High-Cost Drugs Guidelines Solution [SINGLE OR FIRST SITE]

adverse event monitoring

The Partners HealthCare High-Cost Drug Guidelines Solution manages the introduction of new high-cost medications and existing medications by streamlining the development and implementation of system-wide prescribing guidelines. In addition, the High-Cost Drug Guidelines Solution helps identify and coordinate the implementation of cost-saving opportunities. At Partners, this Solution resulted in cost savings for existing drugs estimated at $3.7 million and an $800,000 cost avoidance for new drugs in a single fiscal year.

OUTCOMES

COMPONENTS

  • Facilitates Improvement In Case-Based Reimbursement
  • Helps Control Inventory
  • Avoids Complications from Medication and Dosage Errors
  • Streamlines Criteria for Drug Use Across the System
  • Freedom to Choose Single Guidelines
  • Volume Discounts available for "Bundles" of 5 drug guidelines
  • After adding below guidelines to cart, click here for additional sites.
  • Guidelines* consist of an abstract which includes:
    • Detailed criteria for drug use
    • Evidence-based clinical and economic review
  • One hour consultative call or webinar with Solution champion
  • Guideline Updates for 12 Months
  • (Extended Updates also Available)


*Each Guideline consists of Clinical Expert and Pharmacy & Therapeutics committee input from academic and community hospitals on an 8- to 15-page PDF document.

Industry research has shown that implementing guidelines before or at the time a new drug is available is highly recommended to maximize cost-avoidance opportunities.

The Solution Overview is a downloadable PDF to share with colleagues, decision makers and interested parties at your hospital or health system. This informative one page piece offers a snapshot overview of the Solution as a way to easily share the Solution summary, key components and outcomes.

SOLUTION COMPONENTS

Each Guideline consists of Clinical Expert and Pharmacy & Therapeutics committee input from academic and community hospitals on an 8- to 15-page PDF document, which includes:

  • An abstract
    • Detailed criteria for drug use
    • Evidence-based clinical and economic review
  • One hour consultative call or webinar with Solution champion
  • Guideline Updates for 12 Months
  • Extended Updates also Available

Industry research has shown that implementing guidelines before or at the time a new drug is available is highly recommended to maximize cost-avoidance opportunities.

Drugs Guidelines currently available include:

Ceftaroline, Denosumab: Prevention of Skeletal-Related Events, Doripenem, Dronedarone, Intravenous Iron Products: Focus of Ferumoxytol, Methylnaltrexone in Opioid-Induced Bowel Dysfunction, Regadenoson, Stress Ulcer Prophylaxis, Telavancin

Below you will find a series of questions and answers that will guide you through the objectives, implementation, outcomes and lessons of Partners Healthcare’s High-Cost Drugs Guidelines Solution.


ABSTRACT:

The Partners High-Cost Drug Guidelines Solution manages the introduction of new high-cost medications and existing medications by streamlining the development and implementation of system-wide prescribing guidelines. In addition, the High-Cost Drug Guidelines Solution helps identify and coordinate the implementation of cost-saving opportunities. At Partners, this Solution resulted in cost savings for existing drugs estimated at $3.7 million and an $800,000 cost avoidance for new drugs in a single fiscal year.

The High-Cost Drug Guidelines Solution, developed by Partners HealthCare, offers an independent review of evidence, guideline approval by pharmacy and therapeutics committees and consensus on use by leading clinical experts.


OBJECTIVES:

How are the components of High-Cost Drugs Guidelines Solution used?
The High-Cost Drugs Guidelines Solution forecasts and manages the introduction of new high-cost medications and existing medications by streamlining the development and implementation of system-wide prescribing guidelines. The Solution consists of drug-specific guidelines which include criteria for use plus a review of clinical and economic evidence.

What makes this Solution desirable?

  • Independent Review of Evidence
  • Consensus on Use by Leading Clinical Experts
  • Approval by Pharmacy & Therapeutics Committees

How was the Solution developed?
Partners Healthcare’s Center for Drug Policy was established in August 2007 at the recommendation of the system-level Pharmacy Cost Management Committee, to provide the analytical resources to control the rate of growth of pharmaceutical expenditures across the system of hospitals.

The guideline development process occurred in two phases. While the Center for Drug Policy performed the majority of work in the guideline development process, a working group of pharmacy leadership and clinical experts from each hospital played an integral role in providing their expertise and comments. In phase I, the Center for Drug Policy developed an evidence-based clinical and economic review of the drug. The guideline includes a recommendation for formulary status: formulary non-restricted; formulary restricted; non-formulary but available on a case-by-case basis; and non-formulary, not available. Following a request for formulary addition, the guideline development process entered Phase II. The Partners Center for Drug Policy recruited at least one expert from each hospital where the guideline is relevant. Once the experts reached consensus on clinical content – a process which can require multiple iterations of review, in-person discussion, and conference calls – the guideline was presented at Pharmacy & Therapeutic committees where a formulary request had been received. Comments from the Committees may have been incorporated into the guideline, with approval from clinical experts.


IMPLEMENTATION:

Were there any organizational considerations?
Implementation of the guidelines is performed at an individual hospital level, facilitated by the local pharmacy department and clinical experts who participated in guideline development. Tools for implementation have included targeted email communications, development of order sets, changes in the computer physician order entry system, and education. In addition, the Center for Drug Policy hosted a continuing education program for pharmacists that covered the content of selected guidelines with presentations delivered by clinical experts involved in guideline development.

Which Benchmark/Pertinent Metrics are recommended to use with this Solution?

  • Drug Expenditures
  • Medication Use Evaluation to Assess Guideline Adherence
  • Benchmarking drug use at hospitals against similar hospitals nationwide using a Clinical Data Base/Resource Manager, such as the University HealthSystem Consortium.

Any advice to other hospitals and health systems in preparation to launching this Solution?

  • Verify agreement from local clinical experts and Pharmacy and Therapeutics Committees.
  • Secure ability to implement guideline locally via development of order sets, changes in the computer physician order entry system, and/or education.

PERFORMANCE:

What is the best way to measure and sustain Solution success?

  • Monitoring drug expenditures at least quarterly
  • Assess guideline adherence as needed
  • Benchmark use with similar hospitals nationwide

LESSONS:

Can this Solution be modified to better fit another organization?
The information contained within the Solution materials is adaptable and can be used by any health care system or hospital. It is feasible to implement drug use guidelines across a system of hospitals.

Our Preview section offers you insight into key Solution components. The following screenshots, images, and materials may appear redacted to protect the intellectual property of the Solution.
Click below to view detailed images:

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Q: What software programs or tools are needed to utilize the Solution?
A: Buyers of any of the High-Cost Drug Guideline Solution will need the following software: Adobe Reader.

Q: Can I purchase more than one guideline for my hospital?
A: Yes, you can purchase more than one guideline at any time. For the SINGLE OR FIRST SITE, just select the guidelines you would like to purchase on this page, and add them to your shopping cart. To use guidelines at additional sites, please also click here and select the guidelines that you would like to use at more than one site.

If you would like more than 3 guidelines, we recommend that you purchase a cost-saving Bundle available here.

Q: Can I purchase this Solution for more than one of my hospitals?
A: Yes, this Solution was designed so that it can be implemented at a single site or in several sites within a health system.
For the SINGLE OR FIRST SITE, just select the guidelines you would like to purchase on this page, and add them to your shopping cart. To use guidelines at additional sites, please also click here and select the guidelines that you would like to use at more than one site.

If you would like more than 3 guidelines, we recommend that you purchase a cost-saving Bundle available here.

Q: What is a Bundle?
A: A Bundle is a compilation of any 5 High-Cost Drugs Guidelines that you select. By purchasing a Bundle of drug guidelines versus 5 individual guidelines, you will save $2,500. If you would like more than 3 guidelines, we recommend that purchase the cost-saving Bundle by clicking here.

Q: Is the pricing different for a multi-site system?
A: Yes, the price structure is as follows:

SINGLE OR FIRST SITE
• Individual Drug Guideline $3,000
• Bundle (5 Drug Guidelines) $12,500
• Extended Individual Guideline Update $700
• Extended Bundle Update $2,000

EACH ADDITIONAL SITE

• Individual Drug Guideline $1,000
• Bundles (5 Drug Guidelines) $4,200
• Extended Individual Guideline Update $250
• Extended Bundle Update $700

Q: Are there updates available for this Solution?
A: Yes, included in your guidelines purchase, you are eligible to receive revisions that Partners HealthCare may make to any drug guidelines you have purchased (for one year from date of purchase).

To purchase updates for individual guidelines to use in a SINGLE or FIRST SITE (corresponding to this page) click here.

To purchase updates for individual guidelines to use in EACH ADDITIONAL SITE click here.

To purchase updates for a Bundle of drug guidelines click here.

Q: Are there extended updates available for this Solution?
A: Yes, in addition to the 12 months of guideline updates included in your initial purchase, extended updates make you eligible to receive revisions that Partners HealthCare may make to any drug guidelines you have purchased for an additional 12 months from date of purchase.

Q: Has anyone taken these guidelines and implemented them in an EMR/Pharmacy System/CPOE system?
A: Yes, some of the guidelines have been completely or partially implemented in an EMR/pharmacy system/CPOE system (both internally developed and off-the-shelf 3rd party) at some of Partners' 13 hospitals, primarily at their 5 acute care hospitals.

Q: How quickly are drug guidelines made available after the drug is put into circulation?
A: It typically takes Partners HealthCare 3-6 months to create these guidelines.

Q: Regarding guideline updates: When does Partners does update the guidelines, and when will the updates be available?
A: Whenever updates to previously listed guidelines are required, Partners will typically release the updates within 3-6 months.

Q: How does Partners address conflict of interest?
A: Partners Healthcare has a robust disclosure process. First, the Center for Drug Policy does not interact with pharmaceutical companies at all. Second, all clinical experts are required to give Partners permission to access their conflict of interest information which is submitted annually to the organizations. This conflict of interest information is included in the guideline during the development process. Thus, the Center for Drug Policy, clinical experts, and Pharmacy & Therapeutics Committees have access to this information as they review and approve the guidelines.

Q: Do the guidelines deal with supply shortages?
A: No.

Q: Do the guidelines contain ordersets?
A: No, not at this time. Some of the Partners’ hospitals have developed ordersets for
select guidelines. They would consider providing these ordersets in the future if
there is sufficient interest.

Q: What hospitals are the guidelines are used currently used?
The High-Cost Drugs Guidelines are currently in use at:

Brigham and Women's Hospital, world-renowned in virtually every area of adult medicine, is a 777 bed teaching hospital of Harvard Medical School. Consistently ranked by US News & World Report as one of America’s Best Hospitals, Brigham and Women’s leadership in state-of-the-art treatments and technologies, patient- and family-focused care, patient quality and safety, and biomedical breakthroughs have improved the health of people around the world.

Massachusetts General Hospital offers sophisticated diagnostic and therapeutic care in virtually every specialty and subspecialty of medicine and surgery. Massachusetts General Hospital has been consistently named one of the country's best hospitals by U.S. News and World Report. Mass General conducts the largest hospital-based research program in the United States and is the oldest and largest teaching affiliate of Harvard Medical School.

Faulkner Hospital offers complete medical, surgical and psychiatric care, as well as a full complement of emergency, ambulatory and diagnostic services. As Faulkner enters its second century of service, it will be a dynamic leader accountable for providing community-responsive health care.

• Since its incorporation in April 1921, Martha's Vineyard Hospital has been committed to delivering high quality, compassionate medical care to each and every member of the Vineyard's year-round and seasonal community, as well as all who visit.

McLean Hospital is a world leader in psychiatric care, research, and teaching. The largest psychiatric teaching facility of Harvard Medical School, McLean Hospital receives more research funding than any other private psychiatric hospital in the nation. The hospital is also ranked as the nation’s top freestanding psychiatric hospital, according to U.S. News & World Report.

Nantucket Cottage Hospital is a not-for-profit Critical Access Hospital that serves an island community 30 miles from the mainland. It has a deep tradition of compassion and cares for a population of 10,000 full-time residents that increases to more than 50,000 during the summer months.

Newton-Wellesley Hospital is one of the most comprehensive medical centers in the western suburbs of Boston. Newton-Wellesley Hospital is a non-profit organization offering patients a wide range of medical, surgical, obstetric, psychiatric, pediatric, and subspecialty care.

North Shore Medical Center (NSMC) is the largest health care provider on the North Shore. It offers state-of-the-art medical and surgical care, as well as multiple services in collaboration with Massachusetts General Hospital.

Partners Community Healthcare Inc. (PCHI)
• MGH Institute of Health Professions
• Partners HealthCare at Home
• Spaulding Rehabilitation Network

Q: When will I receive my order?
A: Upon verification and payment receipt.

Q: How is the Solution delivered?
A: You will be able to download the Solution through a secure unique link as soon as your order is verified and your payment is confirmed. You will be contacted when your Solution is available for download.

Q: What if I have problems with downloading or using the Solution?
A: We hope that does not happen but if it should, please contact Solutions@MX.com. We will escalate as needed to the Licensor.

Q: Can I return a Solution?
A: Yes, your satisfaction is guaranteed. If you are dissatisfied―within 30 days of purchase, email a full refund request to sales@MX.com. Simply provide Solution feedback and discontinue its use. Details

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