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Specialty Pharmacy Prepared Veletri® Cassette Program

Harrison Farber


Martha Kingman


Susan Raspa

Tiffany Kung

Allison Widlitz

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Conference: 2017 PH Professional Network Symposium

Release Date: 10.06.2017

Presentation Type: Abstracts

File Download: 2017 PHPN Abstract 1003

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Abstract presented at the 2017 PH Professional Network Symposium held in Bethesda, MD on October 5-7, 2017

Purpose

Veletri® is administered as a 24 hour continuous IV infusion via central line. Reconstitution and dilution are required before use, and are typically performed by the patient or caregiver. The Veletri® Ready Sette Go Program (RSGP) was undertaken to provide premixed cassettes as a way to improve patient convenience and satisfaction.

Background

Room temperature stable epoprostenol (Veletri®) is a synthetic prostacyclin indicated to improve exercise capacity in patients with pulmonary arterial hypertension (PAH). Epoprostenol remains the recommended treatment for patients with advanced disease and is the only medication that has demonstrated a survival benefit in idiopathic PAH.1 Despite recommendations, these patients often do not receive intravenous (IV) prostacyclins; this may be due, in part, to issues related to the complex mixing and delivery systems.2

Methodology

The RSGP represents a partnership between practitioners, specialty pharmacy (SP) (Accredo Health Group, Inc.), patients, and industry. On a weekly basis, patients are shipped Veletri® cassettes that have been prepared by pharmacists adhering to USP 797 guidelines. Other processes to ensure patient and product safety include defined patient inclusion criteria, strict shipment procedures, pharmacist training, SP site audits, and emergency protocols. Referrals are limited to PAH centers with experience using IV prostacyclins. This program is offered at no additional cost to patients or payers.

Findings

The RSGP was piloted in 14 PAH centers between 2014 and 2015. Two expansions were implemented to include 34 additional centers. As of Nov 2016, 233 patients had been referred to the program, with 141 currently active. Limitations to patient enrollment include limited contracting with only one SP, patient decision, and payor restrictions.

Implications

IV prostacyclins are underused in severe PAH, possibly due in part to the complicated administration regimens. The Veletri® RSGP was initiated to improve patient convenience by providing SP-prepared premixed cassettes. Additionally, mixing under sterile conditions may reduce the risk of infection. The program has since been expanded twice due to patient and practitioner interest, and now includes 48 PAH centers across the US. Future analyses will aim to evaluate patient satisfaction and other measures to gauge success of the program.