{"doi":"10.1111/ijd.17462","title":"Collaborative management of specialty medications by a dermatologist and pharmacist: a retrospective cohort pilot study","abstract":"Therapeutic advances have transformed the treatment of dermatologic conditions and increased monitoring and administrative burden.1 We have previously described a collaboration between dermatologists and pharmacists to comprehensively co-manage patients on specialty medications, including initial prescriptions, insurance approval, laboratory testing, patient education, regular follow-ups, and medication refills (Figure 1).2 Research suggests similar interventions can reduce the time it takes to fill out the first prescription and increase the likelihood of medication approval.3, 4 This study examines the impacts of the program for a single dermatologist-pharmacist dyad during its initial pilot. This retrospective cohort study includes specialty medication prescriptions from one dermatologist between January 2021 and October 2022. Program implementation began in November 2021. Prescriptions prior to this were considered preimplementation, and prescriptions from January 2022 onwards were considered postimplementation. Prescriptions from November to December 2021 during the initial program roll-out were excluded. Insurance approval and dispensing data were obtained from the electronic health record shared by the clinician and specialty pharmacy. First-choice medications were defined as the ideal medication the physician and patient selected, regardless of a patient's insurance formulary. Fisher's exact test was utilized to compare the percentage of patients whose first-choice medication was approved pre- and postimplementation. The skewness of time from the initial prescription to the first fill was log-transformed to normalize data. The student's t-test was used to compare the time from the initial prescription to the first one filled pre- and postimplementation (Table 2). One hundred ninety prescriptions were included, with 64 preimplementation prescriptions and 126 postimplementation prescriptions. Dupilumab and risankizumab were the most prescribed medications, comprising 53.1% (Table 1). Patients whose first-choice medication was approved increased from 93.8 to 99.2% (P < 0.05). The mean number of days from prescription to first fill decreased from 18.5 [15.0–22.8] days to 13.1 [11.1–15.5] days (P < 0.05) (Table 2). No significant differences in first-choice medication approval rate or mean time to first prescription fill were found between pre- and postimplementation groups among prescriptions for a specific drug class or individual agent. This pilot study identifies the benefits of physician-pharmacist collaboration. Patients prescribed medications postimplementation were more likely to have their first-choice medication approved in a shorter time, first to fill by almost a week. This may translate to better clinical outcomes, greater patient satisfaction, and reduced healthcare costs.5 Although beyond the study scope, improved navigation through the insurance approval process and enhanced patient support to increase follow-through may contribute to these findings. We believe the close collaboration between a single dermatologist and pharmacist, the presence of a pharmacist to provide essential medication information to patients, and pharmacy expertise in the medication approval process play a key role in the success of this program. Study strengths include a representative sample of all patients prescribed a specialty medication with no additional exclusion criteria. Focusing on a single dermatologist-pharmacist dyad also eliminates the potential confounding of individual workflow or practice patterns. The data must also be viewed in the context of the dynamic insurance industry, which has changes in formularies and approval processes that may affect medication approval. Our focus on a single dermatologist-pharmacist dyad during a relatively short period may limit generalizability to different practice workflows. As the program has expanded, research is needed, including data from multiple physicians. Additionally, future","journal":"International Journal of Dermatology","year":2024,"id":502720,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":0,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9473,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2024-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1054194,"name":"Martin D. Slade","orcid":"0000-0001-7480-7470","position":1,"is_corresponding":false},{"id":1352186,"name":"Kimhouy Tong","orcid":"0000-0002-6861-0345","position":2,"is_corresponding":false},{"id":1352530,"name":"Natasha Stroedecke","orcid":null,"position":3,"is_corresponding":false},{"id":1352531,"name":"Ha Lim Shin","orcid":null,"position":4,"is_corresponding":false},{"id":520965,"name":"Jeffrey M. Cohen","orcid":"0000-0002-7709-0548","position":5,"is_corresponding":false},{"id":1207060,"name":"Sarah L. Spaulding","orcid":"0000-0002-4413-8314","position":0,"is_corresponding":true}],"reference_count":5,"raw_metadata":null,"created_at":"2026-07-19T02:10:23.709105Z","pmid":"39212107","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}