Collaboration to transition members to preferred formulary dipeptidyl-peptidase-4 inhibitor.

Objective: To describe the outcomes of a partnership between a drug plan and pharmacists to switch patients from brand name dipeptidyl-peptidase-4 inhibitors to the generic alogliptin.

Study Design: Single-center, retrospective chart review.

Methods: Clinical pharmacists contacted patients with primary care providers within the health system affiliated with the drug plan to facilitate the switch. Drug plan members with external primary care providers were sent letters communicating the formulary change without contact from the clinical pharmacist. Outcomes included the proportion of patients successfully switched to alogliptin, reasons for not switching, changes in hemoglobin A1C (HbA1C), and cost savings.

Results: Initially, more than 50% of patients contacted by pharmacists agreed to switch to alogliptin; however, only 44% were successfully switched to alogliptin per prescription claims data. One patient from the group that received letters without clinical pharmacy intervention switched to alogliptin. Overall, there was no significant difference in the mean HbA 1C level for the patients switched to alogliptin. At the end of the year-long study period, only 12 of the 67 patients successfully switched to alogliptin were still taking alogliptin. Reverting to a branded product and switching to a glucagon-like peptide-1 receptor agonist were the most common reasons that alogliptin was discontinued. Cost savings to the health plan were $220,717, or $0.17 per member per month over 1 year.

Conclusions: The use of pharmacists was beneficial in switching patients to alogliptin and yielded cost savings without compromising patient outcomes.