Purpose: The purpose of this business plan is to show the need and benefit of opening a full time ambulatory pharmacist position in the Gastroenterology/Hepatology clinic at Eskenazi Health.
Background: Hepatitis C is the most common blood borne pathogen in the United States.1 Most patients infected with the virus develop chronic liver disease, and it is the leading indication for liver transplant.2 While this disease is treatable, it requires proper assessment, treatment, and monitoring. As seen in their pilot, having a specialized pharmacist on the treatment team would be crucial in optimizing cost and patient outcomes.
Program Description: The ambulatory pharmacist clinic would be located within the outpatient Gastroenterology/Hepatology Clinic at Eskenazi Health. Providers within the clinic would refer patients to the pharmacist through an online referral form on EPIC. One full time specialized pharmacist would meet with the referred patients. With a collaborative practice agreement the pharmacist would be responsible for discussing the diagnosis, creating treatment goals, initiating lifestyle modifications, genotyping/ assessing viral load, beginning a personalized treatment plan, and monitoring disease progression.
Finances: Studies suggest that patients with chronic hepatitis C who achieve sustained virologic response (SVR) have lower risks of liver-related morbidity and mortality.3 Hep C & Me will provide cost savings by optimizing treatment and improving patient outcomes while generating income for Eskenazi Health.
Marketing Plan: The most important part of promoting this pharmacist utilization is through gaining the trust and respect of other health care professionals. The current part time pilot pharmacist has already generated positive promotion and physician champion to support this position. Additional staff meetings, and informational flyers would be provided to the Gastroenterology/ hepatology clinic staff members to promote understanding and utilization.
Goal: Hep C & Me would allow for more personalized management of Hepatitis C patients. This clinic would improve patient care, create affordable medication plans, and improve outcomes.
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Gauthier TP, Moriera E, Chan C, et. al. Pharmacist engagement within a hepatitis C ambulatory care clinic in the era of a treatment evolution. JAphA. 2016;56(6):670-676. doi:10.1016/j.japh.2016.06.013.
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American Association for the Study of Liver Diseases (AASLD) and Infectious Diseases Society of America (IDSA) Recommendations for Testing, Managing, and Treating Hepatitis C : http://www.hcvguidelines.org/full-report/initial-treatment-hcv-infection.
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Manos MM, Darbinian J, Rubin J, et. al. The effect of hepatitis C treatment response on medical costs: a longitudinal analysis in an integrated care setting. J Manag Care Pharm. 2013;19(6):438-477. doi:10.18553/jmcp.2013.19.6.438.