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OPERATIONS & MGMT
TJC: hospitals still tripping over titration orders ...................................
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ASHP acts on burnout, certification ........................ 6 CLINICAL
Cracks in COVID-19 trials still showing ........
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Opioid use disorder doesn’t have to be an emergency ......................
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Ignoring a common cause of rabies proves deadly ...............
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POLICY
Why are we not still billing for drug waste? ...............................
Can CAR T-Cell Rx Be Moved Outside Hospital?
The ‘OG’ Women of Specialty Pharmacy
By Gina Shaw
How a cadre of visionary female leaders broke through the market’s glass ceiling
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lthough most people who are prescribed chimeric antigen receptor (CAR) T-cell therapy receive it entirely as inpatients, there is growing interest in delivering at least part of the revolutionary treatment in the outpatient setting. One major factor is reimbursement. As the revenue cycle team knows, payment terms often are more favorable when medications are administered outside the hospital. But it’s not just about money, according to Mary McGann, PharmD, BCOP, a clinical pharmacy specialist in blood and marrow transplantation and cellular therapy at the Hollings Cancer Center, Medical University of South Carolina (MUSC), in Charleston. Several other benefits have boosted interest in outpatient CAR T-cell
New CAR-T Data, Other Lymphoma Therapy Insights
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ompeting in the specialty pharmacy space is no easy task, given its intensive data reporting requirements, cold chain logistics and closed-door payor contracts, to name just a few challenges. But if you were a female pharmacy leader eyeing market entry in the early days, there was yet another roadblock to overcome: a traditionally maledominated business that didn’t always embrace the idea that women belonged in the specialty space. Thanks to the efforts of a cadre of visionary female leaders, those barriers are not nearly as iron-clad as in years past. Indeed, these pioLeft to right: Rebecca Anguiano, PharmD (seated), neers have helped build highly sucpharmacy technician Elba Sertuche, Nehrin Khamo, cessful health-system specialty PharmD, and JoAnn Stubbings, BSPharm.
Continued on page 8
Software a Big Time-Saver In Drug Diversion Detection By Adam Leitenberger
By Ted Bosworth
Parenteral Nutrition Therapy See insert after page 16.
Pharmacist’s Role in the Management of Chronic GVHD See insert after page 24.
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n advanced forms of lymphoma, a barrage of new data with chimeric antigen receptor (CAR) T cells was presented at the 2021 annual meeting of the American Society of Hematology (ASH), offering clinicians key guidance on safety and efficacy. Coupled with new findings on promising new “off-the-shelf,” allogeneic targeted agents that avoid some of the logistical challenges of obtaining autologous CAR T cells for infusions, the ASH meeting yielded important information for guiding Continued on page 16
By Gina Shaw
Continued on page 18
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REVIEW ARTICLES
Volume 49 • Number 3 • March 2022
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software-based analytics tool that enhances monitoring and auditing improved the effectiveness of a healthcare system’s drug diversion surveillance program, according to a presentation at the ASHP 2021 Midyear Clinical Meeting and Exhibition, held virtually. Within six months, the application led to an increase in document reconciliation and significant reductions in time spent to complete audits and investigations, JoAnne Myhre, CPhT, FMSHP, the drug diversion program manager at Allina Health System in Minneapolis, and her colleagues reported. “With this new automated documentation audit process, our staff can now focus on
Focus On
Oncology More coverage begins on page 17.
potential practice concerns sooner, because they are not spending time analyzing data and looking for the issues,” Ms. Myhre told Pharmacy Practice News. “The issues are now presented to them, whereas before they had to spend time analyzing the data, performing manual audits and then collating the data to try and see the anomalies.” Having such a tool on hand is an important advance, given the serious hazards drug diversion poses to patients, hospital staff and the general public, Ms. Myrhe noted. She added that the illegal activity also carries potential liability and financial risks for hospital systems. For example, patients may have inadequate pain relief if their prescribed opioids Continued on page 26
