Considerable office resources are utilized in arranging the use of Omalizumab. Once approved by payors there still remain barriers to its continued use in patients. In a small outpatient practice we looked at these factors.
A retrospective chart review was performed on 50 of 186 patients who started on Omalizumab and subsequently, discontinued its use from 2004 to 2008. Reasons were identified and categorized.
Of the 186 patients who started on Omalizumab, the medication could not be continued in the physician office in 50 of the patients (26.88%) over a five year period. This was due to various reasons including: economics 3.23% (6 patients), deceased 7.53% (14 patients), surgery 0.54% (1 patient), clinical decision 1.61% (3 patients), non-compliance 3.23% (6 patients), relocation 1.61% (3 patients), adverse reaction 2.69% (5 patients), patient preference 4.30% (8 patients) and pregnancy and hospice/cancer were both 0.54% (1 patient).
The main reasons for discontinuation of the medication included affordability and non-compliance. Further education to payors and patients, on the hidden economic benefits of continuing treatment including decrease in impairment and increase in productivity may help in continuing to treat patients appropriately. Only a small number of patients discontinued treatment due to adverse reactions in line with medication's safety profile. Relocation, though not a patient non-compliance variable, may be necessitated by changing economic conditions in a given region and may have an adverse effect on the limited resources available in a physician office.
Increasing the ease by which Omalizumab can be arranged may help decrease practice overhead and increase efficiency in small practices.
Alicia Redford, Consultant fee, speaker bureau, advisory committee, etc. Sridhar P. Reddy, MD and Mary Lynn Zaremba, APRN-BC are on speaker bureau for Genentech. Mary Lynn Zaremba APRN-BC is on Novartis speaker bureau. Sridhar P. Reddy, MD is on advisory committee for Genentech.; No Product/Research Disclosure Information