactively assess if patients are on an effective medication for their migraines and to intervene when therapy is determined to be sub-optimal or ineffective. 

This multicenter, retrospective study included adult migraine patients enrolled in health system specialty pharmacy (HSSP) services and initiating treatment with a CGRPm. Pharmacists regularly conducted patient-reported outcomes measure (PROM) surveys to assess therapy effectiveness. If patients were not achieved expected therapeutic results, pharmacists recommended interventions to help patients achieve migraine relief. Data was documented in CPS Arbor® specialty pharmacy technology platform, and reports were generated to assess patient outcomes.  

Results:  562 patients were evaluated. The average time to effective migraine control after therapy initiation was 110 days. After enrollment in HSSP services, the average number of migraine days/month was reduced by 8 days. 37 patients were determined to have ineffective or sub-optimally effective therapies during the 8-12 week efficacy check-in, and 76% of these patients became controlled. Pharmacists made recommendations for 29 of the 37 patients (78%), and 97% of the recommendations were accepted by patients and providers. The average conversion time from ineffective or sub-optimal effectiveness to effective migraine control was 110 days. 

Conclusions:  HSSP services can improve outcomes in patients receiving prophylaxis for migraines as demonstrated by the results. Pharmacist therapy efficacy assessments and interventions were shown to be impactful as they directly corresponded with an increase in patients on effective migraine regimens.